Vasal sterilization has become the most popular method of contraception in many countries since the 1960's. In China, an estimated 30 million men have undergone voluntary sterilization. There have been two major developments in vasectomy technique, the no-scalpel method and the percutaneous chemical vas occlusion. These methods have significantly increased the acceptability of male sterilization in some cultures since no incisions in the skin are required. The effective rate is over 98% for both methods. The clients experience less pain, fewer complications and more rapid recovery. Epidemiological studies of large numbers of volunteers receiving no-scalpel or chemical vas occlusion procedures have resulted in a clearer picture of their safety, effectiveness, simplicity and economy. Meanwhile, some promising reversible vasal sterilization techniques have also been studied.
PIP: In China, an estimated 30 million men have undergone vasal voluntary sterilization, and about 11.97% of Chinese couples rely on vasectomy, according to a 1990 survey. The no-scalpel vasectomy (NSV) and the percutaneous chemical vas occlusion methods are major developments in vasectomy technique with an effectiveness rate of over 98% for both. In a study in Thailand, complication rates were 0.4/100 cases for NSV and 3.1 for the incisional approach. Since 1971, over 10 million Chinese men have undergone NSV. Vas ligation is the most popularly used method in China. It has provided 98% of effectiveness in a comprehensive survey involving 64,656 vasectomies in 8 provinces. As an alternative to vas ligation, electrocoagulation creates a firm scar that effectively occludes the ends of the vas. The contraceptive efficacy of electric cautery was reported at 99.62%-100% in 7439 vasectomies during a period of 10 years; azoospermia and complication rates were 0% and 0.53%, respectively, in 1088 vasectomies. The complication rate was less than 2%, including hematoma, infection, painful sperm granuloma, epididymitis, and sexual dysfunction, in a comprehensive survey involving 179,741 vasectomies in 8 provinces. 2 large cross-sectional epidemiologic studies done in Sichuan Province showed that men with vasectomies were not at greater risk of coronary heart disease, hypertension, hyperlipidemia, and diabetes than men who had not undergone the procedure. Recently, 2 epidemiological studies conducted in the US suggested that vasectomy may be associated with an increased risk of prostate cancer. The risk of developing prostate cancer by the age of 80 is about 1 in 500 in Shanghai. Whereas approximately 1 of 11 men in the US will develop prostate cancer. It is possible that the disease goes undiagnosed, but a combination of diet and hormonal factors related to race may help explain some of the variation.