A comparative study of fascial sheath interposition versus no fascial sheath interposition in No Scalpel Vasectomy

Background: Since the introduction of male sterilization by surgery on vas deferens, several techniques have emerged to improve the results in terms of time, invasiveness, post operative infection, complications and success rate. Introduction: Vasectomy was introduced by Sharp in 1897. No scalpel vasectomy was introduced in China by Dr. Li Shun-Qiang in 1974. Intact fascial sheath helps in restoration of vas lumen and fascial sheath interposition prevents recanalization of vas by prevention of meeting of epithelialization from cut end of vas. Material and methods: The study was performed at PGIMS, Rohtak by performing surgery and follow-up up to one year of 326 subjects of no scalpel vasectomy. Clients were allocated in two groups. Group - A (155) with fascial sheath interposition and Group ? B (171) without fascial sheath interposition. Surgeries were performed as a routine surgical procedure after full preparation of client including consent. Results: Majority of clients (56.1%) in Group - A were in age group 31-40 years followed by 22-30 years (28.4%), 41-50 years (14.8%) and 0.7% in age group more than 50 years. In Group ? B, majority were also in age group 21-30 years (63.7%), followed by 31-40 years (29.8%), 41-50 years(5.9%) and 0.6% were of above 50 years. In Group ? A, fascial sheath interposition was not possible in 17.2% clients due to non separation of sheath from vas. Sperm granuloma formation was observed in 8.6% in Group - A and 5.6% in Group - B. In comparison of 100% success rate in Group - A failure rate of 1.8% was observed in Group - B. Conclusion: The present study supports the existing literature that fascial sheath interposition adds a little more to the operating time of vasectomy, increases chances of wound infection and granuloma but has a less failure rate of vasectomy.