Introduction of non-scalpel vasectomy at the Mexican Social Security Institute

Abstract

Since government approval of the Mexican Family Planning Program in 1977, the Mexican Social Security Institute (IMSS) has been one of the major family planning service providers in Mexico. No-scalpel vasectomy, a refined surgical vasectomy technique developed and widely used in China, has been introduced in 20 countries, including Mexico. This paper will describe the experience of the IMSS in introducing the no-scalpel vasectomy technique into its service delivery system, and will review the clinical and programmatic experience, and the impact of no-scalpel vasectomy on client and provider attitudes toward vasectomy.

Vasectomy surgical techniques: a systematic review

“…Overall, NSV was associated with less pain in three studies [37,40,41] and with the same level of pain in three others [25,26,38,39]. Frequency of long-term pain and of hospitalization for adverse events was similar with both approaches [37].…”

“…A non-randomized parallel controlled trial was also of moderate quality [5]. All other studies were observational and of low or very low quality [7,25,26,39-42]. …”

“…The incisional technique was a mix of single and double incision in one RCT [37] and was unspecified in three observational studies [39-41]. The occlusion technique also varied among studies.…”

“…Most evaluated bleeding and/or hematoma [5,7,25,26,37-39,41,42], infection [5,7,25,26,37,38,41,42], and post-vasectomy pain [25,26,37-41]. Time to recovery, granuloma, long-term adverse events, and hospitalization were measured in some studies.…”

“…However, five studies [5,37-39,42] found a lower risk of bleeding and/or hematoma with NSV, one found fewer hematoma but more bleeding [41], and two observed a similar risk [7,25,26]. Moreover, the three best quality studies – two of moderate [5,38] and one of high quality [37] – showed a clinically and statistically significant difference in favor of NSV.…”