A Cochrane review «Vasectomy occlusion techniques for male sterilization»1 «Cook LA, Van Vliet HA, Lopez LM et al. Vasectomy o...»1 included 6 studies with different comparison designs and with a total of 1 524 subjects. One high-quality, large multi-centre study (n=841) compared vasectomy (no-scalpel approach) + fascial interposition with vasectomy without fascial interposition (a technique in which one severed end of the vas is covered with the sheath tissues of the vas to enhance the barrier effect). The fascial interposition group was less likely to have vasectomy failure.
A meta-analysis «Auyeung AB, Almejally A, Alsaggar F et al. Inciden...»2 ascertaining post-vasectomy pain following scalpel or non-scalpel vasectomy included 18 articles. Study follow-up ranged from 2 weeks to 37 years and sample sizes from 12 to 723 patients. The overall incidence of post-vasectomy pain was 15% (95% CI 9% to 25%); for scalpel 24% (95% CI 15% to 36%), and for non-scalpel technique 7% (95% CI 4% to 13%). Post-vasectomy pain syndrome occurred in 5% (95% CI 3% to 8%) of subjects, with similar estimates for both techniques.
A study «Smith K, Byrne, Castaño JM et al. Vasectomy and Pr...»3 investigated the prospective association of vasectomy with prostate cancer in a large European cohort. A total of 84 753 men provided information on vasectomy status (15% with vasectomy) at recruitment and were followed for incidence of prostate cancer and death. 4 377 men were diagnosed with prostate cancer, including 641 with vasectomy. Vasectomy was not associated with prostate cancer risk (hazard ratio 1.05; 95% CI 0.96 to 1.15), and no evidence for heterogeneity by stage of disease or years since vasectomy.