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A combination of check tug and fascial interposition with no-scalpel vasectomy
  1. Vivek Kumar, MS, FRCS, Senior SHO-Urology1 and
  2. Ramchandra M Kaza, MS, Prof. Surgery2
  1. Leighton Hospital, Crewe, UK
  2. Maulana Azad Medical College, Delhi, India
  1. Correspondence Mr Vivek Kumar, MH-79, Leighton Hospital, Crewe, Cheshire, CW1 4QJ, UK. Tel: 01270 255141 extn. 2691 bleep: 2422, Fax: 01270 587696, Email: vkumar3908{at}


The prospective study was carried out to evaluate the success rates of combining a check tug and fascial interposition while performing a no-scalpel vasectomy.

A total of 2150 male acceptors visiting the family welfare clinic of Lok Nayak Hospital, Delhi, from July 1992 to June 1995 and opting for a no-scalpel vasectomy, underwent a combination of check tug and fascial interposition during the procedure. These men were followed-up for failure rates as shown by semen analysis, 3 months and at least 20 ejaculations following the procedure.

All the clients showed a negative sperm count during the subsequent follow-up, less than two non-motile sperms per high power field being taken as a negative count (n = 5) and there were no reported pregnancies.

A check tug ensures that the same vas deferens is not ligated twice, particularly as the approach is a midline one. The fascial interposition prevents spontaneous recanalisation of the cut vas. Thus the combination of the two would further increase the reliability of the procedure.

  • check tug
  • fascial interposition
  • midline

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