{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:30:55Z","timestamp":1788345055682,"version":"build-2803163510"},"update-to":[{"DOI":"10.12688\/gatesopenres.12986.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T00:00:00Z","timestamp":1563753600000}}],"reference-count":36,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T00:00:00Z","timestamp":1563753600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007867","name":"Universit\u00e9 Laval","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007867","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1181398"],"award-info":[{"award-number":["OPP1181398"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["gatesopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Gates Open Res"],"abstract":"<ns5:p><ns5:bold>Background: \u00a0<\/ns5:bold>Research evidence published 10 to 15 years ago has shown that the type of vasectomy surgical technique performed can influence the effectiveness and the safety of the procedure. \u00a0The objective of this study was to determine if evidence-based vasectomy surgical techniques are integrated in the vasectomy programs of selected low-resource countries.<\/ns5:p><ns5:p> <ns5:bold>Methods: <\/ns5:bold>The surgical techniques recommended to perform the two steps of the vasectomy procedure (isolation\/exposition and occlusion of the vas deferens) were extracted from current evidence-based clinical practice guidelines. Documents describing male sterilisation standards and practice from Kenya, Rwanda, India, Nepal, Mexico, Honduras, Colombia and Haiti were reviewed to assess adequacy with international guideline recommendations.<\/ns5:p><ns5:p> <ns5:bold>Results: <\/ns5:bold>Best recommended techniques are 1) a minimally invasive technique including the no-scalpel technique (known as the no-scalpel vasectomy (NSV)) to isolate and expose the vas deferens, and 2) cautery of the mucosa of the vas preferably combined with interposition of the fascia (FI) to occlude the vas deferens. The NSV is largely adopted and performed to isolate the vas in selected low-resources countries. Ligation and excision (LE) of a small segment of the vas deferens combined with FI is the most common vas occlusion technique mentioned in the country standards. Cautery as recommended in the guidelines is seldom used in selected countries.<\/ns5:p><ns5:p> <ns5:bold>Conclusions: <\/ns5:bold>\u00a0 Effective and adapted vasectomy vas occlusion techniques are available, but are still underused in many low-resource countries. Providing the most effective vasectomy surgical techniques increases users\u2019 confidence and satisfaction regarding male sterilization and may lead to higher acceptability and uptake.<\/ns5:p>","DOI":"10.12688\/gatesopenres.12986.2","type":"journal-article","created":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T11:20:09Z","timestamp":1563794409000},"page":"1462","update-policy":"https:\/\/doi.org\/10.12688\/gatesopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Are evidence-based vasectomy surgical techniques performed in low-resource countries?"],"prefix":"10.12688","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8972-5491","authenticated-orcid":false,"given":"Michel","family":"Labrecque","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2019,7,22]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"1621-5","DOI":"10.1016\/S0022-5347(05)68181-5","article-title":"A comparative study of the no scalpel and standard incision approaches to vasectomy in 5 countries. The Male Sterilization Investigator Team.","volume":"162","author":"D Sokal","year":"1999","journal-title":"J Urol."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1186\/1741-7015-2-6","article-title":"Vasectomy by ligation and excision, with or without fascial interposition: a randomized controlled trial [ISRCTN77781689].","volume":"2","author":"D Sokal","year":"2004","journal-title":"BMC Med."},{"key":"ref-3","doi-asserted-by":"crossref","first-page":"2495-8; discussion 2498","DOI":"10.1016\/S0022-5347(05)64176-6","article-title":"Effectiveness and complications associated with 2 vasectomy occlusion techniques.","volume":"168","author":"M Labrecque","year":"2002","journal-title":"J Urol."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/1471-2490-4-12","article-title":"A comparison of vas occlusion techniques: cautery more effective than ligation and excision with fascial interposition.","volume":"4","author":"D 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Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T23:46:43Z","timestamp":1569023203000},"score":1,"resource":{"primary":{"URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,22]]},"references-count":36,"URL":"https:\/\/doi.org\/10.12688\/gatesopenres.12986.2","relation":{},"ISSN":["2572-4754"],"issn-type":[{"value":"2572-4754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,22]]},"assertion":[{"value":"Indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/gatesopenres.14093.r27174, David Sokal, Male Contraception Initiative, Durham, NC, USA, 06 Jun 2019, version 1, indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v1#referee-response-27174","order":0,"name":"referee-response-27174","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>michel labrecque<\/b>; \n<i>Posted: 17 Jul 2019<\/i>; I wish to thank Dr. Sokal for his review. Although I agree that a bold format for vasectomy techniques (table 1) and countries (table 2) would enhance clarity, the current format was suggested by the editor. I clarified who FRSH are in the text: the Faculty of Sexual &amp; Reproductive Healthcare (FSRH), the standard-setting organisation for family planning and sexual health in United Kingdom (2104).","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v2#referee-comment-3195","order":1,"name":"referee-comment-3195","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/gatesopenres.14093.r27324, Philip S. Li, Omar Al Hussein Alawamlh, Center for Reproductive Medicine and Microsurgery, Department of Urology, Weill Cornell Medicine, New York City, NY, USA, 19 Jun 2019, version 1, indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v1#referee-response-27324","order":2,"name":"referee-response-27324","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>michel labrecque<\/b>; \n<i>Posted: 17 Jul 2019<\/i>; I wish to thank Dr. Li and Dr. Al Hussein Alawamlh for their review. Grammatical errors noted were corrected in version 2.","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v2#referee-comment-3194","order":3,"name":"referee-comment-3194","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/gatesopenres.14093.r27345, Joel L. Marmar, Honorary Staff, Cooper University Hospital, Camden, NJ, USA, 10 Jul 2019, version 1, indexed","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v1#referee-response-27345","order":4,"name":"referee-response-27345","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>michel labrecque<\/b>; \n<i>Posted: 17 Jul 2019<\/i>; I wish to thank Dr. Marmar for his review.","URL":"https:\/\/gatesopenresearch.org\/articles\/3-1462\/v2#referee-comment-3196","order":5,"name":"referee-comment-3196","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This study was funded by the Bill & Melinda Gates Foundation [OPP1181398] and The Michel-Labrecque Fund for Male Reproductive Health from the Laval University Fondation.","order":6,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}