Arellano Lara S, Gonzalez Barrera J L, Hernandez Ono A, Moreno Alcazar O, Espinosa Perez J
Servicios de Planeación Familiar, Instituto Mexicano del Seguro Social, México, D.F., México.
Arch Med Res. 1997 Winter;28(4):517-22.
In Mexico, the Mexican Institute of Social Security (IMSS) had adopted the no-scalpel vasectomy technique by the end of 1989. The technique was described by Dr. Li Shunquiang in 1974, and more than 60 million no-scalpel vasectomies have been performed in 26 countries. Among the advantages with no-scalpel vasectomy is that it has fewer complications (0.4%) compared to the traditional technique (3.1%). We studied 1,000 clinical charts of the subjects operated on between January, 1990 and January, 1993, with the objective of reporting our experiences as well as analyzing whether there existed a correlation between the subject's social and demographic characteristics and the number of control spermatic counts he attended postoperatively. In 97.9% of the cases, subjects had no postoperative hemorrhage or hematoma. None of the subjects had a surgical wound infection. In addition, 54.4% of the subjects came to the first control spermatic count, 39.7% came to the second, and only 18.4% came to all three controls. In an attempt to find a characteristic which defined the subject who attends his postoperative control spermatic counts, we found an association using chi2 between the attendance at two controls with the subjects who had been married from 6 - 10 years (p = 0.059), and with the subjects who had an income of three minimum wages. Regarding the attendance at all three controls, we found an association with subjects who had an income of two minimum wages (p = 0.037). We also found a weak correlation between the attendance at all three controls and the reason reported for not having more children (the couple did not want more children) (r = 0.07; p = 0.025) and with the manner in which the subjects were referred to the clinic (came on their own initiative) (r = 0.09; p = 0.006). Finally, we consider that no-scalpel vasectomy can be implemented as an adequate family planning method in Mexico's primary care centers. The lack of adequate attendance at postoperative control spermatic counts does not seem to have an important association with the subject's demographic characteristics, so it appears warranted that this issue be studied from a psychological point of view.
在墨西哥，墨西哥社会保障局（IMSS）在1989年底采用了无刀输精管结扎术。该技术由李顺强医生于1974年描述，已在26个国家实施了超过6000万例无刀输精管结扎术。无刀输精管结扎术的优点之一是与传统技术（3.1%）相比，其并发症更少（0.4%）。我们研究了1990年1月至1993年1月期间接受手术的1000例患者的临床病历，目的是报告我们的经验，并分析患者的社会和人口统计学特征与术后接受的精子计数检查次数之间是否存在相关性。在97.9%的病例中，患者术后无出血或血肿。无一例患者发生手术伤口感染。此外，54.4%的患者前来进行首次精子计数检查，39.7%的患者前来进行第二次检查，只有18.4%的患者进行了全部三次检查。为了找出能确定前来接受术后精子计数检查的患者特征，我们使用卡方检验发现，接受两次检查的患者与结婚6至10年的患者（p = 0.059）以及收入为三个最低工资标准的患者之间存在关联。关于接受全部三次检查的情况，我们发现与收入为两个最低工资标准的患者存在关联（p = 0.037）。我们还发现，接受全部三次检查与报告的不想要更多孩子的原因（夫妻不想再要孩子）之间存在弱相关性（r = 0.07；p = 0.025），并且与患者前往诊所的方式（主动前来）之间存在相关性（r = 0.09；p = 0.006）。最后，我们认为无刀输精管结扎术可作为墨西哥初级保健中心一种适当的计划生育方法实施。术后精子计数检查的参与率不足似乎与患者的人口统计学特征没有重要关联，因此从心理学角度研究这个问题似乎是有必要的。
