***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE We compare the safety , ease of use and effectiveness of the no scalpel and st and ard incision approaches to vasectomy . MATERIAL S AND METHODS A multicenter , r and omized , partially masked controlled trial was conducted at 8 sites in Brazil , Guatemala , Indonesia , Sri Lanka and Thail and . Semen sample s were collected 10 weeks postoperatively and tested to ascertain sterility using verification of no living spermatozoa . RESULTS The study included 1,429 men seeking vasectomy . The efficacy of the 2 approaches was virtually identical . In the no scalpel group operating time was significantly shorter , and complications and pain were less frequent than in the st and ard incision group . The no scalpel group resumed intercourse sooner , probably as a result of less pain following the procedure . CONCLUSIONS The no scalpel approach is an important advance in the surgical approach to vasectomy , and offers fewer side effects and greater comfort compared to the st and ard incision technique , without compromising efficacy The aim of this study was to introduce a novel male contraceptive method , an intra-vas device ( IVD ) , and to assess the efficacy , safety and satisfaction of recipients compared with no-scalpel vasectomy ( NSV ) . A phase II r and omized controlled trial was conducted in China in 2003 . Two hundred and eighty-eight male subjects seeking vasectomy were r and omly assigned to the IVD or NSV group . Follow up included a telephone question naire on the 14th postoperative day and visits at the third and 12th postoperative months . The follow-up rates at the three time points were 100 % , 100 % and 96.5 % respectively . There was no technical failure in any subject . The surgical conditions were similar in both groups , but the IVD group experienced an additional 5 min of operative time ( p<0.001 ) . The IVD group recovered normal activity and sexual intercourse more rapidly ( both p<0.05 ) . The azoospermia rate was lower in the IVD group than in the NSV group at the third and 12th postoperative months . The rate of contraceptive success based on semen analyses was similar in both groups , especially at the 12th postoperative month ( 94.3 % in the IVD group vs. 98.6 % in the NSV group ; p=0.054 ) . The IVD group had less risk of complications ( i.e. pain , congestive epididymitis and sperm granuloma ) . More subjects reported satisfaction with IVD sterilization than with NSV . The two procedures were similar in terms of surgical complications . The IVD was slightly less effective , but had a lower risk of later adverse events than the NSV technique . The IVD group also reported a higher level of satisfaction Objective To compare the intra-operative experience and postoperative sequelae between the  st and ard Marie Stopes scalpel vasectomy procedure and electrocautery non-scalpel vasectomy ( ENSV ) techniques .  Design R and omised prospect i ve comparative study . Setting Marie Stopes vasectomy centres in the UK . Participants A total of 325 men undergoing vasectomy between January and June 1999 . Intervention R and om allocation to the two study arms plus question naires at 4 and 14 weeks postoperatively . Main outcome measures Ease and speed of the procedure ; pain levels during and after the procedure ; early postoperative complications and time taken to return to work and sexual activity . Results The ENSV technique was marginally quicker to perform . Pain levels intra-operatively were comparable . Response rates to the question naire were 84.6 % and 37 % at 4 and 14 weeks , respectively . The ENSV group experienced less pain and bleeding from the wound postoperatively and were quicker to heal . For men who experienced postoperative problems , the time taken to return to work was marginally better in the ENSV group . The time taken to return to sexual activity was marginally faster in the ENSV group . Conclusion The ENSV procedure appears to be suitable for mass application in locations where electricity is available INTRODUCTION Studies have shown that the Li vasectomy can match the effectiveness of and reduce the duration of operation and rate of complications compared to st and ard vasectomy with bilateral incision . MATERIAL S AND METHODS A prospect i ve , r and omised trial was conducted to compare the Li vasectomy with the st and ard vasectomy with bilateral incision . Data regarding effectiveness , time of operation , the patient 's pain and discomfort , and peroperative and postoperative complications were recorded . Overall , 99 patients were entered in the trial , 51 with vasectomy with bilateral incision , 48 with the Li vasectomy .  RESULTS No significant difference was found between the two methods with regard to effectiveness , time of operation , the patient 's pain and discomfort , and peroperative and postoperative complications . Overall , vasectomy was inadequate in 5 % , haematoma was found in 13 % , infection in 9 % , and scrotal pain or painful ejaculation in 9 % . DISCUSSION The Li vasectomy can be learned and practice d under routine conditions by residents in training with the same effectiveness and the same rate of complications as st and ard vasectomy with bilateral incision . The total morbidity was at the same level as in previous Danish studies , but higher than in the international studies with the Li vasectomy No-scalpel vasectomy was developed to increase acceptability of vasectomy by elimination of the fear of the incision . Although this method has been used for over 8,000,000 men , the technique is largely unknown in developed countries . During the King 's birthday vasectomy festival no-scalpel vasectomy was compared with st and ard incisional vasectomy in 1203 patients . An average of 57 procedures per day could be done by each physician with the no-scalpel method , compared to 33 procedures with the st and ard method ( p less than 0.001 ) . The complication rate was 0.4/100 procedures for no-scalpel vasectomy compared with 3.1/100 for st and ard vasectomy ( p less than 0.001 ) . No-scalpel vasectomy is a rapid and economic alternative to st and ard vasectomy , with fewer complications and increased patient acceptability BACKGROUND AND PURPOSE The simply modified no-scalpel vasectomy ( SMNSV ; percutaneous vasectomy ) technique was reported to simplify the st and ard no-scalpel vasectomy ( SNSV ) procedure . In this report , we introduce our experiences with SMNSV in comparison with the SNSV . MATERIAL S AND METHODS Between July 1999 and June 2002 , 417 men were prospect ively r and omized to be vasectomized at the Taipei Medical University Hospital : 215 acceptors underwent the SNSV and the remaining 202 received the SMNSV .  Using the no-scalpel vasectomy instruments in a percutaneous fashion , the sharp no-scalpel hemostat punctures the skin directly instead of fixating the vas to the skin with the use of a ring clamp , as done in SNSV . The vas is then grasped with the ringed instrument instead of piercing the vas and performing the supination maneuver , as described for SNSV . The intraoperative conditions of each group were recorded . The postoperative pain and life conditions were self-reported . The pain level was assessed using a 10-cm visual analogue scale under various situations . RESULTS The time required for the SMNSV technique was less than that for the SNSV technique ( p < .05 ) . There were no significant differences between the two groups with respect to incision length , postoperative pain , pain at coitus , time of return to work , time of resuming intercourse , self-reported satisfaction in sexual life , postoperative psychological status , postoperative body weight change and postoperative complications ( p > .05 for all items ) . CONCLUSIONS The simply modified vasectomy technique simplifies the SNSV technique . It combines the minimally invasive nature of SNSV with the simplicity of classical vasectomy while conserving many comparable advantages An instrument-independent no-scalpel vasectomy ( IINSV ) technique is reported . This technique does not use the st and ard specific instruments , but comparatively retains the advantages of minimally invasive instrument-dependent no-scalpel vasectomy ( IDNSV ) .  Between July 1999 and June 2002 , 449 men were prospect ively r and omized to be vasectomized at two hospitals in Taipei . Of those who accepted , 215 underwent IDNSV at one hospital and the remaining 234 underwent IINSV at the other . The intra-operative conditions of each group were recorded . The postoperative pain and life conditions were self-reported through a question naire that had been carefully design ed prior to the operations , in which the pain level was assessed using a 10-cm visual analogue scale under varying situations . Men vasectomized using the IINSV method experienced less operation time and postoperative complications ( haematomas , infections and granulomas ) ( p < 0.05 ) . There were no significant differences between the two groups with respect to incision length , postoperative pain , pain at coitus , time of return to work , time of resuming intercourse , self-reported satisfaction in sexual life , postoperative psychological status , postoperative body weight change and vasectomy failure as evidence d by sperm analysis ( p > 0.05 for all items ) . Thus , the IINSV technique can offer an alternative option for vasectomists whenever the specific instruments of st and ard no-scalpel vasectomy are unavailable . The IINSV technique shortens the operation time and reduces the incidence of operative complications when compared with the IDNSV technique , while still retaining the advantages of minimally invasive vasectomy 
    Output:
    
Operations using the no-scalpel approach were faster and had a quicker resumption of sexual activity .
Neither trial found differences in vasectomy effectiveness between the two approaches to the vas .
The no-scalpel approach to the vas result ed in less bleeding , hematoma , infection , and pain as well as a shorter operation time than the traditional incision technique .
No difference in effectiveness was found between the two approaches