title: Office based vasectomy can be performed by supervised urological residents with patient pain and morbidity comparable to those of a staff surgeon procedure.
abstract: OBJECTIVE
  Although it is routinely performed in the ambulatory setting, vasectomy is an intricate surgical procedure with the potential for significant pain and morbidity. We determined from our prospective, institutional review board approved database whether vasectomy pain was affected by whether a staff surgeon or resident was the primary surgeon on the case.
  
  
  METHODS
  One staff surgeon and 14 residents in training year 2, 3 or 5 performed bilateral percutaneous no-scalpel vasectomy. Men scheduled to undergo vasectomy were assigned to the staff urologist (134) or to a resident (133) as the primary surgeon. The staff surgeon demonstrated the first vasectomy each month when a new resident rotated on service and all residents were directly assisted by the staff surgeon. Pain associated with each side of the bilateral vasectomy was assessed with a 0 to 100 mm visual analog scale.
  
  
  RESULTS
  The average visual analog scale score of the 2 sides was 19.5 in patients in the staff cohort and 21.8 in those in the resident cohort. Although mean scores were slightly lower when vasectomy was performed by the staff surgeon, the difference between the staff surgeon and residents was neither statistically nor clinically significant. Furthermore, there were no significant differences in visual analog scale scores among residents of different training years.
  
  
  CONCLUSIONS
  Office based vasectomy can be performed by residents under staff supervision with pain comparable to that of the procedure performed by a staff urologist. Urological resident training can be accomplished without compromising high standards of care.
authors: Glickman Urological and Kidney Institute and Department of Quantitative Health Sciences (AVH, TG), Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors: Carvell T
authors: CT
authors: Nguyen
authors: Adrian V
authors: AV
authors: Hernandez
authors: Tianming
authors: T
authors: Gao
authors: Anil A
authors: AA
authors: Thomas
authors: J Stephen
authors: JS
authors: Jones
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000592:standards* / Q000639:trends; D000704:Analysis of Variance; D002983:Clinical Competence; D015331:Cohort Studies; D006801:Humans; D007396:Internship and Residency; D016014:Linear Models; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis*; D017060:Patient Satisfaction; D011336:Probability; D018570:Risk Assessment; D016896:Treatment Outcome; D014572:Urology / Q000193:education / Q000379:methods; D014659:Vasectomy / Q000009:adverse effects / Q000379:methods*