title: Strengthening vasectomy services in Rwanda: introduction of thermal cautery with fascial interposition.
abstract: BACKGROUND
  Recent developments in vasectomy research indicate that occluding the vas using cautery combined with fascial interposition (FI) significantly lowers failure rates and is an appropriate technology for low-resource settings. We report the introduction of this technique in Ministry of Health (MOH) vasectomy services in Rwanda.
  
  
  METHODS
  In February 2010, an international vasectomy expert trained three Rwandan physicians to become trainers in no-scalpel vasectomy (NSV) with thermal cautery and FI. The training took place over 5 days in five rural health centers.
  
  
  RESULTS
  A total of 67 men received vasectomies (11-16 per day) and trainees successfully mastered the new occlusion technique. The MOH is now scaling up NSV with cautery and FI services nationwide. The initial cadre of trainers has subsequently trained 46 other physicians in this vasectomy technique across 27 districts of Rwanda.
  
  
  CONCLUSIONS
  No-scalpel vasectomy with thermal cautery and FI was successfully introduced in vasectomy services in Rwanda, and a similar initiative should be evaluated in other national vasectomy services worldwide.
authors.affiliation: Department of Family and Emergency Medicine, Laval University/Hôpital Saint-François d'Assise, D6-728, 10 rue de l'Espinay, Québec (Qc), Canada G1L 3L5. michel.labrecque@mfa.ulaval.ca
authors.forename: Michel
authors.initials: M
authors.lastname: Labrecque
authors.forename: Léonard
authors.initials: L
authors.lastname: Kagabo
authors.forename: Dominick
authors.initials: D
authors.lastname: Shattuck
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wesson
authors.forename: Christophe
authors.initials: C
authors.lastname: Rushanika
authors.forename: Donatien
authors.initials: D
authors.lastname: Tshibanbe
authors.forename: Theophile
authors.initials: T
authors.lastname: Nsengiyumva
authors.forename: David C
authors.initials: DC
authors.lastname: Sokal
mesh_terms: D002425:Cautery / Q000295:instrumentation / Q000379:methods; D005193:Family Planning Services; D000071938:Fasciotomy; D006801:Humans; D008297:Male; D012432:Rwanda; D014659:Vasectomy / Q000193:education / Q000379:methods* / Q000706:statistics & numerical data