Overcoming Men’s Fear of the Knife : Chinese Perfect Vasectomy Using Injections of Glue

Chinese doctors have perfected a sterilization technique to help men overcome one of their major reservations about vasectomy: fear of the knife.

The method involves a simple injection which plugs the patient’s sperm ducts with a plastic glue. It’s cheap, takes only a few minutes to perform and has no known side effects.

But the main advantage is still psychological, according to the doctor who invented the method, Li Sunqiang from Chongqing in central China.

“Men feel much better when we tell them there is no need to use the knife. Given a choice between a traditional vasectomy using a scalpel incision and an injection, there is not a man who won’t choose the injection,” Li said.

More than 5OO,OOO men in China have been sterilized using the injection technique. Li says he has performed more than 7O,OOO operations himself since 1972.

The technique is beginning to attract some attention outside China. A World Health Organization consultant, Roger Short, recently praised it as being an example of “Chinese brilliance by simplicity.”

But Dr. Wu Chiehping, president of China’s Medical Assn. and the method’s main advocate, says it is the injection technique, not the glue itself, that is the real advance.

“The ducts are very thin--about the size of the lead in a pencil--and the walls are thick and muscular. Many people have tried to find a way to get into the center of the duct, but it was Li who perfected a technique for doing so,” Wu said.

“The actual method is rather technical, but it is not difficult to learn under supervision. It requires no special equipment and can be done anywhere. Its simplicity makes it especially suited to Third World countries.”

Consultant Short warned that the plastic will have to be tested to prove that it is not cancer-producing before the method can be widely employed, but Wu said there are no worries on this score.

“The plastic polymer we use is called Isobutyl-2-cyanoacrylate, which was first invented in the United States in 1949 and has been used since for a wide range of medical purposes--for instance to glue up incisions as a substitute for stitches. It is just that this plastic has never been used before for this purpose.”

Wu, noted for having treated the late Chairman Mao Tse-tung and former Premier Chou En-lai, added a clever refinement to Li’s technique, which helps provide a “direct hit” on the duct.

There are two sperm ducts that need to be plugged, and just before the plastic glue is inserted, a spermicide with added color is injected--red for the left duct and blue for the right.

When the patient next urinates, a red tinge indicates that the left duct is plugged but the right needs to be re-done, a blue tinge indicates the opposite. A purple hue indicates mission accomplished.

Another refinement of the method being researched in the central city of Taiyuan may provide the most sought-after feature of all sterilization techniques: reversibility. Li said doctors there have been experimenting with a type of plastic that does not stick to the walls of the sperm ducts but simply blocks them. The idea is that the bead of plastic can be removed without having to sever the duct.

The research on the plastic-glue vasectomies is the latest in a string of advances made by the Chinese in recent decades with the same aim: to assuage male fears of the knife.

“As in other countries, most sterilization operations in China are performed on women,” Wu said.

“We have been looking for methods that are more psychologically acceptable to men because we feel men should take a greater share of the responsibility.”