Vasectomy under local anesthesia. [Letter]

I would agree with Dr. J.J. Hobbs (November 15 p. 1352) that vasectomy may be performed in the majority of men using a local anesthetic without undue discomfort or difficulty. The risks of general anesthesia must always be borne in mind and 1 patient is reported to have died this year after receiving general anesthetic for a vasectomy. However my experience in training practitioners to perform vasectomy using a local anesthetic indicates that it certainly is not an operation for "clumsy" hands. Some trainees have not been able to become sufficiently adept to allow them or their patients to feel comfortable with the procedure. A few men express a strong preference for general anesthesia and in a minority the operation is technically best performed under a general anesthetic. It is in these circumstances that the supervised trainee vasectomist may gain experience without detriment to the patient. (Authors modified)