To determine complications, compliance of patients, and results of follow-up after simply modified no-scalpel vasectomy Prospective open study We performed 83 vasectomies under local anesthesia in our department during January 2003 to January 2005 using a simply modified no-scalpel technique. Intraoperative conditions and postoperative complications were recorded. All men were instructed to submit 2 semen samples for analysis (at 3s4 months after vasectomy). Eligible men were between 28 to 53 years old (mean age: 39), operation times were between 10 to 35 minutes (mean time: 20), intraoperative complications included patients, intolerance (necessitating sedation) in 4 cases (5%), difficult vas fixation (leading to longer operative time) in 7 cases (8%), and minor bleeding in 2 patients(2%). Early postoperative complications included scrotal pain (15 cases, 18%) and wound infection (7 cases, 8%). Sixty-seven men (81%) returned for 3-month postvasectomy semen analysis (PVSA), of whom 59 (88%) were azoospermic in first PVSA. From this group just 4 (6%) came for second PVSA. Compliance for first PVSA was directly related to the educational level of volunteers (p<0.05). Of 8 men who were not azoospermic in first PVSA, 7 came for 4-month test. Six men had become azoospermic at that time. Redo vasectomy 6 months after first operation in the failed case showed a double vas deferens at left side neglected in the first operation. This modification is simpler than conventional no-scalpel technique with minor complications not different from it. Despite counseling, compliance with follow-up testing is not acceptable; especially for second sample and better preoperative teaching programs are needed. It seems reasonable to ask the patients to return for PVSA at 4 months just once. Our failed vasectomy case showed the importance of detailed physical examination before vasectomy!