Metrowest Urology: No-Scalpel Vasectomy

The No-Scalpel Vasectomy, Open-Ended Option
An Improved Technique for a Popular Procedure

Introduction

For many years, the vasectomy has been a safe and popular option for couples who no longer want children. Traditionally, this procedure required shaving and an incision in the scrotum, stitches, and some degree of post-operative discomfort. Now, a new variation of this procedure is available called the no-scalpel vasectomy. Developed by a Chinese surgeon, the technique has been used in the United States for several years. It utilizes a very small puncture wound, no stitches, and no shaving; thus, patients experience very little discomfort during or after the procedure. We specialize in the open-ended option; over 7000 no-scalpel vasectomies have been performed in our office.

The Procedure

The purpose of a vasectomy is to prevent the delivery of sperm during intercourse. The vas deferens is a narrow duct that carries sperm from the testicle to the point of delivery. The surgeon locates the vas in the scrotum and then blocks sperm delivery by tying the vas and cauterizing it. This blockage prevents sperm from leaving the body. Fingers are used to gently locate the vas under the skin in the upper portion of the scrotum. In the open-ended no scalpel vasectomy, the end attached to the testicle is left open, thus decreasing the chances for backup pressure and persistent pain. Local anesthetic is injected to numb the skin and the vas area, causing a sensation that most patients describe as similar to a small mosquito bite. Numbing is achieved within 10 seconds. Very little, if any, discomfort is felt while making a tiny puncture in the scrotum and inserting a hemostat. Using special equipment, the vas is then drawn out through the puncture, divided and tied off on one side only. No stitches are needed to close the small wound.

Advantages

Before scheduling a no-scalpel vasectomy, the physicians will discuss the benefits and risks involved, providing sketches that describe the details of the procedure. Your vasectomy will be performed in our office and will take only 5-10 minutes to complete. Following the procedure, the person who accompanied you may drive you home so that you can recover in the familiar comfort of your own home. Benefits of the no-scalpel procedure versus a traditional procedure include:

Usually requires less time to perform.
Less traumatic to the tissues.
Less discomfort during and following the procedure.
Less bleeding.
Less risk of infection.
No stitches.
A single, small puncture entry--no incision.

Often patients are surprised by how quickly and easily they recover. Ice packs can alleviate any immediate discomfort, and an athletic supporter may be worn as needed. You may return to work after two days, and to full activity within a week; for this reason, you may find Friday afternoon a convenient time to schedule the procedure.

Safety

Vasectomies have long been regarded as much safer and simpler procedures than comparable sterilization procedures for women. The no-scalpel vasectomy is, in fact, somewhat safer than traditional vasectomies because of all the advantages listed above.

Effectiveness

As with any vasectomy, the rate of success is greater than 99%. After a vasectomy, sterilization is not instantaneous. Sperm cells which have already traveled up the vas before the operation will be stored at the upper end of the vas near the prostate gland. You will not be considered sterile until the stored sperm is passed. The staff will help you arrange to have your seminal fluid checked after 20 - 25 ejaculations. You should continue to use another form of contraception until two specimens are found to be sperm free. At this point, it is safe to assume that you are sterile.

A Word About Sterilization

A vasectomy should be considered as permanent sterilization. Reversals are possible, though a successful outcome cannot be guaranteed. We encourage patients to consider their needs carefully before electing sterilization; if a reversal is desired, we will be happy to discuss and perform the necessary surgery.