The No-Scalpel Vasectomy
Over 500,000 vasectomy procedures are done each year in the United States.
What is No-scapel Vasectomy? Vasectomy is a simple, safe surgical procedure for permanent male fertility control. The tube (“vas deferens” – also referred to as the “vas”) is a conduit that transports the sperms from the testicles to the outside. Vasectomy interrupts these tubes and thus achieves the desired result of male sterility.
Interruption of the vas does not effect the production or delivery of male hormones-leaving sex drive and potency unaffected. Semen production continues, albeit, without sperms, volume, consistency and other physical aspects of the semen and threrefore the ejaculate remains essentially unchanged.
There are two techniques to perform Vasectomy – the conventional way and the no scalpel vasectomy technique. In the “conventional” technique, incisions are made on each side of the scrotum, and then through the respective openings the tubes are delivered to the outside and then interrupted. Closure of the incisions necessitates the use of sutures. In the “no scapel” technique, procedure is preformed through a single opening created by puncturing the scrotum and then enlarging the opening. The tubes are delivered one at a time to the outside and then interrupted. Due to the elasticity of the scrotum, suture to close the wound is not an absolute necessity. Note, that in both techniques the method to interrupt the tubes remains the same.
The no scalpel vasectomy technique therefore avails itself to be less traumatic and lowers but not eliminate the risk of infection and bleeding. Healing, it is felt, is quicker. Corresondingly, pain is also expected to be less that the conventional technique.
Before your Vasectomy
Please bring the following to your scheduled appointment:
- Your insurance card or payment if you are not using insurance
- A list of your medications
- Pertinent medical information
Risks and Other Important Information
As with any surgical procedure, the primary risks of vasectomy are infection and bleeding. These risks are generally low for this procedure.
It is also important that each patient understand that vasectomy is approached as an irreversible procedure. While vasectomy can be reversed surgically at times, its successful reversal cannot be guaranteed.
Also important is the fact that the vas deferens can grow back together again on their own. This is called recanalization and occurs only rarely. In the literature, figures given vary from one in 1000-1 in 3000 cases. Some reports suggest that fulguration (burning the inside) of the vas reduces this risk or reunification (recannalization) of the ends of the vas significantly.
The Effects of a Vasectomy
A vasectomy leaves the patient unchanged except for the fact that the sperm cord (vas) is blocked. The testes still produce sperm, but the sperm die and are absorbed by the body. Since the ejaculate is mostly seminal fluid its volume decreases only very, very little after a vasectomy. The level of male hormone remains the same and all sexual characteristics remain the same. Ability to have an erection is also entirely unchanged.
Preparing for Your Vasectomy
What to do before your Vasectomy
- May eat a light breakfast or lunch on the day of the procedure.
- Make sure the area is completely shaved. Trim the pubic hair and shave the scrotum sacs
- Remember that you will need somebody to drive you home. We can call your ride home just before the procedure is finished so they don’t have to wait.
- Bring snug underwear or jockstrap with you.
- Please give AT LEAST A 24 hour notice for any cancelled procedures or a charge will be assessed.
If you have any questions, please do not hesitate to call the office.
For patients with mitral valve prolapse and joint replacement ONLY, take your antibiotic 1 hour before procedure.
After your Vasectomy
VASECTOMY POSTOPERATIVE CARE
Activity: Stay as active as your condition and state of well-being allows. Try different positions when you sit or lie down to find the one most comfortable for you. A few hours of rest are all that is usually necessary following a vasectomy.
General Measures: Apply cold cornpresses intermittently (15 minutes on then 15 minutes off) on the operative site. (You may find that a bag of frozen peas works very well!) Use a scrotal suspensory (jock strap) or briefs for a week or so, you may use it longer if it continues to provide comfort. You may have sexual intercourse as soon as you are comfortable. However, you cannot consider yourself to be sterile until there is a test on your semen that reveals no sperm. Use another form of contraception until your test has revealed the absence of sperm. Showering the next day is acceptable – the dressing comes off best when it is wet.
Semen Sample: You will need to bring back a semen sample in approximately 12 weeks after the procedure. Ejaculations will flush out any remaining sperm that may continue to be harbored in the tubes. Frequent ejaculations help to ensure a negative test result.
Collection of Sample: After sample is collected, label the container with your name, and drop it off at our office. We will contact you in 7 to 10 days with the results of your specimen. Samples must be brought in within 24 hours of obtaining it; however there are no storage instructions to follow.
**Notify our office immediately if any of the following occurs**
- You bleed significantly from the operative site.
- You develop chills.
- You develop fever, with a temperature over 100 F orally.
- You experience prolonged pain or difficulty urinating.
- You develop any new symptoms that cause you concern.
Please do not hesitate to contact our office with any questions or concerns during your recovery.
Vasectomy is a simple surgical procedure for permanent male fertility control, in which the tube leading from each testicle is cut and sealed in order to stop sperm from reaching the prostate, where it mixes with the semen. This tube is called the vas deferens, hence “vasectomy”. Without sperm in the semen, a man cannot make his partner pregnant.
A vasectomy leaves the patient unchanged except for the fact that the sperm cord (vas) is blocked. The testes still produce sperm, but they die and are absorbed by the body. The level of male hormone remains the same and all sexual characteristic remain the same. Ability to have an erection is also entirely unchanged.
Over 500,000 vasectomy procedures are performed each year in the United States. The procedure is usually done in an office setting with the use of a local anesthetic such as Xylocaine and takes between 10 and 40 minutes, depending on the surgeon, his technique, and the patient’s specific anatomy. A vasectomy is far safer and far less expensive than female tubal ligation. Furthermore, the effectiveness of a vasectomy can be verified after the surgery with a semen analysis; the only way a woman could know her tubal ligation was ineffective would be if she became pregnant of had expensive X-ray tests.
As with any surgical procedure, the primary risks are infection and bleeding. These risks are generally low for vasectomy. While vasectomy can be reversed surgically at times, its successful reversal cannot be guaranteed, and vasectomy is done with the intent of being permanent. Conversely, the vas deferens can rarely grow back together on its own and cause a pregnancy. This is called recanalization and occurs substantially less than one percent of the time.
Over the years, many questions have been raised regarding possible long-term effects of vasectomy. Issues as to whether vasectomy causes arthritis or atherosclerosis of heart disease have long been put to rest. Most recently, some studies have suggested that vasectomy may cause a slight increase in the risk of getting prostate cancer. By and large, these studies have also been refuted by other urologic data. Studies including tens of thousands of vasectomy patients have shown no clear trends regarding an association between vasectomy and heart disease, arthritis, atherosclerosis, or cancer.
A recent advancement in the vasectomy technique is the no-scalpel vasectomy, In a conventional vasectomy, the physician may make one or two small incisions with a scalpel, and then use sutures or stitches to close them at the end of the procedure. In the no-scalpel method, rather than making an incision, the doctor makes only one tiny puncture into the skin with a special instrument. This instrument is used to gently stretch the skin opening so that the tubes can reached easily.
The tubes are then blocked, using the same method as a conventional vasectomy, but because no incision was made, there is very little bleeding and no stitches are needed to close the tiny opening. The opening will heal quickly with little or no scarring.
The technique of the no-scalpel vasectomy was developed in 1974 by a Chinese physician, Dr. Li Shunqiang, and has been performed on over 8 million men in China. No-scalpel vasectomy was introduced to the United States in 1988 and is now used by many doctors in the U.S. and elsewhere.
Compared to the traditional incision techniques, the no-scalpel vasectomy usually takes less time, causes less discomfort, and may have lower rates of bleeding and infection. Recovery following the no-scalpel procedure is usually complete in three to five days.
The vasectomy only divides the vas and has no effect on sperm that are already beyond that point. It is important not to have unprotected intercourse until the absence of sperm from the ejaculate has been confirmed with a negative sperm check.
Overall, vasectomy is a simple and safe form of birth control which is often preferable to birth control pills, a tubal ligation, diaphragms, or spermicidal. Some men say that without the worry of accidental pregnancy and the bother of other birth control methods, sex is more relaxed and enjoyable than before.
Common reasons for having a vasectomy:
- You want to enjoy sex without worrying about pregnancy.
- You do not want to have more children that you can care for
- Your partner has health problems that make pregnancy difficult
- You do not want to risk passing on a hereditary disease or disability
- You and your partner don’t want to or can’t use other birth control methods.
- You want to save your partner the more extensive surgery involved in tubal ligation, as well as the extra expense.
A vasectomy may not be right for you if:
- You are very young
- You are having a vasectomy just to please your partner and you do not really want it
- You are under a lot of stress
- You are counting on being able to reverse the procedure in the future