A vasectomy is a permanent, surgical birth control procedure for men that stops the release of sperm by transecting the tube – called the vas deferens. This specialized tube delivers sperm from the testicles. After a vasectomy, sperm is still produced, but it is just reabsorbed by the body, which is what happens to excess sperm naturally.
A no-scalpel vasectomy (NSV) procedure differs from conventional vasectomies in the methodology. Instead of an incision being made, the urologist makes a single, tiny puncture that is less painful and heals easier. As mentioned, both conventional and no-scalpel vasectomies are generally permanent (see “Reversals” below for exceptions), with a 99.85% effectiveness rate.
The Procedure: The NSV is generally a brief procedure, generally taking between ten and fifteen minutes. It can be done under sedation in our ambulatory surgery center or under local anesthesia in the office. For patients who chose to have it done in the office a local anesthetic is applied to a specific area of the scrotum (typically Xylocaine, which is related to Novocaine). Once the area is completely numb, a tiny puncture is made in the scrotum. The surgeon then locates the vas deferens which is then transected and clipped. Afterwards, the puncture may be sutured, but it is typically unnecessary being only 2-3 millimeters. The site heals quickly with little-to-no scarring.
Simply arrive at the specified time to the office after having filled your prescriptions for pain pills and antibiotics. Bring underwear that provides good scrotal support, like a jockstrap or tight briefs. Please do not eat or drink for three hours before the NSV if it is to be done in the office, and nothing after midnight the night before if it is to be done in the surgical center under sedation.
For the rest of the day: There should be minimal discomfort. In fact, your scrotum will be numb for several hours thanks to the local anesthetic. Just stay off your feet, wear underwear that provides good support and apply ice or cold packs to the scrotum to keep swelling down.
After 48 hours: You can return to work after a day or two, provided that your work doesn’t require heavy lifting or strenuous labor.
After 1 week: You will generally want to wait a week to have sex, to give the area a chance to heal properly. IMPORTANT NOTE! You can still get your partner pregnant until all the residual sperm is cleared out, which typically takes six to eight weeks and fifteen to twenty ejaculations.
After eight weeks: Return to our office to test your sperm count. Note that eliminating residual sperm depends more on number of ejaculations and less a matter of time. Once sterility is confirmed you may safely discontinue other forms of birth control. Note that vasectomy does not protect you or your partner from the transmission of sexually transmitted diseases.
Risks of No-Scalpel Vasectomy
One of the major advantages to a no-scalpel vasectomy procedure is the low risk of complications. However, no surgical procedure is risk-free. The most common risks include:
– Bleeding and swelling. A hematoma (a pocket of blood outside a blood vessel) is the most common side effect, but its incidence is quite low: 0.1% to 3% of patients.
– Infection. Wound infections are also very rare, occurring in around 0.2% to 0.6% of patients.
– Failure (see “Reversals” below for more information).
We should also mention unintended pregnancy. This isn’t so much a risk of the procedure, as a failure of some patients to realize there will be residual sperm in the system that must be eliminated through ejaculation before sperm count will reduce to zero.
The more common after-effects will disappear as the area heals, while ice and scrotal support will ease symptoms. The more serious side effects, like infection, are rare. It is advisable to avoid NSAID (non-steroidal anti-inflammatory) drugs like aspirin, which can increase the chance of internal bleeding.
Impact on Sexual Function
A no-scalpel vasectomy procedure is purely mechanical. In other words, the only change to the body is to block the delivery of sperm. Testosterone production is not affected at all. Therefore, sex drive and potency (i.e., the ability to have and maintain an erection) will remain unchanged. Additionally, men will continue to ejaculate, because seminal fluid is produced separately from sperm. The volume of ejaculate will change very minimally.
Benefits of No-Scalpel Vasectomies
– Lower risk and fewer complications than conventional vasectomies
– Less pain and swelling
– Faster healing without sutures
– Quicker overall procedure
A no-scalpel vasectomy is generally permanent, and you shouldn’t expect to be able to reverse it at will. There are, however, a couple of notable exceptions.
Recanalization: The human body has an amazing capacity to heal itself. The vas deferens can sometimes grow back together. This is rare – occurring less than 0.5% of the time – but this “recanalization” will restore a man’s fertility. Recanalization will typically occur within 12 weeks of the NSV.
Surgical Reversal: It is sometimes possible to undo a vasectomy surgically, but this cannot be guaranteed.
Reasons to Consider a No-Scalpel Vasectomy
There are nearly as many reasons to consider a vasectomy as there are men who opt for the procedure. Many men choose to have a vasectomy because they don’t want to use other forms of birth control or because pregnancy represents potential risks, like passing on serious hereditary conditions or endangering the mother’s well-being. On the other hand, because a vasectomy is generally permanent, it is important for men to be sure this is the right decision for them.
Our specialists are happy to discuss your situation so we can help you understand the procedure, its benefits and its implications. Please contact us to schedule an appointment.