Faster, Safer, Less Pain, No Stitches
When a physician performs a conventional vasectomy, the flow of sperm is interrupted by cutting the vas deferens, the tube that carries the sperm. However, the no-needle, no-scalpel vasectomy, performed exclusively in this area by Michael Werner, MD, is minimally invasive and recommended over the conventional technique.
In a no-needle, no-scalpel vasectomy, it is the anesthesia that is different. The surgeon uses a device similar to a strong spray gun that allows the anesthesia to be given through the skin which then infiltrates the tissues underneath. With a conventional vasectomy, numbing medication is injected into the spermatic cord and all of its structures.
Here's why the no-needle, no scalpel vasectomy is superior:
- Faster: the procedure takes about 20 minutes
- Safer: there are fewer post-operative complications
- No-Needle Anesthesia: less anesthesia is needed and it's more effective; results in less pain and less bleeding (see how it works without a needle)
- No Stitches: a smaller incision means there's no need for stitches
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Frequently Asked Questions
Recovery and when can I start enjoying it?
How will I feel after a vasectomy? The good news is that since a no-needle, no-scalpel vasectomy is performed with a single small incision in the skin, and minimal manipulation of the structures in the scrotum, the recovery is usually quite easy. Most men return to work the next day or, if the procedure is performed on a Friday, on Monday. Tenderness and swelling of the surgical site and bruising of the scrotum are usually minimal. Ice should be applied intermittently for the first 24 hours.
Resuming Sex: You can resume sex five to seven days after the vasectomy. However, you must continue to use contraception until it is shown you have no sperm in your ejaculate. Six weeks after the vasectomy, you will be asked to produce a semen specimen, which will be evaluated. If there are no sperm, you can begin unprotected intercourse.
What can I expect during the procedure?
In performing a no-scalpel vasectomy, the vas deferens is pushed up against the skin. After anesthesia has been given, it is grabbed through the skin in a small ring shaped clamp. Thus, only the vas deferens and a small amount of tissue around it is isolated, rather than the whole cord. A sharp clamp is used to make a small hole in the skin, and the vas deferens grabbed, and pulled out. It can then be divided, cauterized, and the two sides isolated from each other, prior to putting them back in the scrotum. The incision is so small, that most patients cannot find it. No stitches are needed to close it. Usually, both of the tubes can be grabbed through the same small opening.
What are the risks?
Complications and Failure Rate
Serious complications are rare. Approximately 1 out of 150 patients will develop a hematoma (a collection of blood in the scrotum) which will prolong the recovery13. Infection is extremely rare and can usually be treated with oral antibiotics. Approximately 1 in 1000 vasectomies will have delayed failure, meaning that no sperm is seen at one point after the procedure (confirmed by a semen analysis) and then comes back13. The mechanism of this is unknown. Even with this failure rate, it remains the type of birth control least likely to fail, and the least invasive permanent method of birth control.
Will it Affect my Sex Life?
The answer is a resounding “no”. Many men report that their sex lives are actually improved because they are no longer afraid of an unwanted pregnancy. The testosterone levels, which affect sexual function, are not changed by a vasectomy.
Men who have had a vasectomy also continue to have normal ejaculation with significant fluid. This is because when a man ejaculates, he pushes out fluid containing mature sperm, but only five percent of the ejaculated fluid actually comes from the testicles. Most of the semen (fluid) comes from organs other than the testicles (the prostate, seminal vesicles, and bulbourethral glands). These organs do not make sperm. Thus, men who have had a vasectomy still have normal ejaculation with significant fluid because only the five percent of the fluid made in the testicles, and the sperm, are missing.
Post-Vasectomy Pain Syndrome
One of the most common complications from a vasectomy is continued discomfort in the scrotum. This is referred to as post-vasectomy pain syndrome. It is thought to arise from pressure building up in the part of the vas deferens going back to the testis, after it is cut and sealed. This builds up pressure in the more delicate collecting duct (epididymis).
In an open-ended vasectomy the testicular end of the tube (vas deferens) is not sealed. It is left open, and the very small amount of fluid, carrying the sperm, drains into the scrotum, and is quickly reabsorbed. The other end of the tube is sealed, and the tissue tied around the end, so that there is no way for the sperm to find their way into the far end of the tube, and into the ejaculate. An open-ended vasectomy (as compared to a close-ended vasectomy where both sides of the vas deferens are sealed) decreases the pressure in the testicular vas and the epididymis. An open-ended vasectomy is thought to significantly reduce post-vasectomy pain syndrome. It also makes a vasectomy easier to reverse.