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No-Scalpel Vasectomy

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.  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 characteristics remain the same. Ability to have an erection is also entirely unchanged.

This diagram shows the male reproductive anatomy, and highlights the spot in the vas deferens where a vasectomy is performed.

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.  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.

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 be 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.

Compared to the traditional technique, the “No-Scalpel” vasectomy usually takes less time and causes less discomfort. 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 two negative sperm checks 4 to 6 weeks apart.

Common reasons for having a vasectomy:

  • You want to enjoy sex without worrying about pregnancy.
  • You do not want to have more children than you can care for.
  • Your partner has health problems that make pregnancy difficult.
  • You and your partner don’t want to or can’t use other birth control methods.

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.