Vasectomy -- No-Scalpel Approach

What is a vasectomy?

Vasectomy is the process of dividing the vas (the tube that delivers sperm from the testis to the prostate) in order to prevent conception. It is the most common method of male contraception in this country, where about 500,000 vasectomies are done each year. Since vasectomy simply interrupts the delivery of the sperm and does not change the hormonal function of the testis, sexual drive and ability remain intact. Semen is composed mostly of fluid from the prostate, so the semen will look the same. Vasectomy is thought to be free of known long-term side effects and is considered to be the safest and most reliable method of permanent male sterilization.

How is the no-scalpel vasectomy performed?

After injecting the scrotal skin and each vas with a local anesthetic, we use a special vas-fixation clamp to encircle and firmly secure it without penetrating the skin. One blade of a sharp forceps or clamp is then used to penetrate the scrotal skin. The tips of the forceps are spread, opening the skin, much like spreading apart the weave of a fabric. The vas is thus exposed, lifted out, and occluded by any of the standard techniques, such as cautery or sutures. The second vas is brought through the same opening and occluded in a similar fashion. The skin wound then contracts to a few millimeters.

Compared to the traditional incisional technique, the no-scalpel vasectomy usually takes less time, causes less discomfort and may have lower rates of bleeding and infection. Recovery following the procedure is usually complete in two to three days. Hard work or straining (athletic pursuits or heavy lifting ) is not recommended for seven days. Most patients should wait to have intercourse for a week after the procedure.

What are the most 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 might make pregnancy difficult.
  • You do not want to risk passing on an hereditary disease or disability.
  • You and your partner don't choose to or are unable to use other kinds of birth control.
  • You want to save your partner from the surgery involved in having her tubes tied.
  • Vasectomy is less expensive than tubal ligation.

How can I be sure that I want a vasectomy?

You must be absolutely sure that you don't want to father a child under any circumstances. You must talk to your partner -- and it certainly is a good idea to make this decision together -- consider other kinds of birth control and talk to friends or relatives who may have had a vasectomy. Think about how you would feel if your partner had an unplanned pregnancy. Talk to your doctor, nurse, or family planning counselor.

A vasectomy might not be right for you if you are very young, if your current relationship is not permanent, if you are having a vasectomy just to please your partner and you do not really want it, if you are under a lot of stress, or if you are counting on being able to reverse the procedure at a later time.

How does the vasectomy prevent pregnancy?

Sperm is made in the man's testicles. The sperm then travels from the testicle through a tube called the vas into the body, where it enters the prostate gland. In the prostate, the semen is made and here the sperm mixes with the semen. The prostate is connected to the channel in the penis and hence, the sperm and semen are ejaculated. In a vasectomy, the vas (or tube) is blocked so that sperm cannot reach the prostate to mix with the semen. Without sperm in the semen a man cannot help create a pregnancy.

Does a no-scalpel vasectomy hurt?

When the local anesthetic is injected into the skin of the scrotum you will feel some discomfort, but as soon as it takes effect you should feel no further pain or discomfort. Afterwards, you will be sore for a couple of days and may want to take a mild pain killer, such as Tylenol, but there is usually less discomfort with the no-scalpel technique because of less trauma or injury to the scrotum and tissues. Also, there are no stitches in most cases. We will provide you with complete instructions on what to do after surgery.

How soon can I go back to work?

You should be able to do routine physical work within 48 hours after your vasectomy, and will be able to do heavy physical labor and exercise within a week.

Will the vasectomy change me sexually?

The only thing that will change is that you will not be able to contribute to a pregnancy. Your body will continue to produce the same hormones that give you your sex drive and maleness. You will make the same amount of semen. Vasectomy will not change your beard, muscles, sex drive, erections, climaxes or your voice. Some men say that without the worry of accidental pregnancy or the bother of other birth control methods, sex becomes more relaxed and enjoyable.

Will I be sterile right away?

No. After a vasectomy there are some active sperm left in your system. It may take a dozen to two dozen ejaculations to clear the sperm out downstream from where the vasectomy is performed. You and your partner should use other forms of birth control until we have checked your semen specimens at least twice to make sure they are free of sperm.

Is the no-scalpel vasectomy safe?

Vasectomy in general is safe and simple. Vasectomy is an operation and all surgery has some risk, such as bleeding, infection and pain, but serious problems are unusual. There is always a small chance of the tubes rejoining themselves, and this is the reason that sperm checks are necessary. There have been some controversies in the past about the long-term effects of vasectomy, but to our knowledge there are no long-term risks to vasectomy.