Facts on No-Scalpel Vasectomy

We are pleased to introduce a new method of voluntary sterilization—the no-scalpel vasectomy. This technique was developed in the early 1970's in the People's Republic of China by Dr. Li Shunqiang of the Chongqing Family Planning Scientific Research Institute in Sichuan Province. To date, the Chinese have performed an estimated 15 million no-scalpel vasectomies, and it is now the standard vasectomy technique in China. This refined method of vasectomy was first introduced to the United States ten years ago, and to date, approximately 400 surgeons have been trained by the sponsoring organization, The Association for Voluntary Surgical Contraception. We were part of the first group of urologists in Pennsylvania trained in no-scalpel vasectomy back in 1990. The procedure leaves a 2-mm puncture wound and is less invasive and safer than traditional vasectomy for the patient. It is our hope that by providing a simpler vasectomy technique, we will encourage more men to choose this form of voluntary sterilization.

A vasectomy is a surgical procedure that renders a man sterile. During intercourse, sperm travel from the testicles through the vas deferens, become part of the seminal fluid, and are ejaculated through the penis. When the surgeon performs a vasectomy, he cuts through the vas deferens and ties off the two ends, thus stopping the passage of sperm. The procedure does not affect a man's testicles or his penis. After a vasectomy, a man continues to produce male hormones, to have erections and ejaculations. But because his semen contains no sperm, he cannot impregnate a woman.

However, you are not sterile immediately after the operation. This is because there are some sperm residing above the area where the vas deferens is cut during the procedure. Until all of these sperm have been ejaculated, you will still be fertile and must continue to use contraceptives. We require that you bring a sample of seminal fluid to the office about 6-10 weeks after the surgery or after about 12-15 ejaculations have taken place in order to perform a microscopic examination and confirm that no sperm are present. Only when this has been confirmed can you engage in unprotected intercourse.

For all intents and purposes, you will be permanently sterile. However, no birth control measure is 100% effective (other than total abstinence). The chances of the two cut ends of the vas deferens being spontaneously rejoined are extremely rare, occurring in less than 1 in 1000. As far as medical science can determine at the present time, there are no long-term complications associated with vasectomy. Some men have undergone a reversal in which the vas is reconnected using microscopic techniques in order to be fertile again. There is no guarantee, however, that a vasectomy reversal in the future will be successful.

The Surgery

The surgery is performed under local anesthesia on an outpatient basis either in our office or at the Surgicenter of Bryn Mawr Hospital. You should bring an athletic supporter with you to the office or hospital. Before the procedure, your scrotum will be cleansed with Betadine. Then a local anesthetic will be injected into the skin of your scrotum and around the vas deferens to numb these areas. The scrotum is punctured once and both vas deferens are then lifted out through this tiny opening and cut. The cut ends of the vas deferens are clamped, clipped, and then sealed with an electric current. During the procedure, you may notice some discomfort such as tugging on the testicles. Afterwards, there may be some soreness and tenderness in the area where the surgery was performed, as well as some swelling and black/blue discoloration. As with any surgery, the possibility of an infection and/or bleeding from a cut blood vessel is always present although this is extremely rare.

Postoperative Instructions

You can expect to feel sore for a few days after the procedure. A mild painkiller such as Tylenol should relieve the discomfort. In addition, an athletic supporter, ice packs, and rest from strenuous exercise are recommended for the first 48 hours. You may shower 24 hours after the surgery, but avoid scrubbing the scrotum and pat the area dry afterwards. Apply Bacitracin or Neosporin ointment over the puncture site and keep it covered with gauze until the site has healed. Do not use aspirin, ibuprofen, Motrin, Advil, or Alleve for the first 5 days, but if the discomfort persists, you should switch from Tylenol to one of these medications and also begin to use warm compresses or baths. Should the scrotum swell or you notice any cloudy drainage from the incision, please contact our office.

You may resume sexual activity in one week but continue to have protected intercourse until a semen sample has been checked as described above. YOU ARE NOT STERILE UNTIL A SEMEN SAMPLE SHOWS NO SPERM TO BE PRESENT!

No scalpel vasectomy.

urologychannel has more information on no-scalpel vasectomy.

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