No-Needle, No-Scalpel Vasectomy
No-Scalpel Vasectomy is the most reliable form of contraception available today. It is a minor surgical procedure with a very quick recovery time.
The total cost, including the semen samples, is €450.
What should you expect from a no-needle no-scalpel vasectomy
- Gentle anaesthesia, almost painless with no needles
- No stitches
- Quicker recovery time than a traditional vasectomy
- More comfortable procedure
- Return to work the next day (some men go back to work on the same day)
- Return to sports/more strenuous activities within 3 – 5 days normally
What is a No-Needle No-Scalpel Vasectomy?
No-Scalpel Vasectomy is an office based procedure that many studies show has significant advantages over a conventional vasectomy. With the no-scalpel technique there is no knife and no stitches used. A No-Scalpel Vasectomy has a much quicker recovery time, is safer (one eighth the rate of bleeding and infection) and in some cases may be virtually pain free. During the no-scalpel technique special instruments are used to perform the procedure through a single small access-opening on the front side of the scrotum. The 1 cm slit usually seals within hours, so no stitches are needed. You may return to normal activities the following day and can shower the day after the procedure as well. The most recent recommendations from the American Urology Association now recommend that only a minimally invasive procedure such as a no-scalpel vasectomy be used to do a vasectomy.
Men who were previously not considering vasectomy because of a fear of needles and pain can now feel more at ease with the no-needle, no-scalpel vasectomy technique. In addition to a no-scalpel technique, we also use a No-Needle Technique that involves the use of a spray applicator that delivers a stream of anaesthetic under high pressure. This provides anaesthetic without having to use a needle so injections in the scrotum are unnecessary. This is sufficient to anaesthetise the skin and the vas deferens.
No-needle anaesthesia is very effective, it works much quicker than using a needle, and it avoids that “bee stinging” sensation you experience when you have an injection in your scrotum. Those who have no experience with no-needle anaesthesia feel uncomfortable using it hence they may dismiss it. We always use it for anaesthetic before a vasectomy and you do not need sedation with it. We are currently the only clinic offering No-Needle anaesthesia.
A small group of patients, about 1%, do require injection of a little more anaesthetic. This only causes a small amount of discomfort as the skin and vas have already been partially anaesthetised already
The tiny opening in the skin is made with a pointed haemostat and the skin is spread, rather than cut with a scalpel, to give an opening approximately 1-2 cm in length. Since blood vessels in the skin are spread apart rather than cut, bleeding is less than when a scalpel is used, no stitches are required, and the opening is usually sealed closed (often barely visible) by the next day.
The principal difference with a no-scalpel vasectomy versus a traditional vasectomy is how we access the tubes. In a traditional vasectomy 2 cuts are made, one on each side of the scrotum. Bleeding is more likely and it often requires stitches to close the cuts or to control the bleeding, however experienced vasectomists that do a traditional vasectomy may be able to make a small incision that will not require any sutures. What vasectomists do to the tubes when they access them through the skin is the same and a number of techniques exist.
Once each vas tube is lifted through the small skin opening, we cauterise the inside of the “prostatic” end of the vas, this is the part on top. We then divide the vas, or essentially cut it in the middle and the two ends of the vas are placed out of alignment with each other and kept from rejoining by applying a small titanium clip to the tissue surrounding the vas on one side only so that one end stays inside the sheath, the other outside. The divided ends are then placed back in the scrotum and no sutures are required.
We perform an open-ended vasectomy and do not clip the lower (testicular) end of the vas as doing so may cause a sense of congestion or pressure and may be linked to long term discomfort. This procedure of open ended vasectomy is now routine practice and has been used for quite some time now.
What is the difference between a No-Scalpel Vasectomy and a traditional Vasectomy?
The quick answer to this is that it the equivalent of keyhole surgery for a vasectomy.
Both methods are equally effective at preventing pregnancies and they are just different ways of gaining access to the vas deferens. Performing a No-Scalpel vasectomy is technically more difficult for the doctor which is why some doctors will only do a traditional vasectomy. A No-Scalpel method is minimally invasive and as such it is recommended as the gold standard by the American Urology Association.
Please note; No sedation is necessary for a no-scalpel vasectomy as has been suggested by some doctors that do not perform them. You will be able to drive yourself home afterwards.
In a traditional vasectomy two 1″ incisions are needed, one on each side and sometimes sutures are used to close the wound. With a no-scalpel vasectomy only one small opening is made with no stitches necessary.
What happens when the tubes are delivered through the incisions, either one small opening from a no-scalpel vasectomy or two slightly larger incisions from a traditional vasectomy, is essentially very similar. Their are different ways to divide the vas deferens and to tie or clip them but they all fundamentally provide the same amount of contraception.
The other big difference is the recovery time and any potential complications, both are much less with a no-scalpel vasectomy.
If you are considering having a vasectomy ask your vasectomist can they do a no-scalpel vasectomy for you.
After the procedure
- A scrotal support (jockstrap) needs to be worn for the next 2 days, but ideally for longer if tolerated, we provide the jock strap
- Ice-packs are not necessary
- Normally no follow-up is required but you will have Dr. Mc Cormick’s mobile number should you have any concerns
- It is important to note that other forms of birth control are then required until a semen sample has been proven to be sperm free. One sample is required at approximately 14 weeks. For further information about semen analysis please click here.
- You may return to work the day after the procedure, however if it is a physically strenuous job. for example landscaping, heavy lifting, etc. we recommend you take 2 – 3 days off.
- Sports may be resumed after approximately 3 days rest as well.
- Sexually activity may be resumed after 2 days. Some blood may be noticed in your ejaculate initially but this resolves quickly and is nothing to be concerned about.
Please note that having a vasectomy does not cause any change in libido, amount of ejaculate produced, erections or climax sensation.
It is not necessary to attend for a consultation before the vasectomy procedure. We can discuss the procedure and what is involved on the same day you wish to have the vasectomy performed. We do not require a deposit in advance of the procedure.
It is not necessary for your partner/spouse to attend the appointment with you. The decision to have a vasectomy is generally a joint one by most couples however the ultimate decision rests with the man and it is only with his fully informed consent that we will agree to do a vasectomy.
All vasectomies here are performed by Dr. Mc Cormick, he has over 11 years of surgical experience. If you need any follow-up, you will see him directly. You will be given a number that you can contact us on at any stage should you have any concerns in the first few days after the procedure.
The total inclusive cost of the procedure is €450, this includes the vasectomy procedure and the post-op semen analsysis.
Potential Side Effects of a Vasectomy
Regardless of what method of contraception you and your partner choose they all have side effects, as does pregnancy! Vasectomy has no hormonal side effects and it is the most effective method of contraception available.
First of all please not that having a vasectomy will not affect your libido or sex life in anyway. Vasectomy is also not linked with prostate cancer.
1. Bleeding may occur, although it is much less likely with a no-scalpel technique. Both large and small hematomas (blood collections) are very rare, they only occur in approximately 1 in 1000 cases. It is more common that bruising will occur in your scrotal skin but this is painless and resolves by itself.
2. Infection is also a rare complication and will respond to antibiotics quickly if it does occur.
3. Sperm granuloma is a pea-sized (sometimes tender) lump on the vas tube at the vasectomy site. It’s presence serves to help keep pressure off the testicle so it may actually be a good thing and if a reversal was ever necessary it makes the reversal more likely to succeed.
4. Congestion, due to build-up of sperm and white blood cells upstream from or at the vasectomy site, can occur anytime after vasectomy, but usually goes away with use of an anti-inflammatory drug such as ibuprofen. This is the most common side effect we would see. We perform an open ended vasectomy (the lower end is left open) and this will dramatically decrease any chance of congestion or pressure.
5. PVPS or Post-Vasectomy Pain Syndrome is defined as chronic pain that occurs after a vasectomy. The incidence of pain after a vasectomy ranges from 1 in 100 to 1 in 1000. The number of men that have post-vasectomy pain syndrome that will consider having a reversal to relieve severe pain is approximately 1 in 5000 to 1 in 10,000.
6. Recanalization is the development of a channel for sperm flow between the two cut ends of the vas. If this happens during the healing process (early), the semen never becomes sperm-free until the vasectomy is repeated. This is very rare but it is picked up on semen testing after your vasectomy. If recanalization happens late (months to years afterwards) an unplanned pregnancy could result. The long term failure rate of a vasectomy is approximately 1 in 3000.
Advantages of No-scalplel Vasectomy
- It is a safe and effective procedure
- Eliminates any risk associated with female methods of contraception
- No hormones involved – so no effect on the quality of your sex life, in fact it can only improve it!
- Places the responsibility of contraception with the man
- Does not interrupt sex
- The most effective method of contraception available today
- Long term follow-up or regular doctors appointments are not necessary hence it is more cost effective in the long term
Disadvantages of Vasectomy
- Vasectomy reversal may be done but is not 100% successful
- It does not take effect immediately. Another form of birth control must be used until your semen sample has been proven to be sperm free, this takes approximately 14 weeks
- Does not protect against Sexually Transmitted Infections