No Needle, No Scalpel Vasectomy

Vasectomy is one of the most effective, safe and economical forms of contraception available, but many men are reluctant to undergo the procedure because of concerns about discomfort associated with the procedure. A recent advance in the technique can greatly reduce the anxiety associated with the use of a needle and also diminish the discomfort associated with the procedure.


The current technique for performing vasectomy is the Needle free, no scalpel vasectomy. With this approach, local anesthetic is administered using the Madajet. The Madajet is a device that delivers local anesthesia using a high pressure jet that allows the anesthetic agent to penetrate the tissues without the need for a needle. The sensation associated with the anesthesia delivery is similar to a small rubber band snapping against the skin. The local anesthetic effect is nearly instantaneous as the agent is evenly distributed in the tissues. 90% of individuals require no additional anesthetic beyond the initial application. Using the Madajet, most vasectomies are performed with only 0.6 cc of local anesthetic with a much better anesthetic effect than previously experienced with the 10 – 15 cc’s required with standard needle delivery.


Once the local anesthetic is in place, the no scalpel vasectomy is performed. Instead of using a knife to open the skin, a small sharpened hemostat is used to puncture and spread the skin and tissues overlying the vas deferens. By avoiding the knife, there is less tissue damage which reduces the risk of bleeding and postoperative complications. Generally the puncture wound is so small that no stitches are required for closure and the wound is almost invisible after healing.


The risks associated with vasectomy are similar regardless of the approach. There is a small possibility of bleeding or possible hematoma formation. Infection risk is minimal. There is a slight chance of testicular atrophy and prolonged or chronic post operative pain. The success rate of vasectomy is greater than 99%. Late failures can occur, but are rare. It is very important to rely on alternative birth control until 2 consecutive post procedure semen analyses are free of sperm. Approximately 10 – 15 ejaculations are required to clear the sperm from the system. A vasectomy should have no effect on sexual sensation or experience as the sperm make up only about 1% of the total seminal fluid volume.


Following a vasectomy, a light dressing will be left on the wound and an ice pack should be applied for 4 – 6 hours to reduce the risk of swelling. Showering can begin the following day, but activity should be very light for 1 -2 days, with no heavy lifting or sexual activity for about a week. It is worthwhile to wear briefs or and athletic supporter for the first several days to support the scrotum. Your doctor may give you prescriptions for antibiotic, pain medication and possibly something to help you relax before the procedure as well.

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