No- Needle, No- Scalpel Vasectomy

“The Gentle Vasectomy”

Technique

Dr Stearn provides high quality male vasectomy care, using the No-Needle, No-Scalpel Vasectomy procedure. This is a simple, quick, and virtually painless procedure, done in office. It is sometimes referred to as “The Gentle Vasectomy”. It is a quick, effective and comfortable method. Studies show that no-needle, no-scalpel vasectomies have a complication rate eight times lower than conventional approaches using a scalpel, and involve less discomfort. Healing is quicker than a conventional vasectomy, and there is less intra-operative discomfort during a no-needle, no-scalpel vasectomy. Doing a vasectomy through a tiny central opening, as is the case with a no-needle, no-scalpel vasectomy, versus making a larger cut requiring sutures, is therefore preferable and results in a less complex recovery.

Dr Stearn’s no-needle, no-scalpel vasectomy surgery is covered by Alberta Health Care, except in rare cases where a subsequent vasectomy is needed.

What is different about a No-Needle, No- Scalpel Vasectomy?

The no-needle, no-scalpel vasectomy is different from a conventional vasectomy, in the way that Dr Stearn accesses the tubes, not in the way that he blocks them. In addition, an improved method of local anesthesia, the no-needle method, helps to make the procedure virtually painless. This is achieved by a method called “the no-needle freezing”, whereby the need for a needle entering the scrotum for anesthetic is prevented. A standard anesthetic injection with a syringe can be less comfortable, and offers a higher risk of hematoma from the needle. It is therefore preferable to push the anesthetic through the pores in the scrotal skin with a burst of air. We are the only clinic in Red Deer that currently offers a no-needle anesthesia, in addition to the no-scalpel vasectomy technique.

In a conventional vasectomy, after the scrotum has been numbed with a local anesthetic, the doctor makes two cuts in the skin and lifts each tube out in turn, cutting and blocking them. The doctor then stitches the cuts closed. The third image below (far right) shows the incision and stitches with a conventional vasectomy procedure – different from our no-scalpel technique.

In a No-Scalpel Vasectomy the doctor locates the tubes under the skin and holds them in place with a small clamp. Instead of making two incisions, the doctor makes one tiny puncture with a special instrument. The same instrument is used to gently stretch the opening so the tubes can be reached. This line (in the second image below) accurately represents the actual size of the puncture. (I) Through this tiny opening both tubes are temporarily lifted out and then blocked using heat cauterization.

The first image below on the left shows how the vas tubes are accessed via the small opening. The image in the centre gives you an idea of the actual size of the cut that Dr Stearn will make during your no-scalpel vasectomy. The third image is shown to compare the no-scalpel technique with the cuts made during a conventional vasectomy.

Ensuring sterilization by facial interposition

Dr Stearn also carries out a crucial step, called fascial interposition, to ensure sterilization. This step involves tying the sheath or covering of the vas over one end of the cut tube with a dissolving thread, to create a natural barrier between the two cut ends. This is an additional step to ensure that sperm will not be able to enter your semen after your vasectomy. Not only is the vas tube blocked by heat cauterization – it is also covered with a protective sheath. Dr Stearn carries out fascial interposition using dissolvable thread, so as to not leave any foreign bodies in the scrotum.

The fine tubes are then gently placed back into the scrotum, and the tiny opening heals within days and soon becomes invisible. There is very little bleeding with the no-scalpel technique. No stitches are required to close the tiny opening, which heals quickly, without a scar.

How does a vasectomy prevent pregnancy?

Sperm are made in a man’s testes. The sperm travels through two tubes (right and left vas) in the scrotum during sexual climax, and mixes with semen (from the prostate and seminal vesicles), to come out of the penis. During a vasectomy, these tubes are blocked so that sperm cannot reach the semen. Therefore men who have had a vasectomy ejaculate semen without sperm. A man cannot make his partner pregnant without sperm. Sperm only makes up a minute portion of the ejaculate (1%), and therefore no change in ejaculation post-vasectomy is noticeable. A vasectomy will not in any way affect your sexual experience, erections, performance, or ejaculations. The only change is that the ejaculation no longer contains sperm, which means pregnancy is no longer possible.

Benefits of the No-Needle, No-Scalpel Vasectomy Procedure

  • Convenience (done in office)

  • No incision

  • No needle anesthetic

  • No stitches because no incision gets made

  • Quick procedure

  • Minimal discomfort

  • Fast recovery

  • Effective contraception

Potential Complications and Risks of Vasectomy

There are no life-threatening complications associated with a no-needle, no-scalpel vasectomy. The minor complications that can arise are generally short-lived and resolve with ice, rest, anti-inflammatories, and time. Long term safety with no-needle, no-scalpel vasectomies is considered excellent, although all of the following are possible:

  • Mild discomfort: Some men report a mild aching sensation to the scrotum for a few hours to a few days after the procedure. Our gentle vasectomy ensures a positive outcome with the least amount of pain.

  • Vasovagal reaction: In rare cases men may feel faint for a few minutes after the procedure. While most men can drive themselves home after the procedure, we highly recommend that you come with someone to drive you home after the procedure.

  • Mild bleeding into the scrotum (1/400): This may form a small tender swelling for a few days.

  • Scrotal hematoma (1/1000): A major bleed into the scrotum causing a grapefruit size tender scrotum which may take months to heal.

  • Infection (1/500): This may look like redness and tenderness at the healing site opening or non specific tenderness within the scrotum, which may require oral antibiotics. (More serious infection is possible, which is abscess formation that may require intravenous antibiotics 1/1000).

  • Epididymitis (1/100): Tender swelling of the epididymis, the tube connecting the vas deferens and the testes.

  • Sperm granuloma (1/500): A small, potentially uncomfortable, bead-like structure made of leaked sperm that may develop at the site where the tube was cut and blocked.

  • Post Vasectomy Pain Syndrome (1/1000): A rare complication of a persisting dull ache in the testicle where the inflammation does not settle down. It may resolve on its own or may need another surgical procedure.

  • Failure (less than 1/1000): Because a doctor has inadequately blocked one or both tubes, or because one or both tubes have rejoined.

  • Re-canalization (1/1000): This is a rare outcome for men who develop a channel for sperm to flow after a vasectomy, which may result in failure of the procedure. It may occur during the healing phase (1/1000) or very rarely months to years later (1/many 1000s).

  • Reactive hydrocele (1/10,000): This is a swelling in the scrotum that occurs when fluid collects in the thin sheath surrounding a testicle.