The No-Needle, No-Scalpel Vasectomy (NNNSV) Podcast
Dr. Stormont, let’s talk about vasectomies. Are men still cringing at the word for good reason?
Not at all. Vasectomy is the safest and most effective method of permanent contraception available to men today. It is a quick and simple procedure, and is less invasive and expensive than tubal ligation. For these reasons, every year about 500,000 vasectomies are done in the US. Newer techniques make the procedure even less invasive, where truly no needle, scalpel or stitches are usually necessary.
That doesn’t sound too drastic.
It isn’t at all. Introduced in 1985, the No-Scalpel Vasectomy is currently the most popular and least invasive way to perform a vasectomy. No scalpel or knife is used for this minimally invasive procedure which reduces the incision size, procedure time, pain, bleeding and postoperative complications, compared to a conventional vasectomy. Instead, the physician carefully isolates the vas with his fingers and uses a special instrument to make a 2-3 mm opening in the skin, through which the vas is delivered, cut and sealed to block sperm. A band-aid, but no stitches, are usually all that is needed for the small opening, which heals quickly without any noticeable scarring.
That sounds pretty easy.
It gets even easier. The No-Needle procedure is a unique technique to anesthetize the skin before the opening is made, making the entire procedure virtually painless. A high pressure jet injector sprays anesthesia through the skin with a few puffs of air -- in under a minute, the skin is completely numb without using needles. The vasectomy is then completed using the No Scalpel technique, the entire procedure taking 10-15 minutes. Some of my patients will take a mild sedative before the procedure -- the rest who just have the local anesthetic can drive themselves home.
The procedure is known as the No-Needle, No-Scalpel Vasectomy – or No Needle Vasectomy, for short.
Can anyone have this procedure?
During a consultation, I discuss the procedure in detail, and perform a brief physical examination to determine if a NNNS is right for the patient. He must be sure that he and his significant other feel informed and comfortable with their decision.
And vasectomy is fairly safe, right? And it can be reversed?
A patient needs to understand that although vasectomy can be reversed, it should be considered a permanent procedure, as reversal is expensive and not guaranteed. I explain to my patients that a vasectomy is safe, and there are no long term health risks. Vasectomy only interrupts the tubes that carry sperm from the testes, so urination and sexual functioning is not affected. The only difference is there is slightly less ejaculated fluid, since the semen no longer contains sperm. Just as before the procedure, the body naturally absorbs the unused sperm.
Are there any risks with the no-scalpel vasectomy?
Although an NNNSV is safer than a standard vasectomy, there can rarely still be problems, as with all contraceptive methods. Though infrequent, bleeding and infection are the most common complications. To minimize this, my patients use a bag of frozen vegetables and stay off their feet for 48 hrs after the procedure. I send them home with an antibiotic, and advise them to avoid strenuous activity for a week.
Another potential risk is mild testicle aching, which usually resolves after 1-2 weeks -- in a small percentage of men it can last longer.
Do vasectomies ever NOT work?
Probably the worst potential problem, failure, is another remote risk. Although vasectomy is over 99% effective and superior to the pill, condoms, the rhythm method and tubal ligation, even when performed perfectly it is possible for live sperm to find their way through the occluded vas. Failure of a vasectomy usually occurs in the first few months, and since sperm normally can remain in the vas for weeks or months after a vasectomy, it is important that couples use alternative birth control until 2 sperm samples -- usually taken 6-8 wks after the vas -- show no sperm.
