The “No Scalpel” Vasectomy
Permanent Birth Control for Men
A vasectomy is a safe, simple, and effective surgical procedure that makes a man sterile (unable to father a child). “No-scalpel” is a special technique for performing a vasectomy that often results in less swelling and pain than the traditional method. Any vasectomy is a serious step to take and should be considered permanent. You and your partner must be absolutely sure that you won’t want children in the future.
How a Vasectomy Works
When you have a vasectomy, the two vas deferens tubes are cut to keep sperm from traveling from the testes to the penis. This is the only change in your reproductive system. The testes still produce sperm, but since the sperm have nowhere to go, they die and are absorbed by you body. Your prostate and seminal vesicles still produce fluids, so your semen doesn’t look or feel any different. Your male hormone level remains the same, so your hair distribution, the pitch of your voice, and your sexual drive don’t change.
Possible Risks and Complications
A no-scalpel vasectomy usually involves less swelling and bleeding than a traditional vasectomy. But a no-scalpel vasectomy still has risks, including bleeding and infection. You may also have any of the following after surgery:
- Minor pain
- Sperm granuloma is a small, harmless lump that may form where the vas deferens is sealed off.
- Sperm buildup (congestion) may cause soreness in the testes. Anti-inflammatory medications can provide relief.
- Epididymitis is inflammation that may cause scrotal aching. This often goes away without treatment. Anti-inflammatory medications can provide relief.
- The vas deferens reconnect in rare cases. This makes you fertile again and can result in an unwanted pregnancy.
- Sperm antibodies are a common response of the body to absorbed sperm. The antibodies can make you sterile, even if you later try to reverse the vasectomy.
- Long-term testicular discomfort may occur after surgery, but is very rare.
The no-scalpel procedure is similar to a traditional vasectomy in many respects, but it’s done without incisions or stitches. This generally results in faster healing.
You will be asked to undress and lie on the exam table. Sterile drapes are placed over you to help prevent infection. You’re given injections of anesthetic into your scrotum to prevent you from feeling pain. Once the aesthetic takes effect, the doctor makes two small punctures in the scrotum with a pointed clamp. The two vas deferens are lifted through the punctures and cut. A section of each vas may be removed. You may feel a pulling sensation during this process. The two cut ends are sealed by heat (cauterized) and may also be tied or clipped. The puncture heals naturally without stitches.
After the Procedure
If you’ve been given medications to help you relax, you’ll need to have someone drive you home. Any discomfort you feel is usually very mild. Ice or a frozen peas package is helpful. If you need it, an over-the-counter pain reliever may help.
When to Call Your Doctor
Call Dr. Lander if you notice any of the following after surgery:
- Increasing pain or swelling in you scrotum
- A large black-and-blue area, or a growing lump
- Fever or chills
- Increasing redness or drainage of the incision
- Trouble urinating
- Until You’re Sterile
After a vasectomy, some sperm remain in your semen. Because sperm are often trapped in the upper part of the vas deferens, it takes a few months (approximately 40 ejaculations) before you’re sterile. A post-operative semen exam can tell you when no sperm are left in your semen. It’s absolutely essential that you continue to use another method of birth control after your vasectomy until Dr. Lander tells you that your sperm count is zero.
Pre-Operative Vasectomy Instructions “The No-Scalpel Method”
Please follow these instructions as indicated. If anything is unclear, feel free to contact our office for further information at
- NO aspirin, aspirin products, or blood thinners are to be taken 7 days prior to your vasectomy. The following is a list of products which contain aspirin or blood thinning properties:
- ALL brands of aspirin
- Alka Seltzer
If you are not sure about medication that you are taking, please consult a pharmacist.
- The night before your vasectomy, cut all the hair at the base of your penis and scrotum as short as possible with scissors, and then shave the area at the base of the penis and the entire scrotum. Please pay particular attention to the upper half of the scrotum and the base of the penis as this is the site of the incision. It is very important that the procedure for the shave is followed properly.
- The day of your appointment for the vasectomy, take a shower. Wash all areas of your body thoroughly.
- Bring a scrotal support, such as a “jock strap”, with you on the day of your vasectomy.
- There are no dietary restrictions either before or after your vasectomy. However, no alcohol should be consumed 8 hours prior to your visit and a light meal rather than a heavy one is preferable before surgery.
- Have someone available to drive you home after your vasectomy.
- In general, your post-vasectomy period should be marked by modified physical activity. Your basic goal is not to increase your intra-abdominal pressure (tighten your stomach muscles). Couch rest with minimal activity for the first 48 hours. DO NOT engage in any strenuous activity, heavy lifting, or athletics for a period of 10 to 14 days. This can aggravate your scrotal condition.
- Place an ice pack on scrotum intermittently (30 minutes on, 60 minutes off) for 24 hours after your arrival home.
- A slight amount of bleeding and swelling is expected.
- After 48 hours, you may shower the incisions. DO NOT tub soak for 5 days. Dab the scrotum gently or use a hair dryer to dry off.
- For the first 7 days, it is suggested you wear a scrotal support or night briefs.
- Moderate scrotal or groin pain can occur up to 4 to 6 weeks after the vasectomy. Advil used as directed will help. If this becomes severe or marked swelling of the testicles occur, return to be checked.
- A small lump may develop on each side at the site of the vasectomy. This is normal.
- One may resume sexual activity after 3 to 4 days. IMPORTANT- you are not sterile. Continue to use your usual form of birth control until your semen has been checked for sperm. In the average male, approximately 40 ejaculations are necessary before the ejaculate is sperm free. It is after this number of ejaculations that your semen should be checked for sperm. IMPORTANT
- Please call or come to the Emergency Room if you experience:
- Fever of 101 degrees or more.
- Excessive bleeding and swelling of the testicles.
- Severe pain not relieved with Extra Strength Tylenol or Advil.
Post-Vasectomy Semen Analysis
- As you will note on your Post-Vasectomy Instruction Sheet, you are not sterile for a given period of time. Please read that paragraph carefully.
- The purpose of this semen analysis is to verify that you no longer have sperm in your ejaculate. The presence of even one sperm in your ejaculate still renders you fertile.
- At the conclusion of your vasectomy, you will be given a laboratory slip titled, “Semen Analysis” after 40 ejaculations.
- The results of your analysis will be mailed or phoned to you when those results are returned to the office by the laboratory.