No Scalpel Vasectomy. Not Kidding.

So, how does this sound?  You are on your lunch hour- you have 30 minutes to kill……and you’ve got 3 kids at home in your two-bedroom apartment that are bouncing off the walls.  You really don’t want to go back to using condoms and your wife has been on birth control pills for many years……. perhaps it’s time for a Vasectomy!

Vasectomy procedures are becoming increasingly popular in our practice with men living the lifestyle above.  Of course there are other reasons men are undergoing “male contraception” as well…..men with partners who have medical issues that preclude various forms of female contraception, men who simply cannot imagine themselves as fathers – ever, and men who have decided, after their wives have experienced “the joys of pregnancy and childbirth” one or more times, that it is their turn to share in the next phase of their reproductive responsibilities.    

In my 30 year experience as a urologist, I am quite sure we are performing more vasectomies in the office now than ever before.   To be fair, I don’t want to make it sound too easy.  New York State has a “mandatory 30 day reconsideration period” so it is necessary to first schedule a consultation with your Urologist, and have the procedure, post-procedure expectations, risks, benefits, and an appropriate physical examination performed.  An “official” NYS Vasectomy Consent form is reviewed and signed, and then there is a 30 day wait until the procedure can be performed.  So a package of condoms or two may still be necessary.

I have been doing the “No-Scalpel Vasectomy” since it was first brought to this country by “our friends” in mainland China (I guess you can say this is one technology we stole from them).  It was developed there to facilitate their “one-child policy” in the 1980’s. The procedure was taught to and practiced by “farmer surgeons” who set up mass sterilization clinics in villages throughout the heartland of China. 

Needless to say, the technique has been improved upon in the US –and to my knowledge, I don’t believe it is being performed by any farmers here.  To their credit though, the procedure is simple, straightforward, with instruments specifically developed for this procedure that allow for a single midline scrotal opening enabling both vasa to be individually localized, divided and tied off and/or cauterized.  The local anesthesia used for the procedure gives 100% analgesia – no pain during the procedure, and that’s a promise. The anesthetic lasts 2-3 hours – more than enough time to get yourself home to a couch to binge-watch Netflix w/ a bag of frozen peas wrapped around your scrotum (I recommend “Babylon Berlin”).

The success rate is nearly 100% - better than any other form of birth control – with minimal complications.  In my experience, it is almost unheard of for a patient to contact me after the procedure with any complaints of pain or discomfort.   Having said that, the first few days after this procedure is not a walk in the park……they are uncomfortable, because, as I emphasize to all my patients, I operated on their BALLS!!!  It is a sensitive area, duh. But by the time I see them on their two-week follow-up visit, they are always doing perfectly fine. 

Some final points – it is necessary to continue using contraception after the procedure is performed for 2-3 months, to allow the residual sperm stored in the upper vas deferens and seminal vesicles to be ejaculated out of the body – at least 30 times.  (It is a tough job but somebody has to do it.)  A post-procedure semen analysis will be scheduled after 2-3 months and once that returns with a  “no sperm seen” grade, you are “free to move about the cabin”.  Finally, yes – the procedure can be reversed…but if you have to ask about that, you should probably stick with condoms.  It’s a lot easier and much less expensive.