A No-Scalpel Vasectomy is a safe and effective minor surgical procedure which can be easily performed under local anaesthetic. It is the most reliable method of long term contraception available. It can be provided in the convenience of the surgery and most men can return to normal activities within a few days. The benefit of No-Scalpel Vasectomy over conventional vasectomy is reduced discomfort, far less bruising and bleeding and a shorter recovery time after your vasectomy.
Vasectomy Kerry is the only provider of the No Scalpel technique in Kerry. This technique carries far less complications than traditional vasectomy and avoids the risk of general anaesthetic in hospital vasectomies. The procedure itself takes about 20 minutes to perform.
The Vas Deferens is the tube which carries sperm from your testes to mix with semen. In a No-Scalpel vasectomy this tube is divided and sealed thus preventing sperm from entering the semen. The opening needed to access the Vas Deferens is made on the under surface of the scrotum. It is normally very small (2-3mm) and on most occasions does not even need stitches to seal the wound. It normally heals within 24-36 hours. It is important to note that division of the Vas Deferens does not affect the ejaculate other than removing it of sperm. There will be no difference to sexual function or a difference from the enjoyment of intercourse.
After your vasectomy it is important to continue to use alternative contraception for up to 24 weeks. Vasectomy is usually 99.9% effective at 20 weeks after the procedure.
Traditional Vasectomy V’s No Scalpel Vaectomy
The most recent recommendations from the American Urology Association now recommend that only a minimally invasive procedure such as a no-scalpel vasectomy be used to do a vasectomy.
The main difference is in the method used to access the tubes which carry sperm.
Traditional vasectomies: 2 incisions are made on each side of the scrotum. Traditional vasectomies carry a higher risk of bleeding and stitches are often required to close the cuts and control bleeding.
No Scalpel Vasectomy: This is essentially keyhole surgery for vasectomies. A single small opening is required to access the tubes. This opening does not require any stitches to heal. No Scalpel vasectomies carry ten times less risk than traditional vasectomies.
Both methods are equally as effective for contraception but No Scalpel Vasectomies carry a much lower risk of side effects. Performing a No-Scalpel vasectomy is technically more difficult for the doctor which is why some doctors will only do a traditional vasectomy. A No-Scalpel method is minimally invasive and as such it is recommended as the gold standard by the American Urology Association.
What should you expect from a no-needle no-scalpel vasectomy:
- Gentle anaesthesia, almost painless.
- No stitches.
- Quicker recovery time than a traditional vasectomy.
- More comfortable procedure.
- Return to work the next day (some men go back to work on the same day).
- Return to sports/more strenuous activities within 3 – 5 days normally.
Initial Consultation
Prior to your vasectomy Dr Moloney will invite you to an initial consultation. The procedure will be discussed in full and any questions which you may have will be addressed. Dr Moloney will also carry out an examination to ensure that a vasectomy is the best choice for you. It is recommended that this consultation be undertaken on a separate day to your procedure so as to allow appropriate time to consider all the information. Your partner is also welcome to attend this appointment. Dr Moloney will examine you to help determine your suitability for vasectomy.
Before your vasectomy
- It is necessary to shave the hair off the scrotum and the base of the penis. This is best performed 2 days prior to the procedure. Shaving is best done with a disposable razor to remove the bulk of the hair and a scissors to trim off the remainder. It may not be possible to proceed with the procedure on the day if this is not adequately performed in advance of the procedure. It reduces the risk of infection occurring.
- Do not use and powder or deodorant in the genital area on the day of the vasectomy.
- Do not use aspirin, soluble disprin or anti-inflammatories on the week previous to the vasectomy as this may increase your tendency to bleed.
- Eat as normal on the morning of your vasectomy.
- Shower as normal on the morning of the procedure.
- We suggest wearing good supportive underwear on the day of the procedure and for the next week after in order to give scrotal support.
What to expect after your vasectomy
- Rest at home for 24 hours after your procedure.
- In the first 48 hours some mild discomfort can be expected which can easily be managed with supportive underwear and over the counter painkillers such as Paracetamol and Ibuprofen.
- While the majority of patients can return to work the day after the procedure. The exception may be where you have a position that involved a high level of physical activity. In this circumstance you may be advised not to return to work for up to 72 hours post your vasectomy.
- Bruising on the scrotum is quite normal in the days following your vasectomy and this will gradually reduce over a period of a week.
- Non-contact sports can be resumed a week after your vasectomy. Contact sports may be resumed two weeks after the procedure.
- Sexual activity may be resumed usually 48 to 72 hours after your vasectomy. Some blood may be noted in the ejaculate but this is nothing to be worried about and normally resolves quickly. It is essential to continue to use other forms of contraception until you have two clear semen samples.
Semen Analysis
It is essential that you comply with semen analysis testing following your vasectomy. This is to guarantee that there are no moving sperm in your semen prior to resuming intercourse without contraceptive cover. At Vasectomy Kerry we will explain the manner by which you should provide these samples and also provide you with the appropriate containers and postage envelopes before you head home after your vasectomy. Currently two clear semen specimens are required prior to confirming the efficacy of your vasectomy. These samples are collected at 20 and 24 weeks after your procedure. These samples should be posted to the laboratory and we provide special transport envelopes pre-stamped for your convenience. It is important to continue using contraception until we have informed you of the results of this test.
Potential Side Effects
All methods of contraception carry side effects. No Scalpel Vasectomy is still the safest and most effective means of long term contraception. It is important to know that there are no hormonal side effects after a vasectomy. It will not affect your sex drive and is not linked with testicular or prostate cancer.
Haematoma (bruising) may occur. The risk of a small haematoma is about 1 in every 100 cases. The risk of a larger haematoma which may require some ice and mild pain relief is 4 in 1000.
Infection is a rare side effect following a vasectomy but will respond to antibiotic therapy if it occurs.
Sperm granuloma is a pea-sized lump that can be a little tender that can appear several months after the procedure. It usually does not cause any problems.
Post-Vasectomy Pain Syndrome (PVPS) is a rare (<1%) complication of vasectomies where pain persists beyond 6 months after their vasectomy. The incidence of this is <1% of vasectomies. This is generally treated with anti-inflammatories such as nurofen and simple pain-killers.
Recanalisation is where the vas deferens manages to "grow back" and reverse the vasectomy making a man potentially fertile again. This can occur in the initial months in 1 in 300 vasectomies. In the rare event of this occurring it will be identified by the semen analysis you carry out after your vasectomy. Your vasectomy is considered effective only once it has been demonstrated by semen analysis that you have no moving sperm in your semen. Recanalisation may occur later than this time in 1 in 4000 vasectomies.
Vasectomy remains the most reliable and extremely safe form of contraception.