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No Scalpel Vasectomy Procedure

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Keep in mind that there will be slight variations in no-scalpel vasectomy (NSV) procedures amongst different physicians. The time taken to perform the surgery ranges from 5 - 15 minutes.

When you arrive at the doctor's office or hospital you are taken into the vasectomy procedure room. You lay down on the table, and the surgical assistant cleans the scrotal area with iodine. The assistant then puts an elastic around your penis and clips the elastic to your shirt to expose the scrotum. You are then covered with a surgical drape and the scrotum is brought through an opening.

Freezing

Oral sedative medications are virtually never required. Two techniques are commonly used:

Needle Vasectomy Procedure

The customary technique utilizes a needle to inject a small amount of freezing solution into the scrotal skin, then inject a little more freezing solution alongside each sperm tube. This will cause a momentary dull ache, and after that you should not feel anything.

The No Needle Vasectomy Procedure

The "No Needle Anesthesia" (nna) is a modern technique, accomplished by applying a pressurized jet spray to numb the area through a pen-like device, eliminating the need for a needle. The jet injector delivers a hypospray of Xylocaine under pressure instantly over each vas deferens.
This method has been use since about 2002. It has three main advantages for the patient:

  • It is considered virtually painless.
  • Requires about 1/50th less anesthetic
  • Length of time for anesthetic onset is reduced to 10-20 seconds
    from 60-90 seconds

The no-needle vasectomy (NNV) technique serves to reduce fear and anxiety prior to and during a vasectomy procedure, making it easier and faster for the surgeon.

Blocking of the Vas Tubes

The vasectomy procedure differs among no-scalpel vasectomy doctors with respect to how the the vas tubes are blocked. For example, once the vas tubes have been brought out through the opening in the scrotum, some procedures involve just cutting and tying the ends of the tube. Others cauterize (burn) the ends. Still others affix metal clips to the ends. Combinations of any of these are possible. (different methods described below)

Once the sperm tube (1.) is lifted out of the scrotum, it is cut and both ends are blocked. (2.). A small section of the vas tube also may be removed at this point. If the tubes are cauterized, the cauterization on the ends of the tubes stimulates the formation of a strong scar that blocks the tubes.

Fascial Interposition

Some NSV doctors carry out an additional step (3.), that some studies suggest increases the success of the procedure, called fascial interposition. This step involves bringing the fascial sheath, or covering of the sperm tube, over one end of the cut tube to create a natural barrier between the two cut ends. Fascial interposition can be carried out using titanium clips or with a dissolvable thread.

Open Vasectomy

An open vasectomy is a vasectomy procedure that lets the testicular end of the tube (that is cut) remain open. Some studies suggest that doing so may reduce the risk of post vasectomy pain.

The doctor then gently places the separated and blocked ends back in the scrotum, and the same procedure is done through the same small opening on the other sperm tube. The opening is finally covered with a gauze pad, and you can pull up your athletic support and clothes. The one small skin opening closes itself without stitches within days and heals almost without a trace.

The NSV procedure takes anywhere from 15 to 30 minutes, depending on your anatomy. After having something to drink and relaxing for a few minutes, most men have no trouble driving home on their own, but it is safer to have someone drive you home.

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