What is no-scalpel vasectomy?
No-scalpel vasectomy is a way of performing the vasectomy operation by using special forceps, which avoids cutting with a scalpel. Thus, this operation can be performed more quickly and with much less discomfort for the patient.
The no-scalpel vasectomy was invented by Dr. Li Shunqiang in 1974 in China, at a time when only one child per family was allowed, with the aim of achieving a definitive contraceptive method with simpler instruments and allowing patients to return to their usual work the same day of the intervention. This also succeeded in reducing men’s fear of the operation, and since then more than 15 million Chinese have undergone vasectomy with the no-scalpel technique. This technique was introduced in the West by Marc Goldstein (USA) in 1984, and in our country by Dr Villadoms in 1994. At present, this technique of no-scalpel vasectomy is considered the best available.
What does the technique consist of?
The conventional vasectomy technique consists of making two cuts with a scalpel in the skin (one in each testicle), to extract, cut and/or tie each of the vas deferens, through which the sperm leave the testicle.
It is a simple and effective procedure, but most of the complications (bleeding, hemorrhage, hematoma and infection) are caused by the scalpel incision.
The no-scalpel vasectomy technique does not require any cutting, and therefore no scalpel is used. Specially designed forceps are used to separate the skin and externalize the vas deferens in a much less traumatic way.
A more recent advance is the so-called no-scalpel, needle-free vasectomy, which avoids the initial uncomfortable prick to apply the local anesthetic. By means of a device, called MadaJet, the anesthetic spray is applied to the skin and the vas deferens, making the vasectomy painless.
Are there any risks?
Any surgical procedure can have risks. In the case of vasectomy, the most frequent risks are bleeding (hematoma), testicular pain or infection. What has been demonstrated is that these risks of complication are much lower with the no-scalpel vasectomy technique than with the conventional technique.
In fact, the WHO recommends the following in this regard:
“Compared to the traditional incisional method, no-scalpel vasectomy resulted in less bleeding, hematoma and pain during or after the procedure. The surgical procedure is shorter and men who undergo vasectomy can resume sexual activity more quickly. The no-scalpel technique is currently used in more than 40 countries.”
Is it reversible?
Vasectomy is a permanent method of contraception, but it can be reversible most of the time through a microsurgical operation called vaso-vasostomy. However, this reversal is a much more expensive and delicate operation than vasectomy, and if many years have passed since the vasectomy, it is likely that it is not possible to have a sufficient number of sperm in the semen to achieve a natural pregnancy, which would make it necessary to use assisted reproductive techniques (in vitro fertilization).
That is why we do not recommend having a vasectomy if there are doubts about having more children.
Does vasectomy change sexuality?
Vasectomy does not affect testicular hormone production, only sperm production.
Sexual desire and potency, sensations during intercourse, orgasm and ejaculation do not change.
Nor does it affect the voice, muscle mass or beard.
In fact, many couples tell us that the fact of losing the fear of an unwanted pregnancy, and stop using other contraceptive methods, greatly improves their sex life.
Is the patient sterile after the procedure?
The contraceptive effect of vasectomy is not immediate. It is necessary to wait for 20 to 30 ejaculations to empty all the sperm that were accumulated in the seminal tract. At least one semen analysis (spermiogram or seminogram) indicating azoospermia (total absence of spermatozoa in the semen) should always be done after these ejaculations, in order to be able to stop using other contraceptive methods safely.
When can you resume sexual intercourse?
It is advisable to avoid intense physical activity for the first 48 hours. After that, sexual intercourse can be resumed as soon as no discomfort is noticed, although most usually wait about a week. It should be remembered to take contraceptive measures until the semen analysis indicates that there are no sperm left.