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The No-Needle Vasectomy

Vasectomy

Vasectomy is an operation performed on a man to cause permanent sterility. It works by blocking the transport of sperm from the testicles. Semen is still ejaculated and appears normal, but it will not contain sperm. Vasectomy does not affect a man’s sex drive or hormones or sexual performance.

Vasectomy is a common operation, performed about 500,000 times annually in the U.S. It is a brief procedure that is performed in a doctor’s office or a clinic. The operation takes about 10 minutes, and you may return to light work the next day, but you will need to avoid strenuous work and sports for one week. You may still be fertile for several weeks after vasectomy. For this reason, you must use temporary birth control until your semen is tested and shows no more sperm.

Vasectomy through the decades has consistently proven to be a safe and effective surgery. Techniques vary among surgeons, depending upon training and experience. Since the 1970s, doctors around the world have contributed to advances in instruments and technique that have made possible less invasive vasectomies.

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No-Scalpel Vasectomy

One such advancement was the No-Scalpel Vasectomy, a refinement, based on an innovative instrument introduced by Dr. Li Shunquiang in China, called the sharp dissecting forceps. This innovation eliminated the scalpel. At The Vasectomy Clinic, Dr. Wilson has used the no-scalpel technique since 1989 in over 20,000 vasectomies.

No-Needle No-Scalpel Vasectomy

Eliminating the scalpel was a welcome advance, but many patients still felt anxious about the needle. In 1999 Dr. Wilson first succeeded in eliminating the needle entirely from vasectomy. He called this the no-needle no-scalpel vasectomy (NNNSV), or simply No-Needle Vasectomy (NNV).

In No-Needle Vasectomy, Dr. Wilson uses a “hypospray” injector to instantly deliver a tiny stream of lidocaine solution through the skin and into the vas deferens. There is no needle or syringe. The skin and vas are instantly numb. A second hypospray injection numbs the other vas.

Just one hypospray on each vas is faster and more effective than lidocaine delivered by needle injection. Patients typically describe the sensation as a mild snap, like a rubber band against the skin. So while it is not entirely painless, the hypospray has been widely preferred over a needle among over 16,000 NNV patients at The Vasectomy Clinic. In addition to improving patient comfort and relieving anxiety, it also avoids needle damage to blood vessels in the area.

The result of this continued development and refinement of vasectomy technique has been improved comfort, quick healing, and rare complications for our patients. There are now many doctors in the U.S., Canada, and other countries who have incorporated these advanced techniques to improve vasectomy outcomes for their patients.

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The Detailed Surgical Procedure

NOTE: Some men do not care to know all the details of the surgical procedure; you may skip over this section. Others want to know more after reading this summary. We would like to provide you with all the information you need. Please feel free to call us for more information.

After completing the consultation and the necessary paperwork, we will make you comfortable, reclining on an exam table. Your partner may sit beside you. The doctor will examine your genital area and ensure that preparation is adequate. He will cleanse the scrotum with a warm antiseptic solution. He will keep you informed and help you relax during the five to ten minute procedure.

The doctor gently locates each vas deferens and administers local anesthetic with one snap of the hypospray over each vas, which numbs the central skin site and both vasa. The left vas deferens is then held just under the skin on the front of the scrotum while a small puncture opening about 1/8 inch long is made in the skin to expose the vas. The vas is separated from the sheath of surrounding tissues and brought out through the opening. It is then cut and sealed using electrocautery, a small electric current that heats the lining of the vas.

The sealing effect of cautery is temporary, but it stimulates formation of a strong scar that blocks the vas. This method has proven to have a high success rate. The two ends of the vas are then separated by a half-inch, and a layer of sheath tissue is closed with an absorbable suture, forming a barrier between them. This barrier helps to ensure that when healing is taking place, the ends of the vas will not reunite, allowing sperm to cross. The left vas is then put back in place, and the right vas is located and held where it can be reached through the same central opening. The right vas is cut and sealed, and the sheath sutured, just like on the left. The right vas is then put back into place.

No stitches are needed. The small skin opening will seal closed by itself. Your briefs will hold the gauze dressing in place overnight. After a few minutes you may get dressed and leave.

You are to go directly home to rest until the next day. You will be given written instructions for your care after vasectomy (pdf.)

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More About Anesthesia Using the Hypospray Jet Injector

The hypospray, or jet injector, Dr. Wilson uses for NNV is the MadaJet. The late Ralph Adam, M.D., founder of Mada Medical, Inc., invented the MadaJet and introduced it in the 1970’s. It has most commonly been used for dental anesthesia. It is one of several designs of needle-free jet injectors used in place of a needle and syringe for administration of medications, vaccines, and local anesthetics.

Gas powered jet injectors have been used since the 1940’s for immunizing military personnel and school children. The MadaJet utilizes a spring-loaded piston, which generates about 2000 psi in the fluid chamber. The lidocaine fluid is emitted through an orifice of about .006 inches, then through an air space, forming the tiny stream that penetrates the skin. Entering the superficial tissues, the lidocaine disperses evenly and instantly within about a dime-size area to block all the nerve receptors to a depth of about ¼ inch, with great efficiency. Each vas, in turn, must be held accurately in position for the hypospray.

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