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Vasectomy is the name given to the surgical operation to provide long term contraception for men. A vasectomy and is the most efficient form of permanent male contraception currently available.
In a vasectomy, the tubes carrying sperm (vas deferens) from the testicles are interrupted. This prevents sperm from mixing with the semen fluid, making the man sterile.
The production of the male hormone testosterone by the testes is completely unaffected as it all continues to go directly into the bloodstream, hence sex drive and libido are unaltered.
WHAT DO YOU NEED TO KNOW ABOUT SCALPEL-FREE VASECTOMY?
Vasectomy is a surgical procedure that cuts the vas deferens, preventing sperm from reaching the urethra rendering a man infertile.
In New Zealand, two techniques are used – a traditional surgical method and a “no-scalpel” version. It is generally accepted that both are equally effective but that the no-scalpel method is increasingly popular due to greater patient comfort during and after the procedure.
Vasectomy is regarded as a simple, safe, and effective form of male sterilization and is intended to be permanent (although a vasectomy reversal procedure is available).
It is estimated that vasectomy is at least 99% effective in preventing pregnancy. Vasectomy can fail if a canal develops between the two ends of the vas deferens through which the sperm can travel (recanalisation). This occurs in less than 1% of cases.
Both vasectomy techniques are performed in either a doctor’s surgery or a day-stay clinic and take approximately 30–45 minutes.
Some insurance providers will cover Vasectomy.
The Answers You Need
WHAT IS A NO-SCALPEL VASECTOMY?
The No-Scalpel Vasectomy is the latest minimally invasive technique of performing a vasectomy. By avoiding larger surgical incisions the procedure can be completed faster and more efficiently and complications such as pain, bleeding and infections are significantly reduced.
HOW DOES THE NO-SCALPEL VASECTOMY DIFFER FROM THE TRADITIONAL VASECTOMY?
The main difference between no-scalpel and conventional vasectomies is how the surgeon accesses the vas deferens.
With conventional surgery, an incision is made on each side of the scrotum to reach the vas deferens.
With a no-scalpel vasectomy, the vas deferens are held with a clamp from outside the scrotum and a Li instrument is used to make a small hole in the scrotum for access to the ducts.
A 2014 review notes the benefits of a no-scalpel vasectomy include almost 5 times fewer infections, hematomas (blood clots that cause swelling under the skin), and other problems.
It can also be done more quickly than a conventional vasectomy and requires no sutures to close up incisions. A no-scalpel vasectomy also means less pain and bleeding.
WHAT DOES THE NO-SCALPEL VASECTOMY PROCEDURE INVOLVE?
A No-Scalpel Vasectomy is a short outpatient procedure. You can expect to be in the clinic for around 1 hr from arrival to heading home to relax after the procedure.
During a no-scalpel vasectomy, the doctor locates the vas deferens by feeling them beneath the skin of the scrotum. Using a special 'no sting' local anaesthetic injected into the skin in front of the scrotum the vas is held in place by a precision clamp.
A single small puncture is then made through the numbed skin, using a special surgical instrument. The same surgical instrument holds the puncture hole open while a loop of one vas deferens is lifted out and a section of 1–2 cm is removed.
The cut ends are then folded over and sealed before being returned to the scrotum through the puncture hole.
The other vas deferens is brought out through the same puncture hole and the procedure is repeated.
After the procedure, the puncture wound contracts to about 2mm in length, is not visible to the man and does not require stitches or a dressing.
You will then be sent home with some simple pain relief and advised to take it easy over the next few days before resuming normal activities.
DO I NEED TO ARRANGE FOLLOW UP AFTER NO-SCALPEL VASECTOMY?
Generally, there is no follow up within the clinic following surgery. There are no sutures to remove and follow up can be performed over the phone with the nurse.
Following the procedure, you will need to perform a sperm count at 3 months to confirm you are infertile. There can be sperm in the ejaculated fluid for many months after the operation (rarely up to 18 months). You must continue to use contraception until postoperative sperm tests have been carried out and you have at least 1 satisfactory sperm test showing no more live (motile) sperm. You will be given further information about this after the operation before you go home.
ARE THERE ANY POSSIBLE COMPLICATIONS FROM NO-SCALPEL VASECTOMY?
Pain: can occur as a result of injecting local anaesthetic – this is more likely on the face or about the eyelids. This settles without any lasting problems within a week or so.
Bleeding: the treated area once healed may be slightly pink or even red for several months – this usually resolves over a period of 4-6 months.
Infection: is an uncommon complication of this surgical method. It is more likely to occur in the deeper wounds associated with wart removal rather than the site of a skin tag or mole removal. Increasing pain, heat, redness and smelly discharge are signs of infection. If you think an infection is developing please call us and we will arrange an urgent follow-up appointment.
Scarring: is usually not associated with the removal of moles or skin tags, although infection can result in scarring. Scar tissue can form when warts are removed.
Delayed healing: This is a very rare complication that can occur and is usually on the lower leg or anterior chest.
Pigmentation: Again very rarely the removal of the surface of a mole can stimulate the production of pigment. The site of the raised mole heals flat as expected but brown or black pigment can form under the skin for about 3 to 5 months after the surgery. It is often best to leave the pigment as removing it requires breaking the skin surface and therefore a small scar would form.
Regrowth: Occasionally a skin tag, mole or “barnacle” will re-grow. This usually occurs within a year or so of removing the lesion.
Incomplete removal: Occasionally a lesion is incompletely removed. This can occur because a small fragment of the lesion remains and cannot be seen at the time of surgery and is not obvious until the lesion has healed. A brief follow up procedure will remove the remaining lesion. The cost for a follow-up procedure is approximately $50.