Dr. Wayland Hsiao
When the Urology Department of Emory Healthcare started offering no-scalpel, no-needle vasectomies as part of their men’s health treatment options, our ears perked up. Obviously, as the name implies, this type of vasectomy procedure allows doctors to forego the scalpel and needle combination used in traditional vasectomies, but what is used in their place? And what are the benefits? To get our questions answered, we went straight to the source, Emory’s own Dr. Wayland Hsiao, who is one of the surgeons performing the procedure. Our questions for Dr. Hsiao (and his answers) are below:
What exactly does it mean when we say no-scalpel, no-needle vasectomy? Can you describe the procedure?
A vasectomy is a procedure in which when the outflow of sperm through the vas deferens is interrupted to stop the outflow of sperm. It is a permanent form of male contraception. The procedure has no effect on sexual function. The no-scalpel vasectomy is a technique that allows us to perform the vasectomy through a puncture. The puncture is made in the scrotum and requires no suturing or stitches.
When compared to the conventional vasectomy, the primary difference is that the vas deferens tissues and blood vessels are spread aside from the surgical site rather than cut with a knife. This is less traumatic, and results in less pain and fewer postoperative complications. To numb the patient before the vasectomy, a Madajet injector is used. This is a tool that facilitates a highly pressurized lidocaine (anesthetic) to be sprayed on and through the scrotal skin to numb the skin and the underlying vas deferens. No needle is used in this anesthetic technique.
So, in terms of how the procedure is performed, what are the biggest differences?
We are able to replace the traditional scalpel with a specially design sharp clamp, which alleviates the need for an incision. The traditional incision is replaced by a small puncture hole which seals itself after the procedure. We also replace the needle with an anesthetic spray (diffused via the Madajet injector) that is applied to the scrotal skin and the vas deferens itself.
What are the benefits to no-scalpel, no-needle vasectomy?
Good question. There are several. With the no-scalpel vasectomy, there is less bleeding. In fact, the bleeding rate decreases from being seen in about 3% of patients down to 0.3%. In other words, there is 10 times lesser chance of bleeding. The infection rate after vasectomy is also decreased with the no-scalpel, no-needle technique. Infection is seen in 1.4% of patients with a traditional approach, while we only see infections inabout 0.1% of men undergoing the no-scalpel technique.
The bladeless vasectomy procedure is also faster, because the need for suturing is eliminated because there is no incision. The hole or puncture (2-3mm) created from the procedure will close up on its own.
Are there any risks associated with this procedure? If so, what are they?
The no-scalpel, no-needle vasectomy doesn’t come with any additional risks that we don’t already see with the standard vasectomy procedure, which include the risk of hematoma (with no-scalpel, this risk is significantly lowered to less than 0.5 %) and infection. As is true with all vasectomy procedures, the procedure is not guaranteed to be 100% effective. The general post-vasectomy failure rate is less than 0.5 % (1 in 500 short term failure; 1 in 4500 long term failure).
How long does the no-scalpel, no-needle vasectomy take?
The procedure takes about 30 minutes.
What can patients expect after the no-scalpel, no-needle vasectomy?
Patients can expect to experience swelling of scrotom for 2-3 days and bruising for up to a week. They might also experience a feeling of heaviness or dragging testes for 2-3 weeks.
How long is the recovery? How soon can I have sex post-procedure?
To achieve full recovery, patients should wait approximately 2 weeks after the procedure before participating in intercourse, but men should consult with their physician for guidance here.