The No-scalpel Vasectomy (NSV) was originally developed in China in 1974 by Dr. Li Shunqiang. Two specialized surgical instruments, a pointed hemostat and a ring clamp, replace the scalpel. NSV, as compared to the traditional incisional technique, results in less bleeding, less hematomas, less infections, less pain, and a shorter operative time.
The most common practice is local anesthesia applied with either a very fine needle or a high powered spray applicator. Neither are painful – A spray applicator feels like a rubber band snap at worst and the needles are so tiny you can barely feel them at all – and both work. Some men ask for general anesthesia. While certainly that one’s right, and perhaps even suitable for the most anxious of men, it’s not needed nor recommended.
A vasectomy should be carefully considered by any man – or where appropriate, any woman – whose family is complete – be it someone with many children or someone certain he doesn’t want any children at all. Although a reversal is theoretically possible, (see below), you should consider vasectomy a permanent form of contraception.
The no-scalpel vasectomy can be over 99% effective, making it one of the most effective options available for both men and women. That said, the patient must continue using birth control until he has been formally cleared by a doctor that there is no sperm left in his semen. This normally takes approximately 3 months and/or up to 30 ejaculations.
This varies from country to country depending on medical licensing rules and regulations. In some places, only urologists are permitted to do a vasectomy. In most countries, any physician is eligible as long as he or she has been trained. In some countries, due to a shortage of doctors, nurse practitioners can become vasectomy providers. Practice might not make perfect, but it’s very likely to make you better, so the more vasectomies a provider has done, the better he or she is likely to be.
A vasectomy only blocks the sperm from entering the seminal stream. Sperm makes up less than 5% of an ejaculation (the rest is semen), so there will be no noticeable difference in volume. After a vasectomy there should not be any sperm when you ejaulate and therefore no fear of pregnancy.
Sperm gets reabsorbed in the body.
There is no decrease in desire, difficulty maintaining an erection or problems with orgasm according to a large Australian study published in the Journal of Sexual Medicine in 2010. In fact, vasectomized men are statistically more likely to see an increase in sexual satisfaction. This is probably due to eliminating anxiety caused by the fear of an unintended pregnancy
Although it is an extremely reliable and safe option, there are always risks involved with any medical procedure. This might include ‘regret’ if your family dynamics change, emotional stress and bleeding. For a complete list of possible effects, click here.
A little swelling and bruising at the incision area is to be expected. A pain reliever, such as aspirin, Advil or Tylenol can help with any short-term pain or discomfort. But if you experience an increase in pain or swelling, or develop a fever—indications of possible infection—see your doctor. On rare occasions, ongoing discomfort in the scrotum is experienced, but normally disappears over weeks or months.
Choosing the provider that is right for you is very important so take the time to do all necessary research.
According to the American Urological Association, between 1-2% of men suffer lasting pain associated with their vasectomy. We recognize that while your pain is not a statistical anomaly and as such is both very real and very unfortunate, do keep in mind that a decision not to get a vasectomy doesn’t eliminate suffering associated with birth control, it just puts all of the burden on women. If you are one of the unfortunate few who suffers lasting pain, be sure to reach out to your provider immediately.
A vasectomy can, in theory, be reversed with a vasovasostomy or vasoepididymostomy. How successful the procedure is depends on several factors—in particular, the length of time since the vasectomy was done (the longer the interval, the more difficult the procedure is, possibly due to scarring that increases over time). A reversal may also be done to treat chronic vasectomy-related scrotal pain.
Because the procedure is more complex than a vasectomy, it’s best done by a provider (this is usually a urologist) who specializes in microsurgery. It can take anywhere from 3 to 12 months for sperm to reappear in semen. Sperm can also be surgically harvested during a reversal and used for in vitro fertilization.
Keep in mind that a reversal is a much more expensive and lengthy procedure and is not guaranteed to succeed. For that reason, we strongly advise you to consider a vasectomy as a permanent form of family planning. That said, we believe that reversals should be available in every country. If there is any doubt in your mind or any part of you concerned that in the future you’ll want to be able to directly impregnate a woman, you should consider freezing your sperm.
Well, for one, tubals are more painful, more invasive and the recuperation time much longer. And worse, while a failed vasectomy (exceedingly rare) ends up in a normal pregnancy, a failed tubal ligation can result in an ectopic pregnancy, one of the leading causes of maternal mortality.
There are about 50 million men who have received a vasectomy worldwide and 500,000 yearly in the US, making it the nation’s second most common procedure performed on males (after circumcision). There are very few countries where more vasectomies are done than tubal ligations.
Sterilization protects approximately 222 million women and men of reproductive age from unintended pregnancies. 180 million women have elected tubal ligation while nearly 43 million men have chosen vasectomy to safely limit family size. In some countries the disparity is over 100 times more tubals than vasectomies.
A 2014 study indicated a correlation between the two but many other studies, before and since, indicate the opposite, including this 2016 study published in the Journal of Clinical Oncology. https://www.asco.org/about-asco/press-center/news-releases/large-study-finds-no-link-between-vasectomy-and-prostate</a>
If you’re sexually active and not in a long-term monogamous relationship, you still have to protect yourself and your partner. After the vasectomy you can transmit or acquire an STI or an STD when having unprotected sex. If you or your sexual partner has an STI or an STD or even if you’re not sure of the status of your partner, you should definitely use a condom and visit a doctor immediately.
Sadly, for now, there’s not much choice out there. There’s abstinence which is a very hard sell. There’s withdrawal and rhythm which is not reliable. Next, there are condoms, which are critical for young men, but mostly valued for safe sex purposes. Indeed, 18 of 100 men who use condoms as their primary form of birth control get a woman pregnant within a year. And then there is vasectomy. Clearly, we are desperately in need of alternatives for which World Vasectomy Day enthusiastically supports research and development. To learn more to visit the Male Contraceptive Initiative.
You may still have viable sperm in your system for several weeks and even months after the procedure. To avoid unintended pregnancy, use an alternative birth control method until a semen analysis confirms no detectable motile sperm.
There are many excellent sites and many qualified providers. We recommend visiting the websites of World Vasectomy Day’s co founder, Dr. Doug Stein, http://www.vasweb.com/vasectomy.html or of Dr. Charles Monteith at https://www.bestvasectomy.com If you prefer French, then visit Dr. Michel Labrecque’s site, http://vasectomie.net/la-vasectomie/quest-ce-que-la-vasectomie/</a.
If you’re committed to further research (and/or perhaps you have interest in doing vasectomies yourself) check out the American Urological Association’s (AUA) https://www.auanet.org/education/guidelines/vasectomy.cfm”>guidelines</a>.
Banking sperm is a relatively easy process, but not necessarily available or affordable to everyone nor everywhere. To get more specific information, look on line or visit Dr. Stein’s website https://www.vasweb.com/spermbanking.html.
The science and research regarding fertility is constantly being upgraded so you must do your research if you are committed to get pregnant after a vasectomy. Here are two website you might visit: improvinghttps://myfertilitycenter.com/vasectomy-reversal-alternatives-pesa/. and https://www.vasectomy.com/article/vasectomy-reversal/alternatives/alternative-reproduction-techniques