We perform the no scalpel vasectomy with local anesthesia, much like the dentist uses to fill a cavity. The anesthetic is pressure-injected through the skin and the vas, not the testicle as many people incorrectly think. No needles are use to anesthetize the area and the medicine works immediately. This is a new improvement over the traditional syringe and needle injection technique. Below is a photograph of the “No Needle” pressure injector.
After the procedure it is best to go home and rest for 24 hours, off of your feet. An ice pack or bag of “frozen peas” should be used intermittently 20 minutes on, 20 minutes off) for 24-48 hours. This will minimize any pain, swelling or bleeding.
We recommend no heavy lifting and no ejaculation for a week after the vasectomy. You should be able to resume all normal activity after this point. Doing too much activity too soon could result in a longer recovery time or a complication.
While it is OK to shower the day after the vasectomy, bathing, swimming or surfing should be avoided for at least one week to make sure the tiny skin perforations are sealed completely. Most importantly, you should not play golf the day after the vasectomy, despite what your friends tell you!
Recovery Follow Up
It is very important to follow up after the vasectomy. The reason for follow up is that you are not sterile immediately after the procedure. Sperm live in the reproductive tract upstream from where the vasectomy is performed and it can take from six weeks to three months for these sperm to be flushed out of the system or die off.
We recommend that you have a minimum of two semen analyses starting around six weeks after the vasectomy or after 20 ejaculations. You must have two consecutive semen analyses that show no sperm in order to be considered sterile, and you must use some form of birth control until that time.
An option to consider prior to having your vasectomy is sperm banking. Some men choose to have their sperm frozen and stored just in case they change their mind and want more children in the future. Having frozen sperm would mean that they would not necessarily need a vasectomy reversal or have to do in-vitro fertilization, both of which can be costly.
Sperm can be stored indefinitely and used at any time with an artificial insemination procedure. We recommend that our patients store their sperm at The California Cryobank, the world’s largest and most reputable sperm bank. We will help make all the arrangements for you should you choose this option.
Risks and Complications
As with any surgical procedure, a vasectomy carries with it the potential for risks and complications. You need to be aware of these to help you consider the choice you are about to make.
Any time a surgeon makes a cut or poke anywhere on the body, there exists the possibility for pain, bleeding, swelling or infection. The complications specific to vasectomy include:
- Failure of the procedure,
- Sperm granuloma formation,
- Injury to the blood supply of the testicle resulting in the testicle getting smaller (atrophy) and
- Chronic testicular or epididymal pain (post vasectomy pain syndrome).
Fortunately these complications are rare when we perform the no-scalpel vasectomy using our technique. While the reported complication rates for vasectomy vary between 5%-10%, our complication rate has been much lower, under 1%.
In the last 1000 vasectomies that Dr. Werthman has performed, the complications were as follows:
Failure of procedure: 1
Sperm granuloma requiring treatment: 1
Hematoma (bleeding): 2
Chronic pain: 1
Testicular injury/atrophy: 0
Total complications: 7/1000 or 0.7%