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 used 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
During a vasectomy the vas deferens must be isolated from the muscular sheath surrounding them, nerves must be gently set aside and only then can the tubes be properly severed. Laser energy is not at this time controllable to the fine degree necessary to perform this delicate task. Only a skilled surgeon using specially developed instruments can clear away tissue, nerves and tiny blood vessels from the sperm tubes so that the vasectomy can effectively be done.
A laser can be used to create the incision required to expose the vas deferens and can be used to sever the tubes, but since the tubes must be exposed in some manner a laser vasectomy does not differ from a traditional vasectomy other than in the instrument used to make the incision. In practical terms, using laser technology is expensive and not as effective as the specially designed instruments available for this purpose.
Many men and their surgeons prefer the gentle ‘no scalpel’ method since the tubes are located, prepared and severed with far less trauma to tissue and with far less emotional stress to the patient. Laser vasectomy offers no useful benefit to conventional vasectomy methods either in shortening the time of the procedure or by being less invasive. Whatever method is used, the vas deferens must first be exposed through an opening created by a scalpel, laser energy or pointed forceps specially designed for vasectomy.
Laser vasectomy not considered a beneficial alternative to either traditional or no scalpel vasectomy by the vast majority of urologists. Patients asking about laser vasectomy are mainly unaware of the fact that laser vasectomy still requires an incision into the scrotum.
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