About the procedure
The no-scalpel technique was developed in China in 1974 by Dr Shunqiang Li. Conventional vasectomy involves a scalpel incision to both sides of the scrotum and sharp dissection to gain access the vas deferens tubes. The no scalpel technique involves puncturing the scrotal skin with one entry into the middle of the scrotum. No scalpel is used to puncture the skin or importantly in the dissection to isolate the vas deferens. This technique has proven to reduce complication risk by 10 times. In addition, the procedure itself is more comfortable during and also after as no stitch is required to close the skin.
No-scalpel vasectomy is regarded as a safe, in-office procedure. To find out more about the risks of vasectomy click here.
It is true that vasectomy can be reversed. This is usually done with microsurgery to bring the two end of the vas deferens together (vasovasotomy) or to bring the vas to the epididymis (vasoepididymostomy). However, vasectomy should be regarded as an irreversible form of contraception. This is because reversals are not always successful and if a man goes into a vasectomy expecting it to be successfully reversed later down the line, he may be proven to be disappointed.
An alternative to vasectomy is sperm retrieval which maybe offered by specialized fertility clinics.
Laser sounds appealing. Lasers are used frequently in medicine and are definitely a great technology. But not for such a simple procedure as no-scalpel vasectomy. I do not know anyone that does it, nor are there any studies showing benefit of laser vasectomy in humans.
The benefits of no-scalpel vasectomy are:
- Less risk of bleeding and scrotal haematomas (collections of blood within the scrotum)
- Less risk of infection
- Single incision procedure
- No stitches required
Vasectomies performed by Dr Ranaweera are “open-ended”. In some vasectomies the testicular end of the separated vas tube is closed by stitch, clip or electrocautery. Theoretically, this plugs the sperm and pressure may build within the structures upstream (which importantly includes the epididymis). This sudden increase in pressure results in congestion and an exaggerated inflammatory response. Inflammation may contribute to post-vasectomy pain syndrome and scarring which reduces the success of reversal.
An open-ended vasectomy refers to a technique where the both cut ends of the vas tubes left open. This allows for sperm to escape the vas and may result in the formation of a sperm granuloma. Again, in theory, this reduces the inflammation upstream which may decrease the risk of post-vasectomy pain syndrome and increases the success of later vasectomy reversal.
The “open-ended” technique sounds superior in theory but the benefits are probably overstated for the following reasons:
- Sperm granulomas do not always form and if they do, they can be just as uncomfortable as post-vasectomy epididymal inflammation.
- Patients can still have epididymal inflammation (Although the pain from both epididymal inflammation and sperm granulomas usually settled with anti-inflammatory medication none-the less).
- Reversal success is not dependant on whether a man has had an “open-ended” or “close-ended” vasectomy
There is no minimum age as such for a vasectomy. However, if you are under the age of 30 and have fewer than 2 children, we ask that you book in for a consult to discuss your situation before committing to vasectomy. We like to know that you have thought about the ramifications of vasectomy and the options available for you prior to undergoing a potentially irreversible procedure. Please read here for more information.
Generally, the procedure takes about 10-20 minutes.
Preparation for you procedure
- Read the Instructions and information sheet.
- Print and fill out Registration form.
- Print and fill out Consent form.
- Call our clinic on (07) 5441 1455 to make a booking. A $100 deposit will be required at the time of booking.
- Make sure you do not take any blood thinning medications for 7 days before the procedure.
- Bring or invest in some tight underwear (briefs not boxers) to wear immediately after the procedure and for 7 days into recovery.
- Arrive 10-15 minutes before your procedure
This depends on the type of work you do. If you work in an office environment which does not involve heavy lifting or intense labouring then you may return to work the following day. This is also if you are relatively comfortable. If your work involves heavy lifting or more intensive physical labour, then we suggest that you do not go back to work for at least 48 hours. If you are pain and tenderness free after this time, I suggest a gradual return to work duties. When you do return to work, please wear supportive underwear for at least 7 days post procedure.
Pain is very subjective and each man will experience a different level of discomfort. Local anaesthetic is used to make the procedure as comfortable as possible. This usually wears off a few hours after the procedure. Following this, most men are surprised at how little pain they have. In general, pain can be controlled with paracetamol and wearing supportive underwear. Sometimes anti-inflammatory medications (such as Nurofen or Advil) is required. It is unusual to escalate pain relief, however, it is advisable that you speak with Dr Ranaweera or seek medical attention if you feel your level of pain is severe or increasing.
Usually you may return to sexual activity 48 hours after the procedure provided that you are relatively comfortable to do so.
The minimum time to submit a sample is 12 weeks and 20 ejaculations following the procedure. Information about the logistics of semen collection can be found here at the bottom of the page.
Usually the sperm analysis results come in fairly quickly (sometimes on the same day). I advise patients to wait 1 week and if they have not received any information from us, to contact us. About 80% of when will be azoospermic at this point (no evidence of sperm in the sample). If there are sperm seen in the sample, then it depends how many and how motile the sperm are. If there are a few non-motile sperm, then the Australian College of Surgeons advise repeat monthly testing until there are no sperm or there are 2 samples in a row showing few non-motile sperm at least 7 months after vasectomy.