I. Introduction
A. Definition and Purpose of Vasectomy
A vasectomy is a minor surgical procedure and birth control alternative for men who don’t want to have children anymore. Experts consider vasectomy as the only permanent birth control method for males.
When you undergo a vasectomy, your doctor will cut or seal the vas deferens (sperm ducts) in your scrotum area. These ducts transport sperm from your testicles to your penis. A vasectomy will prevent sperm from mixing with your semen rendering you sterile or infertile.
Vasectomies are a popular option for Australian men because of their extremely low failure rate (0.1 percent). Approximately 30,000 Aussie males get a vasectomy annually.
B. Evolution of Vasectomy Techniques
British surgeon Sir Astley Cooper recorded the first vasectomy in world medical history in 1823. He performed the vasectomy on a dog. Cooper discovered vasectomy did not diminish the size of the dog’s testicles.
At the time, many physicians resorted to castration (removal of the testicles) as a way to relieve benign prostatic hyperplasia (benign enlargement of the prostate). Some 62 years after Sir Astley Cooper’s milestone, French surgeon and urologist Felix Guyon performed vasectomies to help men with benign prostatic hyperplasia (BPH).
Guyon’s Swedish counterpart Karl Gustav Lennander also believed vasectomies were a reliable alternative to castration. British physician Reginald Harrison reported at the turn of the 20th century approximately 100 males with BPH had undergone vasectomies.
As the world ushered in the 20th century, vasectomies became a way for older men to regain their youthful vigour and virility. Austrian physiologist Eugen Steinach became a proponent of vasectomy for this objective.
Thousands of males underwent a vasectomy in the early 20th century so they could reverse ageing. Among the more prominent men who did so were Irish poet William Butler “W.B.” Yeats and Austrian neurologist Sigmund Freud. Before long, the principle of vasectomy as a way to restore male virility fizzled out because physicians believed it had a mere placebo effect on patients.
Vasectomies eventually became a reliable method of male birth control and family planning in World War II. India, one of the world’s most populous nations, became a vasectomy hotbed in the mid-1950s. The trend continued growing on a global scale in the next 20 years. An average of 40,000 American men underwent a vasectomy in the mid-1960s. Fast forward 50 years later, that figure ballooned to more than 500,000 annually.
Sterilisation methods became unpopular in Australia after World War II. Although this became the trend for almost three decades, Australian legislation didn’t formulate specific policies and laws forbidding sterilisation. Nevertheless, many groups disapproved of sterilisation for moral reasons. The Federal Assembly of the Australian Medical Association took this stance from 1962 to 1971.
Vasectomies have become a popular method of birth control and family planning in Australia since then. An average of 30,000 Aussie men undergo vasectomies every year. It has become so popular, not even the COVID-19 pandemic could stop it. In fact, Australia experienced a massive surge in vasectomies during the onset of the pandemic in 2020.
C. Focus on No-Scalpel Vasectomy (NSV)
II. Understanding Vasectomy
A. Brief Overview of Traditional Vasectomy
In a traditional or conventional vasectomy, your physician will inject your scrotum with an anaesthetic. Next, he will make two small incisions on each side of your scrotum. Consequently, your doctor will have access to your vas deferens (ducts that transport sperm from your testicles to your penis).
Your physician will cut each of your vas deferens. He will either tie or seal the ends of your sperm ducts afterward. Finally, he will stitch the cuts to finish off the procedure.
B. Advantages of No-Scalpel Vasectomy
A no-scalpel vasectomy (NSV) has several unique advantages over its traditional counterpart:
- Decreased infection risk and quicker healing time: A no-scalpel vasectomy involves less trauma than a traditional vasectomy. The chances of bleeding, post-operative pain, infection, residual scarring, and complications are much lower when you undergo an NSV.
- You will also heal faster: many men resume their normal daily activities 48 hours after they experience a no-scalpel vasectomy. On the other hand, recovery time for a conventional vasectomy takes roughly one week.
- No stitches: Since no-scalpel vasectomies require no stitches, you don’t have to see your doctor again to have them removed.
- High rate of success: No-scalpel vasectomies’ protection rate form unwanted pregnancies have hovered near the 100 percent range since Dr. Li Shunquiang performed the first NSV procedure in China in 1974.
- Fast process: Your doctor can finish your no-scalpel vasectomy procedure in just 20 minutes.
C. Common Misconceptions
Common myths and misconceptions about no-scalpel vasectomies (NSV) include:
- Detrimental effect on libido: Some men worry their sexual drive will plummet after they undergo a no-scalpel vasectomy. If you’re one of them, don’t fret because this isn’t true. On the contrary, many men experience an increase in their libidos after experiencing an NSV. A study published in the 9 September 2015 issue of the Journal of Sexual Medicine revealed men who underwent a vasectomy had sexual intercourse an average of 5.9 times per month. In contrast, their non-vasectomised counterparts had intercourse an average of 4.9 times monthly.
- Unbearable pain: At first glance, a vasectomy procedure looks like a harrowing and painful ordeal. However, this isn’t the case. In fact, physicians consider a no-scalpel vasectomy a relatively painless procedure. The most uncomfortable part of a no-scalpel vasectomy is your doctor anesthetizing your scrotal area. Some physicians use a no-needle technique for the anaesthesia.In that scenario, they use a device to spray the anaesthetic on your scrotum. The sensation feels similar to a mosquito bite. You will feel the numbing sensation after several sprays later – you won’t feel any discomfort for the rest of the procedure.
- Different semen appearance: Some patients fear their semen will look differently after their physicians perform an NSV on them. This isn’t true at all. Your semen’s appearance will remain the same as it did prior to your procedure.
- Prostate cancer risk: Undergoing a no-scalpel vasectomy (NSV) will not increase your risk of prostate cancer. Contemporary studies in the past 30 years have debunked the link between NSV and this disease. Medical experts confirmed this in a comprehensive study involving 3 million subjects and 53 case studies several years ago. A study that comprehensive should put your fears of prostate cancer to rest once and for all.
- Cardiovascular disease risk: No-scalpel vasectomies don’t increase your risk of getting cardiovascular disease.
- No condoms post-surgery: if you thought a no-scalpel vasectomy will make you sterile right away, think again. Engaging in unprotected sexual intercourse with your partner just several days after your NSV procedure can still make her pregnant. Your semen still has enough sperms that can fertilise her egg. It takes approximately 10 to 20 ejaculations after your NSV procedure before your semen’s sperm count becomes drastically reduced. With that in mind, your physician will conduct a semen analysis eight to 12 weeks after your no-scalpel vasectomy. If he’s satisfied with the results, you can stop alternative methods of birth control.
III. Preparing for a No-Scalpel Vasectomy
A. Consultation with a Urologist
Medical experts consider a no-scalpel vasectomy (NSV) a permanent procedure. It’s a potentially life-changing decision not only for you, but for your partner as well.
Prior to your NSV, you must schedule a consultation with a reputable urologist. He will break down the steps you must take before, during, and after the procedure. Your doctor will also explain to you potential risks and complications.
However, don’t fret: no-scalpel vasectomies have a high success rate. The chances of developing complications are slim. A study published in the Indian Journal of Surgery on 21 January 2012 revealed only a combined 1.7 percent of 649 NSV cases developed complications.
Don’t take the consultation with your urologist lightly. It’s a great opportunity to ask him all of your questions about a no-scalpel vasectomy. If you’ve been anxious and worried, sharing your sentiments with your physician will help you cope emotionally in the days leading up to your procedure.
B. Eligibility Criteria
A male must be at least 18 years old to be eligible for a vasectomy in Australia. This requirement stems from the permanent nature of the procedure. Society expects a male who reaches majority age to understand the long-term repercussions of his decision to undergo an NSV.
C. Health Assessment, Counselling, and Informed Consent
If you meet the age requirement for a no-scalpel vasectomy, you will take an initial health assessment. First, your physician will confirm if you’re sure about your decision to undergo an NSV. He will explain the process to you in great detail after you give your go-signal.
Your doctor will enquire about your medical history and ensure you’re not taking any medicines such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). These medications could increase the chances of bleeding.
Next, your urologist will ask you to fill out an informed consent form to ensure you understand the possible consequences of having a no-scalpel vasectomy.
Once you’ve completed the informed consent form, your doctor will conduct a physical examination. In this step, he will confirm locating your vas deferens (sperm ducts).
IV. The No-Scalpel Vasectomy Procedure
A. Step 1: Anaesthesia Administration
1. Local Anaesthesia Overview
Your doctor will anaesthetise your scrotal area in one of two ways:
- Conventional local anaesthesia: In this scenario, your physician will inject the anaesthetic into your scrotum with a needle.
- No-needle anaesthesia: As the term suggests, your doctor will numb your scrotal area without the use of a needle. Instead, he will spray the skin in your scrotal area with an anaesthetic.
2. Patient Comfort and Pain Management
The conventional local anaesthesia process is the most uncomfortable phase of a no-scalpel vasectomy (NSV).
On the other hand, a no-needle anaesthesia produces much less pain and discomfort than its conventional counterpart. If you receive a no-needle anaesthesia, you will feel more comfortable during your no-scalpel vasectomy. Listening to soothing music or playing games on your device will help take your mind off the procedure as it progresses.
B. Step 2: Locating the Vas Deferens
1. Non-Invasive Approach
Your physician will make an opening with a no-scalpel skin dissector in your scrotum after anesthetizing it. He will do a so-called “test pinch” with this instrument to make sure your entire scrotal area has been numbed with the anaesthesia.
2. Precision Techniques
Next, your doctor will insert one side of the no-scalpel skin dissector into the skin of your scrotum. The insertion produces a superficial puncture in your skin.
C. Step 3: Isolating and Sealing the Vas Deferens
1. Minimal Disruption to Surrounding Tissues
Your physician will isolate your vas deferens (sperm duct) through that opening using a three-finger technique. He will use a no-scalpel ring forceps to secure your sperm duct beneath the scrotal skin. This step requires precision and expertise: your doctor will use the forceps without grasping the blood vessels in your scrotum.
Next, your physician will use a no-needle dissector to remove the fascial covering surrounding your sperm duct. Consequently, he will expose your vas deferens above your scrotal skin. Urologists call this process the “supination manoeuvre.”
2. Importance of Proper Sealing
Your doctor will use a battery-powered thermal coagulation device to open your sperm duct and divide it into the upper (prostatic) and lower (testicular) ends. This device will lightly coagulate (change from fluid to solid or semi-solid) the upper end of your vas deferens. This upper end will seal faster because of the coagulation process. Not only that, but the chances of vasectomy failure also diminishes greatly.
Your physician will cut the tubes of your vas deferens. Next, he will suture and cauterise the ends of the tubes consequently sealing them off. The superficial puncture he made earlier using the no-scalpel skin dissector will heal naturally.
V. Recovery and Aftercare
A. Immediate Post-Procedure Care
1. Rest and Relaxation
You can drive home depending on the kind of anaesthesia your doctor used. If he used local anaesthesia, you can go behind the wheel. On the other hand, if your physician used IV twilight sedation, you won’t be able to operate a vehicle for the next 24 hours. Ask one of your friends to drive you home after your NSV procedure if this were the case.
Rest and recuperate as much as possible during the first 48 hours after your no-scalpel vasectomy. Refrain from doing any strenuous activities or heavy lifting for at least one week.
Wear a jock strap or athletic supporter during the first week of your recovery. This will help keep the gauze in your scrotal area in place. You can take a shower 24 hours after your procedure. Avoid drying the affected area vigorously. Dab or pat it lightly with a towel instead.
It’s normal to discover a bit of bleeding in your scrotum. However, if the bleeding persists or you experience other unusual symptoms, contact your doctor immediately.
2. Ice Packs and Pain Management
Place an ice pack for no more than 20 minutes at a time every hour during the first three days of your recovery. Using ice packs after undergoing a no-scalpel vasectomy (NSV) will help diminish swelling in your scrotal area.
B. Resuming Normal Activities
Do not report for work the day after your no-scalpel vasectomy (NSV). Rest at home for the next 48 hours. Most men who undergo an NSV typically resume their normal activities two days after the procedure. They usually experience full recovery after one week.
You can have sexual intercourse one week after your NSV procedure. However, it bears repeating: your semen still has sperm at this point in the recovery process. It takes around 10 to 20 ejaculations before the sperm content in your semen disappears.
Use alternative birth control methods such as latex condoms for eight to 12 weeks after your no-scalpel vasectomy to prevent unwanted pregnancies.
C. Follow-Up Appointments and Semen Analysis
Your urologist will schedule a follow-up semen analysis around eight to 12 weeks after your NSV procedure. The semen analysis will determine the volume and quality of your sperm.
You will provide your doctor with a semen sample during your follow-up appointment. He will analyse your semen’s sperm count and sperm activity (motility) using a microscope. If your physician determines your semen has no sperm content or very little sperm motility, your results are normal.
Hence, you can stop using artificial birth control methods when you have sexual intercourse. Your no-scalpel vasectomy (NSV) was successful.
If your semen analysis produces abnormal results, your physician may require further testing to determine the underlying cause.
VI. Benefits of No-Scalpel Vasectomy
A. Reduced Procedure Time
A no-scalpel vasectomy (NSV) typically takes 20 to 30 minutes to complete. It’s a quick outpatient procedure that produces impressive results.
B. Lower Risk of Complications
NSV procedures produce a lower risk of complications when you compare it to its traditional counterpart. This has been the trend since the mid-to-late 1990s when no-scalpel vasectomies were relatively new – they had been practised for just 25 years at the time.
As many as four percent of patients reported infections after undergoing a traditional vasectomy at the time. In contrast, no more than 0.9 percent of patients reported the same complication.
Another typical complication arising from vasectomies was haematoma or bleeding. Roughly 10.7 percent of males who underwent a traditional vasectomy experienced this side effect in the late 1990s. There were fewer men (2.1 percent) who bled after they underwent an NSV procedure.
The trend continues to the present day. No-scalpel vasectomies have produced significantly fewer complications than the traditional method.
C. Faster Recovery Period
Most males who undergo an NSV procedure resume their normal daily activities 48 hours afterward. On the other hand, men who prefer the traditional incisional variety take roughly one week to recover.
VII. Addressing Common Concerns
A. Impact on Sexual Function
Some Australian men worry their sex drive will plummet after undergoing a no-scalpel vasectomy. If you’re one of them, you can put your fears to rest because this isn’t true. Your libido and sex drive won’t suffer after your NSV procedure. This type of vasectomy also doesn’t cause erectile dysfunction.
In fact, many men experience higher libidos and supercharged sex drives after experiencing a no-scalpel vasectomy. Who knows? You could be one of them.
B. Reversibility Considerations
When you decide to have a no-scalpel vasectomy (NSV), it’s better to assume the mindset that it’s a permanent means of birth control. Once you made your decision, there’s no turning back.
However, plans in life change. For example, if you were single prior to your NSV procedure, there’s a chance you could meet your lifetime partner afterward. You are suddenly entertaining the thought of having children although you’re already sterile.
If, for some reason, you have a sudden change of heart after the procedure, don’t fret. It’s possible to undergo a vasectomy reversal. Bear in mind this reversal procedure costs significantly more than your NSV. Plus, a vasectomy reversal’s success rate isn’t always 100 percent.
Make sure to discuss your sentiments with your partner before deciding to have a vasectomy reversal. Another alternative is preserving your semen sample in a laboratory before you undergo an NSV procedure. You and your partner can opt for in-vitro fertilisation (IVF) if you decide to have kids in the future.
C. Long-Term Health Effects
Some common misconceptions about a no-scalpel vasectomy (NSV) include cancer and cardiovascular disease. There’s no truth that an NSV procedure will produce these health issues.
In fact, an excerpt from the July 2021 issue of The World Journal of Men’s Health says, “”There is no increased risk with vasectomy and autoimmune disease, cardiovascular disease, prostate cancer, and sexual dysfunction.” With that in mind, you’re not compromising your long-term health after experiencing a no-scalpel vasectomy.
VIII. Personal Stories and Testimonials
A. Real Experiences of Individuals Who Opted for No-Scalpel Vasectomy
Let’s take a look at two men who underwent successful no-scalpel vasectomy (NSV) in recent years.
Daniel is a 31-year-old American man who resides in Brooklyn, New York. He and his wife decided he will undergo a no-scalpel vasectomy after having their second child. Prior to the decision, Daniel’s wife took oral contraceptives.
Daniel’s doctor used local anaesthesia for his NSV procedure. He said he felt little pain during his no-scalpel vasectomy.
Daniel told his doctor during his follow-up appointment he returned to work just two days after “getting the snip.” He took pain medication to offset mild discomfort in his right groin area during the week after the procedure. He had two semen analyses eight weeks after his no-scalpel vasectomy. The results revealed his semen had no sperm content.
On the other side of the globe, Paul, a native of New Zealand, also decided to undergo a no-scalpel vasectomy. He said the anaesthetic produced mild discomfort for only a few days. Other than that, his NSV procedure went smoothly.
In the bigger scheme of things, Paul’s sex life improved dramatically after he had a no-scalpel vasectomy. He felt NSVs “should be normalised as lifestyle choices” for men who seek an effective method of permanent birth control.
B. Insights into Decision-Making Process
Undergoing a no-scalpel vasectomy is a potentially life-changing decision. This is a permanent form of male birth control you shouldn’t take lightly.
If you’re a single male who doesn’t want to have children in the future, you must weigh this decision very carefully. Will you have a change of heart several years down the track? Will you yearn to become a father when you meet your future lifetime partner?
On the other hand, men in committed relationships should have a heart-to-heart talk with their partners before “getting the snip.”
Here are some factors to consider:
- Your household income: Can you and your partner support more children?
- Parenting: Do you feel you can raise more children in the future?
- Health issues: Will pregnancy affect your partner’s long-term health? Is she comfortable taking alternative methods of birth control such as the pill? Is she willing to undergo tubal ligation?
IX. Conclusion
A. Recap of No-Scalpel Vasectomy Process
A no-scalpel vasectomy (NSV) is a minimally-invasive and permanent form of male birth control. An average of 25,000 to 30,000 Australian males undergo a vasectomy annually. An NSV is a relatively quick outpatient procedure that takes an average of 20 to 30 minutes.
First, your physician will numb your scrotal area with an anaesthetic. Many urologists use no-needle vasectomy sprays to make the process less invasive.
Next, your doctor will make a small puncture in your skin and isolate your vas deferens (sperm duct). He will lightly coagulate the upper end of this duct so it will seal faster. He will also cut and seal your vas deferens to prevent sperm from mixing with your semen after roughly 10 to 20 ejaculations. A no-scalpel vasectomy doesn’t require the use of stitches. Hence, you don’t need to ask your urologist to remove them in your next visit.
It typically takes 48 hours for male patients to resume their normal activities after an NSV procedure. Their doctors will ask them to refrain from doing strenuous activities and exercises for one week.
Patients can also have sexual intercourse one week after their no-scalpel vasectomy. However, they must use other methods of birth control such as latex condoms because their semen could still contain sperm eight to 12 weeks after the procedure. Their urologists will conduct a semen analysis after that eight-to-12 week time frame to determine if their semen has no sperm content.
No-scalpel vasectomies don’t result in any serious long-term health issues. Not only that, but many male patients also say their sex lives improved tremendously after “getting the snip.”
B. Encouragement for Informed Decision-Making
Your decision to undergo a no-scalpel vasectomy (NSV) will depend mainly on your current situation and lifestyle. Single males must weigh the decision to become sterile and forego fatherhood very carefully. On the other hand, males in committed relationships will make a mutual decision that also involves the feelings and sentiments of their partners.
Whatever situation you’re in, your life will change after your NSV procedure. If you need any assistance, please feel free to call us at 1300 677 647 or send us an email at reception@scalpelfreevasectomy.com.au. Our staff members will get back to you as soon as possible.
C. Future Developments in Vasectomy Techniques
Australia has witnessed several exciting developments in vasectomy techniques in recent years. The country celebrated a major breakthrough with the completion of the first vasectomy reversal using RoboticScope on 18 October 2022.
RoboticScope is a form of microsurgery that involves the head movements of the surgeon and foot pedal movements. This technological advancement allows doctors to pace themselves during a surgical procedure, ward off strain and fatigue, and ensure a higher rate of success. AT the time of the breakthrough, 20 other countries had been using RoboticScope for their various surgical processes.
On the other side of the globe, Signati Medical in Rhode Island, USA recently announced it will develop a minimally-invasive device that performs sealed vasectomy procedures (SVP). It will mark the first major vasectomy technology breakthrough in the country in 20 years.
Medical professionals will conduct a study of the SVP device at Louisiana State university Medical Centre this month. If urologists eventually use the contraption, it will shorten the vasectomy process, make vasectomy safer for male patients, and shorten recovery time.
Will vasectomy professionals in Australia eventually follow suit in the near future? When the time comes, Aussie men who want to undergo a vasectomy will enjoy a near-seamless procedure.
X. Additional Resources
A. Further Reading on Vasectomy
https://www.vasectomy.org.au/procedure/
https://vasectomyaustralia.com.au/frequently-asked-questions/
https://gentleproceduressydney.com.au/vasectomy/
https://www.abc.net.au/news/2020-12-29/getting-a-vasectomy-myths-australia/12917746
https://www.nhs.uk/conditions/contraception/vasectomy-male-sterilisation/
https://www.urophoenix.com/2021/09/23/benefits-of-having-a-no-needle-no-scalpel-vasectomy/
https://drsnip.com.au/6-vasectomy-myths-busted/
https://www.sciencedirect.com/science/article/abs/pii/S1743609515341977
https://qprostate.com.au/busting-myth-vasectomy-prostate-cancer/
https://www.vasectomy.org.au/faqs/what-age-can-you-get-vasectomy-australia/
https://my.clevelandclinic.org/health/treatments/4423-vasectomy
https://www.vasectomyclinics.com/in-office-no-needle-no-scalpel-vasectomy/
https://www.bestvasectomy.com/no-scalpel-vasectomy-no-scalpel-technique-explained/
https://buenafeclinic.com/what-are-the-different-types-of-vasectomy-procedures/
https://my.clevelandclinic.org/health/diagnostics/21520-semen-analysis
https://www.bestvasectomy.com/risk-of-no-scalpel-vasectomy-compared-with-conventional-vasectomy/
https://vasectomyaustralia.com.au/blog/will-a-vasectomy-affect-my-libido/
https://vasectomyaustralia.com.au/blog/does-vasectomy-cause-erectile-dysfunction/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255399/
https://www.newyorkurologyspecialists.com/vasectomy/real-stories/2-children/
https://www1.racgp.org.au/ajgp/2023/january-february/surgical-management-of-male-infertility
https://www.katelarisurology.com.au/the-first-vasectomy-reversal-in-australia-using-roboticscope/
https://www.urologytimes.com/view/fda-grants-ide-approval-for-study-of-vasectomy-device
https://www.katelarisurology.com.au/5-questions-to-ask-when-choosing-the-best-urologist-in-sydney/
B. Finding a Qualified Urologist
If you’re thinking about undergoing a no-scalpel vasectomy (NSV), finding a reputable and qualified urologist is half the battle won.
Here are some factors to consider when seeking a qualified urologist:
- Modern technology: A urologist who adopts the latest technology will ensure a safe procedure.
- Up-to-date: You will have peace of mind if your urologist keeps up with the latest trends and research in his field.
- Track record: Read online reviews of the urologist’s clinic. If patients complain about his services consistently, that’s a red flag. On the other hand, a urologist who gets good reviews and wins awards from recognised institutions is worth considering.
Dr. Raj Selvarajan established Scalpel Free Vasectomy in Mackay, QLD in 2014. He also has clinics in Brisbane, Burpengary East, North Lakes, and Springwood. Dr. Raj has done approximately 10,000 successful scalpel-free vasectomies in Australia and the UK.
If you’re thinking about getting a scalpel-free vasectomy, call us at 1300 677 647. One of our staff members will schedule your appointment with Dr. Raj.
C. Support Groups and Forums for Individuals Considering Vasectomy
Are you at a crossroads in your scalpel-free vasectomy journey? Do you need further guidance on how to proceed? Here are some support groups and forums you can join:
https://community.whattoexpect.com/forums/australian-parents/topic/vasectomy-baby.html
https://www.dad.info/forum/mens-health/vasectomy-stories/
https://www.facebook.com/groups/1362272350523022/
Dr.Raj Selvarajan MBBS MRCS(Ed) MRCGP(UK) FRACGP MMed(UQ)
Scalpel Free Vasectomist,
Course Organiser – Advanced Workshop in No Scalpel Vasectomy (HealthCert)
