More than 500,000 men in the United States choose vasectomy each year. It is also known to be one of the safest and most effective means of permanent birth control. The No Scalpel Vasectomy is a procedure that lowers the already low risk of the procedure and gets the man back to his usual routine faster and with usually minimal post procedure discomfort. Most often, the procedure is performed in our office using a local anesthetic. The No-Needle technique uses the Mada jet Injector to replace or limit use of a needle for delivery of anesthesia to the vas deferens and scrotal skin overlying it. Over the past 22 years I have performed over 1000 No-Scalpel vasectomy procedures. The following present important information about the Vasectomy Procedure. If you have questions please don’t hesitate to contact me at 516-487-2700 or by e-mail at drgilbert@BruceGilbertMD.com
THE VASECTOMY PROCEDURE
Vasectomy is a surgical procedure that interrupts the normal passage of sperm. In this procedure the vas deferens, the tubes that carry sperm from the testicle to the ejaculatory ducts, are severed and the open ends are blocked.
The No-Scalpel Vasectomy is an even safer and less invasive procedure that has reduced the time to recovery and markedly lowered the already low complication rate of this procedure.
The No-Needle No-Scalpel Vasectomy uses an innovative technique to anesthetize the scrotum and vas deferens (first described by R Weiss and P Li, J Urol,173:1677, 2005) making the procedure essentially painless for the patient. The use of a jet injector eliminates the need to use a needle in most cases and in addition, reduces the amount of anesthetic agent used 10 fold, to less than 1 cc. It is therefore a simple, safe and rapid technique.
After the skin and vas deferens is anesthetized, the vas deferens is gently isolated and held just beneath the scrotal skin by a specially designed instrument which holds the vas deferens firmly without pinching. Without a scalpel, a single small opening is made through the skin and the vas deferens is delivered through this opening. A small length of vas deferens is removed and the open ends sealed in a conventional fashion. The tiny hole in the scrotal skins heals without sutures.
If you have questions please don’t hesitate to contact me at 516-487-2700 or by e-mail at DrGilbert@BruceGilbertMD.com .
- Vasectomy should be considered an irreversible procedure. You will be counseled before consent is obtained.
- For any elective surgery you should be in the best of health. It is important to let my office know if you have any other health problems.
- Avoid aspirin and aspirin products for a week before your vasectomy.
- You will be discharged in satisfactory condition for travel. You should be accompanied by someone capable of driving you home.
- You should limit your activity for 24 hours after the procedure. An ice pack applied to the scrotum for a few hours after the procedure will ease both pain and swelling. Please note: ice should never be applied directly to the scrotum. First place the ice in a plastic bag and then wrap the bag in a cloth prior to placement on the scrotum.
- A small amount of bright red blood is to be expected. DO NOT be alarmed. If you feel that the amount is excessive, or have any other questions, call my office.
- You may experience a dull ache in the testicles and groin after the local anesthetic wears off. If needed, you may take Tylenol for discomfort.
- You may resume light work in 2 or 3 days.
- No heavy work, sports or lifting are allowed for 1 week.
- Sexual intercourse may be resumed in 1 week. Contraception must be used!
- You will NOT be sterile immediately after your vasectomy. This usually takes 2-4 months or 12 to 24 ejaculations. CONTRACEPTION MUST BE USED UNTIL THE ABSENCE OF SPERM IS CONFIRMED BY TWO CONSECUTIVE SEMEN ANALYSES.
Please schedule your first post operative visit 2 weeks after your procedure. We will then see you back and obtain a semen analysis approximately 6 to 8 weeks after your vasectomy. We will advise you when the next analysis needs to be done (usually two weeks later). However, if at anytime after the procedure you have a question or a concern ( whether you think it minor or not) please call…we are always here to assist you in any way we can.
Frequently asked questions regarding Vasectomy:
Can the operation fail?
Yes, but the rate is very low, only in between one and four in 1,000 cases.
How soon can I have sex again?
That depends on you. Most men start again within a week. Others have sex sooner. Some wait longer. But remember, it takes about three months to clear sperm out of your system. Use another form of birth control for vaginal intercourse until at least two semen analysis shows there are no longer sperm in your seminal fluid. I usually see the patient back 2 weeks after the procedure but don’t obtain the first post procedure semen analysis until 8 weeks after the procedure.
How is semen analysis done?
You will provide a sample of your semen by masturbating or by using a special condom during sexual intercourse. The semen will be spun down and examined under a microscope to see if there are any sperm in the specimen.
Will vasectomy affect my sexual pleasure?
Your erections, orgasms, and ejaculations will very likely be the same. Most men say they have greater sexual pleasure because they don’t have to worry about an unwanted pregnancy. Many say there is no change.
Rarely, men lose some sexual desire. More rarely, men lose the ability to become hard. Often, such losses have to do with their emotional condition before the operation.
Will I be as masculine?
Yes. Vasectomy is not castration. Sterility is not impotence. The hormones that affect masculinity, beard, voice, sex drive, etc., are still made in testicles. They still flow throughout the body in the bloodstream.
Will there be “cum” when I “come”?
Yes. But eventually (see above) there will be no sperm in the ejaculate. Your semen is between 2 and 5 percent sperm. The rest is seminal fluid from the prostate and other glands. The change in the amount of fluid is often too little to notice. You might however, notice a clearer or less thick ejaculate.
After vasectomy where do the sperm go?
They dissolve and are absorbed into the body. Dead and unused cells are absorbed by the body throughout life. Antibodies to sperm develop in 50-80 percent of men who have vasectomies. Normally, antibodies protect the body against viruses and bacteria. Sperm antibodies will not affect your general health. But they may lessen the chance of restoring fertility if vasectomy is reversed.
How much time will I have to take off work?
That depends on your general health, attitude, and your job. Most men lose little or no time from work. A few need a day or two to rest. You will have to avoid strenuous labor or exercise for about a week.
Rare complications may require more days at home. However, prompt medical attention should clear up any problems.
How long will the procedure take?
The actual procedure time of a “No Scalpel” vasectomy is about 10 to 15 minutes.
Who will do it?
I personally do all the procedures. I have over 20 years experience in the No-Scalpel vasectomy procedure. The procedure is usually performed in my office under local anesthesia. Please read the information above on pre/post operative care.
If you would like more information please contact
Bruce R.Gilbert, M.D., Ph.D. at 516-487-2700 or info@BruceGilbertMD.com