The Urology Place No-Scalpel, No-Needle Vasectomy
Both Dr. Kella and Dr. Hlavinka use an advanced, no-scalpel, no-needle vasectomy technique for your procedure. Our urologists are expert surgeons who have extensive experience with this technique. We want to insure your comfort during the procedure and give your body as fast as a recovery as possible. Some patients may want the most painless, nerve-free approach possible. Please ask us about IV sedation or our nitrous approach. Using a bit of nitrous gas can eliminate any anxiety and reduce your sensation of any pain. Also, it is very safe. The nitrous is available for approximately $100. You can drive home afterwards.
What happens during the vasectomy procedure?
To begin, we numb the area with lidocaine. With our no-needle technique, we use what’s called a MadaJet to actually spray on a local anesthetic. Sometimes, we may elect to use injected lidocaine. We use a very tiny needle to minimize discomfort.
Next, a special instrument is used to make a tiny opening in your scrotum the size of this dash —. At The Urology Place, we specialize in performing your entire procedure through this single tiny opening. We gently move around your blood vessels and nerves to locate and then isolate your vas deferens, or “vas” for short. Some doctors cut across your blood vessels and nerves to speed up the procedure; we disagree with this technique. By gently moving around your vessels and nerves, and numbing you internally as we do, we reduce bleeding, pain, sexual side effects and infection risk.
Sealing Off your Vasa
Once we have located your first vas, we carefully cut it. We then use pinpoint heat cautery to seal off your vas deferens tube. Multiple studies show cautery is superior to clips for vas occlusion and has a lower failure rate. Dr Kella uses an open ended procedure, meaning we only seal off the upper portion of the vas, leaving the lower half of the divided vas deferens open. After we seal the tissue we place a tiny suture to further seal off the upper vas. Finally we do an “interposition” or put the ends of the vasa into separate compartments. All these steps minimize the chance of the vas accidentally reconnecting.
We then allow the ends of the vas deferens to gently release back into the scrotum. Given your vasa move freely about within your scrotum, we can locate your second vas deferens via the same tiny hole and repeat the procedure without any additional openings.
What are the benefits and differences of an open-ended vasectomy?
All vasectomy procedures involve dividing both the left and right vas deferens. During an open-ended procedure, only the upper half of the vas is sealed with pinpoint cautery and the lower half is left alone. During a closed-ended vasectomy, both the upper and lower portions of the vas are sealed. Open-ended vasectomy reduces pain after the procedure, as well as the longer term risk of painful epididymal disruption. It is equally as effective as closed-ended vasectomy but is easier to reverse should you ever desire a vasectomy reversal. Dr Kella typically performs the open ended technique.
Keeping it Pain Free
One of the biggest keys to keeping your surgery and recovery pain free is our tiny puncture hole and gentle method. In addition, those wanting the least painful route should ask about nitrous gas or IV sedation.
Given we haven’t disrupted or cut any of your blood vessels or nerve endings during the procedure, recovery is actually quite easy. Once we release your second vas back into your scrotum, the tiny puncture hole contracts to a few millimeters. It’s so small it doesn’t require any of the big closure methods required of traditional vasectomies. Depending on your specific case, we may or may not place a tiny self-dissolving stitch in the skin. At this point, your procedure is complete. It’s important to lie down for the first 24 to 48 hours after your procedure as much as possible for optimal healing.