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"Painless Vasectomy…?"

"Well, not really." But, I did have a nice little chuckle when one of our High Country Health Care employees called me to inquire about this new procedure she had heard about. You see, someone had told her about a new type of vasectomy that was "painless", and she was hoping that her husband might be more willing to have such a procedure. Unfortunately, she was slightly misinformed. The "new" procedure is actually called a "no-scalpel" vasectomy. And, while it is no more and no less painful from the traditional scalpel variety vasectomy, it does offer a few small advantages. Both techniques use the same local anesthesia, which (if you have been to a dentist or had the need for a laceration repair) does cause some mild burning pain for a few seconds after injected into the skin. Where the techniques differ is in how the vas deferen (the small tube which carries the sperm from the testicle) is isolated.

The "No-scalpel" technique was developed in China, where vasectomy is extremely common. Two new instruments were developed which enable the surgeon to isolate the vas deferen through one tiny hole instead of the usual one or two separate incisions. In addition, the instruments make separating the vas deferen from the spermatic cord, in which it located, easier and less traumatic. The procedure takes less time than the traditional technique and the net result is a lower complication rate and shorter recovery time. There is frequently less swelling and a slightly lower rate of infection and bleeding complications. Because no incision is made in the skin, there are no sutures to be removed. Surgeons often use an absorbable suture under the skin in the scalpel technique, which means no sutures need to be removed, but this can cause more skin irritation at the site of the incision(s).

Back to the top Both techniques are equally effective. Surprisingly, approximately 2 in 1000 vasectomies fail – the body manages to reconnect the tube no matter what technique is used. Tubal ligation has a similar failure rate. Although vasectomies have been successfully reversed (from 15 to 75% rate, depending on how long ago it was done, where the tube was divided, and whether or not sperm antibodies were formed), the procedure should be considered permanent.

If vasectomy seems like it might be the right choice of contraception for you, consult with your doctor. There is also quite a lot of information on the Web about vasectomies.

Larry E. George, is a provider for High Country Health Care, PC, in Silverthorne, CO.