Will I have a local or general anaesthetic?
Can I have a No scalpel Vasectomy?
Absolutely. Both Morehampton Clinic and Churchfields Clinic now offer ‘No Scalpel Vasectomy’ as our standard procedure. This is a new development where instead of making a small incision in the scrotal skin and then grasping the vas, here the vas is held through the skin with a specialised instrument and the skin pierced with a pointed haemostat. There may be fewer risks of complications with this method. The rest of the open ended vasectomy operation is the same no matter which method – no scalpel or traditional – is used, and either way there are no skin sutures. We are not dogmatic. Some men are definitely more suited to traditional vasectomy, some to no scalpel. We decide on the day, and you are always offered either option.
Open ended Vasectomy? What is it, and why?
Blocking the testicular end has been known for decades to create a ‘back pressure’ down the tube to the epididymis and to the testicle, and was presumed to be a common cause of post vasectomy discomfort. However, this double blocking was felt to be necessary for contraceptive reliability.
In the early 1980s, some Australian vasectomists questioned the need for this. In theory, leaving the testicular end open, and not blocking it, should remove the ‘back pressure’ problem. They devised a technique that left the testicular end open, and quickly found that far fewer men complained of this discomfort. The big worry was – would this technique be contraceptively safe? It took a few years before this could be answered, but thankfully the ‘open ended’ technique has exactly the same success rate as blocking both ends, and with less complications.
The Australians initially used a suture around the tissue enclosing the open end to keep it separated from the upper end, which is always closed, but in the early 1990s changed to using a tiny titanium clip instead of a suture. This has now become the ‘gold standard’. The clip does not block the tube, instead it keeps the two vas ends in different tissue planes – a type of belt and braces approach. The clip is miniscule and cannot be felt. Titanium is non ferrous, so it is not detected by metal detectors in airports, and it is safe to have an MRI scan with it in place.
Why will I have an injection, instead of the ‘no needle’ method?
One incision or two?
If you block the tubes, how can a vasectomy fail?
Vasectomy failures are classified in two ways – an early failure picked up on sperm testing and a late failure after ‘all clear’ sperm tests.
Early failures are proven to be dependent upon the skill and experience of the operator, with more experienced vasectomists having fewer failures.
Late failure, that is a failure after clear sperm count, should not happen in theory but unfortunately does. International studies have shown that the rate is the same irrespective of the operators’ skill or the technique used. The cause is unknown. Vasectomy is ten times more reliable than the next most reliable contraceptive method, which is female sterilisation, and statistically 3000 times more reliable than condom use.