Table of ContentsView AllTable of ContentsNo-Scalpel vs. TraditionalProcedurePros and ConsAfter SurgeryCostEffectivenessFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
No-Scalpel vs. Traditional
Procedure
Pros and Cons
After Surgery
Cost
Effectiveness
Frequently Asked Questions
A no-scalpel vasectomy is a minimally invasive male sterilization procedure in which a surgeon makes a small hole in the scrotum and removes part of the vas deferens, the tubes that transport sperm so it can mix with semen.
This procedure differs from a traditionalvasectomyin that, as its name suggests, it does not require a surgeon to use a scalpel (surgical blade). Instead, they find and clamp the vas deferens from the outside and use a tool that only punctures the scrotal skin.
This article reviews the steps involved in a no-scalpel vasectomy, its advantages and disadvantages, effectiveness, side effects, and more.
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Vasectomy: Overview
No-Scalpel vs. Traditional Vasectomy
The goal of a no-scalpel vasectomy (or keyhole vasectomy) is the same as for aconventional vasectomy—to create a blockage (occlusion) in the vas deferens so that sperm can no longer become part of the semen.
No-scalpel vasectomy is as effective as a traditional vasectomy, but is considered the better surgical approach for several reasons.
During a standardvasectomy, two incisions are made in the scrotum to allow the surgeon to reach each of the vas deferens. However, during a no-scalpel vasectomy, only one small puncture is made.
And because the puncture site is so small, patients usually don’t need stitches, have less pain, and heal more quickly.
Compared to traditional vasectomy, a minimally invasive vasectomy also offers:
Minimally invasive vasectomy has been widely accepted as a medical standard for more than a decade. This approach has become far more common than traditional vasectomy.
How No-Scalpel Vasectomy Is Performed
After numbing the area, the surgeon uses a hemostat (locking forceps with a sharp tip) to puncture through the skin of the scrotal sac. Each vas is lifted out of the single puncture site, one at a time. Then the occlusion is performed.
Some surgeons may take the additional step of fascial interposition, which consists of sewing connective tissue over the free prostatic end of the vas (the end closest to the urethra). This creates a tissue barrier between the vasal ends.
Some research suggests that this additional step decreasesfailure rates, but the evidence is inconclusive at this time.
Finally, each end of the vas is allowed to slip back into the scrotum.
Open-Ended Procedures
During both traditional and no-scalpel vasectomies, men may be given the choice to have an “open-ended” procedure. This means that only the prostatic end of the vas is tied or cauterized. The testicular end (closest to the testis) is left open.
The open-ended technique has also been shown to lower complication rates as well as fewer cases ofepididymitis(when the epididymis tube at the back of the testicle responsible for storing and carrying sperm becomes inflamed).
What Is Epididymitis?
Benefits and Disadvantages
Research demonstrates that men who underwent a no-scalpel vasectomy reported:
However, regardless of how they are performed, vasectomies are still surgical procedures that have some cons worth considering:
After Your Vasectomy
Vasectomy is most often an outpatient procedure, which means it’s performed in your surgeon’s office. You’ll go home the same day as your surgery.
Recovering at Home
Most men recover from a vasectomy in about a week. In that time, it’s important to take steps to help your surgical site heal.
Even though you won’t have an incision, you’ll still want to avoid anything that could irritate the area or open the surgical site. That means rest, including no sex, exercise, or heavy lifting.Your surgeon will advise you as to when you can resume your regular activities.
Self-care at home will also include:
You will also need to watch for signs of infection, such as a fever, and report them to your surgeon if they occur.
Potential Side Effects
Typically, a no-scalpel vasectomy has few major side effects and is only linked to a very small chance of infection and little pain. You may experience a reaction to the local anesthesia.
There is a tiny chance of developing sperm granuloma—a hard, sometimes painful pea-sized lump due to the sperm leaking out from the open-ended vas deferens.
Some men report short-term tenderness and a little bit of bruising after the procedure.
Costs
In general,vasectomies are considered a lower-cost surgical option. You may be charged for an initial consultation as well as for your follow-up visit to have your semen analyzed. But, after these up-front costs, there are no ongoing costs to maintain this contraceptive method.
How Much Does a Vasectomy Cost?
Less than 1 out of 100 women whose partners have had a no-scalpel vasectomy—and follow-up testing to ensure its effectiveness—will get pregnant each year.
Of special note, the no-scalpel vasectomy is not 100% guaranteed to be effective. Even when the procedure is performed perfectly, the possibility of recanalization can occur.This is when sperm manage to find their way across the blocked ends of the vas deferens. The possibility of this occurring is very rare (well below .5% of the time).
This is why it is extremely critical that you undergo your semen analyses 6-12 weeks post-vasectomy to be absolutely sure that no sperm are present.
Frequently Asked QuestionsYes, but the procedure is complex and can depend on a variety of factors, including how long it’s been since you had the original procedure. If you are considering a vasectomy reversal, talking to your healthcare provider can help determine whether the procedure is right for you.Like a traditional vasectomy, healing time for a no-scalpel procedure is usually a week or less. Most patients who undergo the procedure are back to work in a few days.
Yes, but the procedure is complex and can depend on a variety of factors, including how long it’s been since you had the original procedure. If you are considering a vasectomy reversal, talking to your healthcare provider can help determine whether the procedure is right for you.
Like a traditional vasectomy, healing time for a no-scalpel procedure is usually a week or less. Most patients who undergo the procedure are back to work in a few days.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
UNC Men’s Health. UNC School of Medicine.A Urologist Answers Questions About the No-Needle, No-Scalpel Vasectomy.
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Errey BB, Edwards IS.Open-ended vasectomy: An assessment.Fertil Steril.1986;45(6):843. doi: 10.1016/s0015-0282(16)49404-5
Edwards IS.Open-ended vasectomy.Adv Contracept Deliv Syst. 1988;4(2-3):195-224.
Patel AP, Smith RP.Vasectomy reversal: a clinical update.Asian J Androl. 2016;18(3):365-371. doi:10.4103/1008-682X.175091
Health Department of Alberta, Alberta Government.Vasectomy: What to Expect at Home.
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Kuan-Chou Chen, Chiung-Chi Peng, Hsiu-Mei Hsieh, Han-Sun Chiang.Simply modified no-scalpel vasectomy (percutaneous vasectomy) — A comparative study against the standard no-scalpel vasectomy.Contraception.2005;71(2): 153-156. doi:10.1016/j.contraception.2004.07.018
Anthony Viera, Timothy Clenney.Vasectomy and other vasal occlusion techniques for male contraception. UpToDate.
Labrecque M, Nazerali H, Mondor M, Fortin V, Nasution M.Effectiveness and complications associated with 2 vasectomy occlusion techniques.J Urol.2002;168(6):2495. doi: 10.1097/01.ju.0000032801.68305.3f
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