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The no-scalpel technique was developed in China in 1974 by Dr Shunqiang Li. Conventional vasectomy involves a scalpel incision to both sides of the scrotum and sharp dissection to gain access the vas deferens tubes. The no scalpel technique involves puncturing the scrotal skin with one entry into the middle of the scrotum. No scalpel is used to puncture the skin or importantly in the dissection to isolate the vas deferens. This technique has proven to reduce complication risk by 10 times. In addition, the procedure itself is more comfortable during and also after as no stitch is required to close the skin.
No-scalpel vasectomy is regarded as a safe, in-office procedure.
It is true that vasectomy can be reversed. This is usually done with microsurgery to bring the two end of the vas deferens together (vasovasotomy) or to bring the vas to the epididymis (vasoepididymostomy). However, vasectomy should be regarded as an irreversible form of contraception. This is because reversals are not always successful and if a man goes into a vasectomy expecting it to be successfully reversed later down the line, he may be proven to be disappointed.
An alternative to vasectomy is sperm retrieval which maybe offered by specialised fertility clinics.
Laser sounds appealing. Lasers are used frequently in medicine and are definitely a great technology. But not for such a simple procedure as no-scalpel vasectomy. I do not know anyone that does it, nor are there any studies showing benefit of laser vasectomy in humans.
The benefits of no-scalpel vasectomy are:
- Less risk of bleeding and scrotal haematomas (collections of blood within the scrotum)
- Less risk of infection
- Single incision procedure
- No stitches required
Vasectomies performed by Dr Ranaweera are “open-ended”. In some vasectomies the testicular end of the separated vas tube is closed by stitch, clip or electrocautery. Theoretically, this plugs the sperm and pressure may build within the structures upstream (which importantly includes the epididymis). This sudden increase in pressure results in congestion and an exaggerated inflammatory response. Inflammation may contribute to post-vasectomy pain syndrome and scarring which reduces the success of reversal.
An open-ended vasectomy refers to a technique where the both cut ends of the vas tubes left open. This allows for sperm to escape the vas and may result in the formation of a sperm granuloma. Again, in theory, this reduces the inflammation upstream which may decrease the risk of post-vasectomy pain syndrome and increases the success of later vasectomy reversal.
The “open-ended” technique sounds superior in theory but the benefits are probably overstated for the following reasons:
- Sperm granulomas do not always form and if they do, they can be just as uncomfortable as post-vasectomy epididymal inflammation.
- Patients can still have epididymal inflammation (Although the pain from both epididymal inflammation and sperm granulomas usually settled with anti-inflammatory medication none-the less).
- Reversal success is not dependant on whether a man has had an “open-ended” or “close-ended” vasectomy
There is no minimum age as such for a vasectomy. However, if you are under the age of 30 and have fewer than 2 children, we ask that you book in for a consult to discuss your situation before committing to vasectomy. We like to know that you have thought about the ramifications of vasectomy and the options available for you prior to undergoing a potentially irreversible procedure.
Generally, the procedure takes about 10-20 minutes.
How much does vasectomy cost - Schedule of fees
(Medicare Rebate $195.40)
(Total Out of Pocket Expense $350.00)
|DEPOSIT||$100 deducted from final fee|
|Bulk – Billed|