One of the most common surgical procedures performed on men is a vasectomy, or male sterilization.  This is a minimally invasive procedure that divides the vas and blocks the transmission of sperm from the testicles to the urethra and allows the sperm to fertilize egg after depositing the ejaculate into the vagina. This article will discuss the different options for effectively accomplishing a vasectomy.

The time honored standard method.

This consists of making two 1-inch incisions on each side of the scrotum using a scalpel after administering a local anesthetic through a small needle. The vas is isolated from the nerves and blood vessels that supply the testicles. Once the vas is isolated, it is blocked using sutures, small metallic clips or cauterization. This technique is safe and effective and has been used for over 75 years.

No-scalpel, no-needle procedure

The no scalpel and no needle technique uses instruments specifically designed for vasectomy that were developed in China several decades ago. No scalpel is used to make the opening in the scrotum and no needle is required to deliver the local anesthetic.  A small single opening, about one-quarter inch is made in the middle of the scrotum and each vas is delivered through the small opening and blocked using sutures, clips or cautery to seal the opening of the vas thus preventing sperm from entering the ejaculate.  This technique is associated with less pain and discomfort during the procedure and less pain after the procedure compared to the standard method.  The no-scalpel technique is also associated with fewer complications such as bleeding and infection after the procedure.

Laser vasectomy

The laser vasectomy is still relatively new and not widely available although several clinics in Florida, California, and Idaho offer the procedure. In this technique, the surgeon uses a laser to access and isolate the vas. However, conventional methods (e.g., sutures or cauterization) are still used to occlude the vas. To date, laser vasectomy has not been shown to offer any significant advantages over the no-scalpel method.

Bottom Line:  When it comes to having a vasectomy, there are clearly a number of choices to consider. I suggest you discuss the various options with your physician.  The vasectomy remains one of the most effective and cost-efficient methods of contraception for many couples.