Easy VasectomyⓇ is a simple, inexpensive, and effective form of permanent male contraception. It is safer, less invasive, and has fewer complications and quick recovery. Under local anesthesia, only a tiny puncture is made at the midline of the scrotum skin. The most popular type of vasectomy is the No-Scalpel Vasectomy..
As of early year 2024, Dr. Shu has performed almost 6500 no-scalpel vasectomies without any major complications and zero failure rate. He invented two-finger technique in facilitating the local anesthesia and holding the vas during the surgery.
Young patients may consider the consultation first before they make the final decisions on vasectomy.
The minimum and necessary concepts that should be discussed in a preoperative vasectomy consultation include the following: (based on American Urological Association Guideline).
Conventional needle anesthesia in vasectomy involves the use of a 27 gauge needle to raise a wheal at the skin of scrotum; it is then advanced its full length along the vas on each side where further anesthetic solution is deposited. Dr. Shu uses the modern no-scalpel technique, exposing each vas in turn through a tiny opening in the front scrotal wall under local anesthesia. Since the opening is so small, it is easy to apply anesthesia without the use of needles. A spray applicator (MadaJet®) delivers a stream of anesthetic so fine that it penetrates the skin and diffuses to a depth of about 3/16 of an inch, enough to surround and anesthetize each vas tube in turn as it is lifted into position beneath the skin, attaining a close to 100% efficacy rate with no need for supplemental anesthetic.
The tiny opening in the dime-sized area of numb skin is made with a pointy hemostat: one tip makes a pinpoint opening, then the two tips are used to spread and enlarge the opening to about 1/4 of an inch. Since blood vessels in the skin are spread apart rather than cut, bleeding is less than when a scalpel is used, no stitches are required, and the opening is usually sealed closed (often barely visible) by the next day.
Once each vas tube is lifted through the small skin opening, it is divided under direct vision with fine pointy hemostat. Nothing is removed; the ends of the divided vas are placed out of alignment and kept from rejoining by applying a tiny clip to the sheath surrounding the vas so that one end stays inside the sheath, the other outside. The lining of the tube on upper end is destroyed with cautery (scarring it), the lower end is open without cauterization. While extremely effective (failure rate less than 1 in 2000), the technique provides for easier reversal (less scarring than when sutures are used) in men who choose reversal later in life. Procedure time is about 10 minutes. Most men say it hurts less than having a blood sample drawn. Many have called it painless.
Steps of Easy VasectomyⓇ:
With the patient lying down, the scrotum skin is cleaned with alcohol and a small amount of local anesthesia is placed into the scrotal skin with a fine needle or needleless pressure spray applicator around the vas deferens. Then the scrotum and its surrounding areas are prepped with Betadine.
Dr. Shu begins the procedure on the right side by gently bringing the vas deferens to a position just under the scrotal skin. A tiny puncture is made in the numbed area of scrotal skin. The vas deferens are then secured and pulled out with a ring clamp through the small opening. The surrounding fascia is stripped with a sharp instrument to expose the vas deferens.
Dr. Shu uses 3 steps to insure complete occlusion: he cuts the vas deferens and destroys the lining of the tube on each end with cautery (scarring it) and places small titanium clips in the vas fascia to separate the opened ends of vas deferens. The vas deferens are then placed back into the scrotum in its normal anatomic position.
1. Antibiotic ointment, gauze and an athletic supporter will be placed over the wound immediately following the procedure. Continue to apply the antibiotic ointment daily until the skin puncture site is completely healed.
2. Once you return home after the surgery. Reclining in bed or on the sofa , Minimizing activity. Read your doctor’s written instructions, No need for ice packs. You may shower and spend more time walking on the second day.
3. The athletic supporter should be worn for at least the first 24 hours or whenever you are up and around for the next 2 days, during sports for the next 7 days. Heavy lifting or vigorous physical activity should be avoided for 1 week.
4. Two days after the procedure, you may return to office work and regular activities. Since no incision is made, a follow-up visit is not required.
5. You may have sexual intercourse 1 week after the procedure. It is uncommon but normal to have some blood in the semen or mild pain for the first few ejaculations.
6. Patients often notice mild scrotal swelling and bruise in the first week following the surgery. The swelling often increases with activity, and may be relieved by wearing the athletic supporter and resting. If the scrotal sac is significantly bruised and expanding in size, please contact the office 952-922-2151.
7. If you experience pain or discomfort, you may take ibuprofen (Advil) 200mg 3 or 4 tablets, 3 times a day with food, and acetaminophen (Tylenol) 2 tablets every 4 hours. If you experience increasing pain, please contact us at 952-922-2151.
8. Infection is very uncommon following the no-scalpel vasectomy procedure. Contact Dr. Shu if you notice excessive redness, tenderness, warmth or drainage from your surgical site.
9. Some men develop a small, tender nodule where the vas was cut. These sperm granulomas can produce discomfort, but almost always resolve spontaneously. You can have the site re-examined if you are concerned.
10. Semen analysis testing is done in the 12 weeks (about 20 ejaculations) after your vasectomy:
a. If you live or work close to our clinic, we will provide you with a container and ask you use it to bring a semen sample to the office (for the Edina office only).
b. If you live and work far from our clinic, we will provide you with a mailer so you can send us a semen sample by mail (for both offices).
11. Another form of contraception (such as condoms or birth control pills) must be used for at least three months.
