A bit of anatomy
Sperm is produced in both testes (testicles) and then travels in a tube on both sides (called the vas deferens: plural = vasa) to the seminal vesicle at the back of the bladder where they are stored. Most of the fluid ejaculated (approximately 98% of the semen) is actually produced in the seminal vesicle and prostate gland.
The testicles produce sperm that travels through a pair of tubes called the Vasa Deferens. You can easily feel them through the scrotal skin, like firm spaghetti-sized tubes on either side of the penis. These tubes carry sperm from the testicles out through the penis.
The No-Scalpel Vasectomy procedure (NSV)
The No-Scalpel Vasectomy was developed in china in 1974 by dr. Li Shunqiang. By 1985, an international team made up of members from the World Health Organization (WHO) and Access To Voluntary And Safe Contraception (AVSC), formerly the Association For Voluntary Surgical Contraception, were visiting China to study alternative vasectomy procedures, including the No-Scalpel Vasectomy. In 1988, after careful observation and review of the No-Scalpel Vasectomy procedure, they decided to introduce the technique to North America. Since then, over a million No-Scalpel Vasectomies have been performed in North America and nearly 20 million in China.
A UNIQUE, BLOOD-FREE, AND PAIN-FREE TECHNIQUE
The No-Scalpel Vasectomy (NSV) procedure simply interrupts the flow of sperm by cutting the sperm tubes and blocking their ends (see the diagram below).
The procedure is very simple and can take anywhere between 10-30 minutes. We use a special “no sting” local anesthetic which is injected into the skin in the front of the scrotum instead of doing injections into the testicles.
A single small opening is made in the centre of the scrotum below the penis without usng a scalpel. The opening is only 2 to 4 milimeters in size and will close rapidly and heal without stitches. The vas are located and approximately 1 to 2 centimeters are removed from each. The upper ends are tied off with a special thread that slowly dissolves over 12 weeks. This leaves the bottom ends open (hence the name “Open-Ended method”) allowing sperm which is still produced to escape into the scrotum and be reabsorbed. This reduces any pressure build up and pain in the testes and epididymis after the procedure.
THE OPEN-ENDED TECHNIQUE
At our clinic, we don’t use the closed-ended technique to block the vas tube. We prefer the Open-Ended Technique. This means that once the vas tube is cut, only the upper end of the tube is blocked while the lower end, leaving the testicle, is left unblocked. Many studies show that this method can reduce the risk of long-term congestive pain in the testicle. This approach not only has no detrimental impact on the success rate of the procedure but it creates only half of the thermal cautery damage because only the upper ends of the tubes need to be cauterized. Furthermore, the open-ended method decreased the risks of pressure in testicles.
The No-Needle Vasectomy procedure
This technique uses the MadaJet®, a spray applicator that delivers a fine stream of liquid anesthetic with enough pressure to penetrate the skin at a depth of about 5mm, deep enough to envelop the vas tube held snugly beneath the skin. Each vas is positioned in turn beneath the very middle of the front scrotal wall and given two or three squirts.