There are different techniques in performing a vasectomy. The traditional method uses a scalpel and the modern method which is called the “no scalpel vasectomy”. Both the traditional method and the no-scalpel technique are safe and effective in experienced hands. Urologists usually take advanced training to learning the no scalpel procedure. Most physicians at Michigan Institute of Urology utilize the “no scalpel vasectomy” approach exclusively since this minimally invasive procedure allows for a quick recovery and minimal discomfort.
A local anesthetic is used in all cases to allow the patient to be comfortable during the procedure. During the past few decades, over 15 million no-scalpel vasectomies have been performed with this technique now used around the world. As the name suggests, the
“No-Scalpel” method does not involve a scalpel, but a small opening is still necessary.
The key to the No-Scalpel Vasectomy is the special instruments that allow the procedure
to be done with generally less manipulation of the patient’s tissues.
Vasectomy reversal is a procedure in which reconstructive sperm duct microsurgery is employed with the goal of returning sperm to the ejaculate. Two procedures may be performed in a vasectomy reversal: a straight-forward reversal called a vasovasostomy (VV) or procedure that involves connecting the vas deferens to the ducts closer to the testicle (epididymis) called an epididymovasostomy (EV). The choice of procedure is dependent upon the nature and length of time of the obstruction, the quality of the testis, and the quality of the intravasal fluid. The process begins with a patient history and physical examination, which will provide some indication of the required procedure; however, the determining information is provided by an examination of the vasal fluid. Success of the vasectomy reversal depends on several factors including the required procedure (vasovasostomy vs. epididymovasostomy), the length of time of the obstruction, as well as the post-operative healing.
Operating time for a vasovasostomy is approximately 4 to 5 hours under a general anesthetic. Postoperative care includes an evaluation of wound healing at 2 weeks and a first semen analysis at 6 weeks. Semen analyses are then obtained at 2 month intervals until the semen analysis stabilizes or pregnancy is achieved. Routine follow up semen testing and visits will provide the best success rates.
In addition, sperm can be retrieved during the procedure and through cryopreservation, frozen for future use should the procedure not lead to pregnancy.