A Vasectomy is a minor out-patient procedure performed to intentionally cause sterility for long term birth control. Approximately 500,000 vasectomies are performed in the United States each year. In its simplest terms, a vasectomy is the division of the vas deferens, the tube that carries sperm cells from the testicles to the urethra and out the tip of the penis.  This division permanently blocks the flow of sperm leaving the man with an ejaculate that is visibly the same though contains no sperm cells and therefore cannot cause pregnancy.  The sperm cells make up roughly 1% of a mans ejaculate, which means the volume does not noticeably change. Historically, this procedure was performed using one or two small ½ – ¾ inch incisions, which were then closed with several stitches. We perform vasectomies by combining two superior techniques, No Needle Vasectomy (NNV) and No Scalpel Vasectomy (NSV), to ensure it is as Painless as possible. 

No Needle Vasectomy (NNV): Introduced in the United States in 1999 by Dr. Chuck Wilson, a Family Practice physician from Seattle with a special interest in vasectomies.  Rather than using a small needle to inject lidocaine into the skin and next to the vas deferens, a MadaJet is used to push a tiny stream of lidocaine less than a 1/4 inch (5 mm) into the skin and around the vas deferens tubes.  This happens in a tenth of a second and is nearly painless, while a fraction of the lidocaine and provides equal or superior local anesthesia compared with typical needle infiltration. Patients usually state that it feels similar to a rubber band snap or a flick on the skin; by the time you know it happened, it is already going away or gone.

Interview with Dr. Griffith including additional information and demonstration of MedaJet.

No Scalpel Vasectomy (NSV): First performed in China in the mid-1970’s and became widely available in the United States in the late-1980’s. Rather than a scalpel incision, the skin is gently spread using a special hemostat and the vas deferens is brought out through the skin of this much smaller (1/4 inch) opening (see “NSV opening” in image above). Both vas deferens tubes are divided through this single site. The NSV technique proved to be more comfortable for the patient, have fewer complications, and have a faster recovery time.

What is Your Risk of Vasectomy Failure? After dividing the vas deferens during the procedure, we cauterize or burn the inside of the tube toward the penis so that it will quickly scar, blocking the inside of the tube. The tube on the side of the testicle is left open to allow any residual sperm to be absorbed and reduce risk of discomfort from obstruction. The failure rate of stopping at this point would be around 3% (1 in 33.3). Therefore we separate the two ends, place a layer of fascia (strong connective tissue) between them and clip the fascia in place with a small medical grade titanium clip no bigger than a grain of rice. This provides a mechanical barrier between the two ends and keeps them from growing back together. If you prefer to have a vasectomy without a permanent titanium clip, we can perform it with an absorbable suture. The late failure rate after this is 0.05% (1 in 2,000). This is 10 times better than an intrauterine device (IUD), 20 times better than tubal ligation or birth control pills and 100s of times better than condoms. The only birth control that is better is removal of the testicles, ovaries, uterus or complete abstinence.

When Are You Sterile? The vas deferens tubes are full of millions of sperm cells at the time of the procedure. It takes about 3 months (12 weeks) to completely clear the vas deferens of live, normal sperm cells for 90-96% of men. If you do not want a pregnancy, you must continue to use birth control/contraception until a microscopic exam of your ejaculate (semen analysis) proves that the desired result of sterility has been achieved. Pregnancies can occur in couples who do not use some form of birth control/contraception between the time of their vasectomy and proven sterility.