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ASK THE EXPERTS

YEFIM SHEYNKIN, MD

Patient Question

My wife and I are both 38. We have three kids and are considering permanent sterilization. We've decided upon vasectomy, but I'm very concerned about pain and recovery time. I've heard about a less invasive vasectomy performed without a knife. Is that possible?


Yefim R. Sheynkin, MD

Yefim R. Sheynkin, MD

Associate Professor of Urology
Department of Urology
Director, Male Infertility & Microsurgery
Expert Answer

It is certainly possible with the procedure called No-Scalpel Vasectomy (NSV). Vasectomy is one of the most popular forms of contraception, and is regarded as safe and highly effective. A recent national survey found that 12 percent of married men between 20 and 39 have had vasectomies, which are performed by cutting the vasa deferentia, small tubes that carry sperm from the testicles. In a conventional vasectomy, the physician usually makes two small skin cuts with a knife, and then uses sutures to close the wounds. In the NSV, only one tiny puncture into the skin is required, using a special instrument that is also used to gently stretch the skin opening to reach the tubes. The procedure requires no stitches, takes less time, causes less pain, provides faster recovery, and has bleeding and infection rates approximately ten times lower than conventional vasectomy. With respect to the pain factor, the NSV recently became even less invasive with the No-Needle NSV technique. It is well known that man's most common concern about vasectomy is 'the needle' used for injection of local anesthetic into the scrotum. The new method reduces this needle phobia and anxiety prior to and during the vasectomy. Instead of two needle sticks, a fine stream of liquid anesthetic is delivered with a high-pressure jet injector. This is a nearly painless technique with rapid onset of anesthesia that requires only small amounts of medication.

Currently, only one-third of vasectomies in the United States are performed with the NSV technique. Only a limited number of institutions and practices in the U.S., Stony Brook being one, have the capability to perform the innovative No- Needle NSV. It is important-especially when new and advanced techniques are being used-that an experienced physician, who does this procedure frequently, perform your vasectomy.


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