Dr. Osman’s Technique:
No-scalpel … No-needle….and No-stitches!!!
South East Vasectomy uses the 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 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. Most, about 99%, of patients require no more anesthetic than this for completion of the procedure itself without pain. Some, about 1%, of patients do require injection of a little more anesthetic, but since the skin and vas are already partially numb, injection of more anesthetic with a fine needle rarely causes more than the slightest sensation. 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 surgical scissors. 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. 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 15 minutes. Most men say it hurts less than having a blood sample drawn. Many have called it painless. A scrotal support (jockstrap) is applied and should be worn overnight and reapplied, after a next-morning shower, when up and around for the next 3 days. Ice-packs are not necessary. Men are advised to recline on the evening of the vasectomy, light activity the next day, sex and full activity 3 days after the vasectomy. After vasectomy about half of men will take non-prescription pain pills (Ibuprofen), often just to prevent expected discomfort; the other half don’t take any pain pills. About 1 in 1000 men will have enough discomfort to request a prescription pain medication. Semen samples can be brought to the office anytime after twelve (12) weeks following the procedure to see if all stored sperms have been passed. Ninety-eight percent of men are sperm-free after about 12 weeks and 20-30 ejaculations, some sooner, and a few men will not be sperm-free for 5 or 6 months.