To understand what happens during a No-Scalpel Vasectomy procedure, first review this diagram to see how the male anatomy normally functions.
The testicles produce sperm that travel 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 NSV procedure simply interrupts the flow of sperm by cutting the sperm tubes and blocking their ends.
ARRANGING A NO-SCALPEL VASECTOMY
To arrange for your no-scalpel vasectomy (NSV), your doctor can refer you, or you can call Dr. Lohlun’s main telephone number, (780) 469-5299, for an appointment. The basic NSV procedure is fully covered by Alberta Health Care.
To begin with, you will have an initial consultation. When you arrive at the office you are given a detailed information package to review and a short personal medical history sheet to fill out. We recommend using our online registration form in order to save some paperwork later, if you have a few minutes now to do so.
Once you have completed the history sheet and read through the material (which you take home with you), you will have your consultation with Dr. Lohlun. At this time you will be examined and you will have a chance to discuss any questions or concerns that you might have in a relaxed, friendly and professional setting.
For men coming from outiside of Edmonton, we can offer a single visit procedure – where your consultation will be done by phone so that you will only travel to our clinic for the procedure itself – and with our Premium Services Package you can also have all follow-up done by phone as well. The Premium Services Package is an optional non-insured service recommend for all clients for greater personalized services and enhanced convenience. Please contact our office for details, or see more info on the Vasectomy Fees page.
When you decide that you want to proceed, every effort is made to book an appointment for the procedure on a day convenient for you. At Lohlun Clinics every surgical procedure is done only by Dr. Lohlun and not by other physicians.
Getting Ready For Your NSV
Starting seven days before the procedure, do not take any aspirin or other anti-inflammatory medication. These thin the blood somewhat and increase the risk of bleeding. Similarly one should avoid alcohol for 48 hours before and after the surgery.
- Wash your scrotum for 2 nights before your procedure and for 2 nights after your procedure with an anti-bacterial wash (the anti-bacterial wash is provided as part of the optional care package, that you can purchase from our office on the day of your consult). If you are having a same day consult/surgery then using the antibacterial wash provided for 2 or 3 nights after your surgery is acceptable.
- For our much improved visibility and for hygenic reasons (keeping hair out of the surgical area), we recommend that you shave from the base of the penis and along front and sides of your scrotum.
- Wear the athletic support from your premium services pack to the office. The support should be worn over your underwear.
- If you are having a same day consult and procedure, you can get the after care supply pack with scrotal support and put it on once you get to the office.
- Wear comfortable clothing. Choose pants that you won’t mind getting iodine on after the procedure.
- We also recommend that you wear a T-shirt because the room in which we do the procedure is hot and anything heavier may be uncomfortable for you. The heat of the room relaxes the scrotum and makes the procedure easier to perform.
- Eat a good breakfast! You will feel much more comfortable during the procedure.
- Plan to arrive a little earlier for your appointment. From the time that you arrive at the office until the time you leave, 45 minutes will generally suffice. However we suggest that you give yourself an hour as you may choose to stay longer and relax after your procedure.
- If you are coming from out of town and having a single visit procedure you can get your supply pack on the day of your surgery instead of at the consultation – assuming that you will take advantage of the recommended Premium Service Package.
- Please remember to bring your favourite music for your surgery. Alternatively we will have a selection of background music to play.
- Please review the information on this website in full so that you will know what to expect.
When you arrive at Dr. Lohlun’s office you are taken into the procedure room. You keep your shoes and socks on and simply lower your pants, underwear and athletic support. You lay down on the table, and then your scrotal area is cleansed. An elastic is then gently placed around your penis which is lifted back away from the scrotum. The elastic is then clipped to your shirt. You are then covered with a surgical drape and the scrotum is brought through an opening in the drape. After putting a little freezing solution into the scrotal skin, (not into the testicle), you should not feel anything.
The freezing involves an air jet injector that delivers a spray of anesthetic under high pressure through the skin, virtually painlessly and very effectively. No-needle anaesthesia is included with the Premium Service Package.
Oral sedative medications are almost never required.
Once the area is frozen, Dr. Lohlun locates the tubes one at a time. He gently holds each tube between his fingertips, and grasps them with a specially designed ringed clamp. With a pair of special forceps, he makes one tiny puncture into the skin of the scrotum. This small line “l” , approximately 2 millimetres, represents the true size of the puncture. With the same instrument he gently lifts the first tube out through this opening.
You should be aware that once the tubes have been brought out through the tiny 2mm opening in the scrotum, approaches among physicians on how to block them differ. For example, some procedures involve just cutting and tying the ends of the tube. Others cauterize (burn) the ends. Dr. Lohlun prefers to affix metal titanium clips to the proximal ends.
Once the sperm tube (1.) is lifted out of the scrotum, it is cut and the upper end (abdominal) is cauterized. The cauterization on the end of the tube stimulates the formation of a strong scar that blocks the tube. This procedure is carried out on both sperm tubes.
* Some studies suggest that when the tube is cut, the testicular end should be left open (called Open Vasectomy), and that doing this may, in fact, reduce the likelihood of post-vasectomy pain. The open-ended vasectomy is the technique currently performed at Lohlun Clinics.
Dr. Lohlun then carries out the next step (3.), that some studies suggest increases the success of the procedure, called fascial interposition. This step involves bringing the fascial sheath, or covering of the sperm tube, over one end of the cut tube to create a natural barrier between the two cut ends. Fascial interposition is carried out using titanium clips – or optionally (with the Premium Service Package) dissolving sutures.
Dr. Lohlun then gently places the separated ends back in the scrotum, and the same procedure is done through the same small opening on the other sperm tube. The opening is finally covered with a gauze pad, and you can pull up your athletic support and clothes. In Dr. Lohlun’s hand the one small skin opening is so tiny that it closes itself without the need for stitches or any other skin closure material. This tiny opening heals quickly and virtually without a trace. You can shower after your surgery without any problems, (of course no scrubbing of the surgical area should be done).
Everyone seems to wonder what happens to the sperm after their vasectomy. The testicles will continue to produce sperm that will in turn leak out the lower ends of the cut vas tubes. The sperm cells are surrounded and broken down by the body’s waste removal cells into their component parts, which are either excreted or recycled. This process causes no concerns of any clinical significance.
To view the entire procedure. Check out the video page.
Our procedure is so simple and easy that after having something to drink and relaxing for few minutes, men have no trouble driving home on their own. So at the Lohlun Clinic, you do not have to bring a driver with you.
SCHEDULE A CONSULTATION
After the vasectomy you should rest for 48 hours, even if you don’t feel like you need to. Most men can return to work by the second or third day after the procedure. If your work involves heavy labour you should take up to a week off, but if you do light work you can get away with just a few days off.
After the procedure there may be some soreness, and some men take a mild painkiller. Others report that they experience virtually no pain afterwards.
All men should follow these instructions for the first week after the procedure:
- Take the medication in your Premium pack as ordered.
- Stay off your feet as much as you can for the first two days.
- Use an ice pack on your scrotum for 20 minutes every hour (except when you’re sleeping) for the first two to three days after your vasectomy. You should repeat the icing as often as you can in the first week.
- You can make your own ice pack by putting ice in a plastic bag and wrapping it in a dish towel, or use a bag of frozen peas. Gel packs also work well.
- Do not strain yourself. Do not have sex or lift anything heavier than 15 pounds.
- Keep the incision clean and dry, although it is acceptable to take a gentle shower after your surgery.
- Wear your scrotal support for the entire week unless doing so causes you discomfort.
- Leave some clean gauze with antibiotic ointment applied at the opening in the scrotum for a day or two. It is possible that this practice may further reduce post-operative infection rates.
- Call Dr. Lohlun if you notice ongoing bleeding or a swelling bigger than a marble around the opening or in the scrotum.
- Call Dr. Lohlun if you get a fever, your scrotum gets very red or you notice any unusual discharge.
After the procedure, Dr. Lohlun is available on his cell phone at: 780-999-4345 for your concerns should any arise.
Because you are not sterile right after your vasectomy, temporary birth control is needed until 2 follow-up semen samples confirm that no motile sperm are present. You will be given 2 sample containers and lab requisitions for semen tests to be done at 2 and then 3 months after your procedure. You present a lab requisition to the semen analysis lab at the Royal Alexandra Hospital in Edmonton (directions will be included with your form). Please do not bring samples back to our office. We will call you with the semen test results if you take the Premium Service Package, or you may have follow up appointments at the clinic instead.
By the time of the first sample, two months after your procedure (and after at least 20 ejaculations), 70% of men are sterile. By the second sample, three months after your procedure, up to 95% of men are sterile. A few percent of men may require up to six months and repeated samples to confirm sterility. These tests are very important!
The chance of a sperm passing through the blockage in the sperm tubes is extremely small, especially once the sperm tubes are cut, cauterized and then separated by the fascial sheath barrier. But failure is possible; the incidence of failure is estimated between .1% and 1%, and varies with the skill and experience of the operator and with the approach used to block the tubes. It is for this reason that testing semen samples is essential. We are pleased to report that the Pollock Technique, over many thousands of surgeries, has demonstrated an outstanding success rate with a very low complication rate.