No- scalpel vasectomy

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2. Small incision in the scrotum under LA
 A piece of vas at least 1cm removed after clamping
Cut ends are ligated & folded upon themselves
Sutured so that cut ends face away from each other
oSterility not immediate (at least 30 ejaculations)
oSperms are stored in reproductive tract upto 3 months
oSperms destroyed intra luminally by phagocytosis
o2 semen analysis- no sperm –man declared sterile

3. COMPLICATIONS OF VASECTOMY
Local pain, skin discolouration, bleeding
Infection, trauma to artery ,gangrene
Ab formation, autoimmune disease
Failure rate
Granuloma formation
Spontaneous recanalization
Spermatocele formation
Haematoma

4. Non Scalpel Vasectomy
Local Anaesthesia is
given
Vas deferens fixed by
a ring forceps so that
only minimal amount
of tissue is present in
the ring

5. Skin directly overlying
the vas in the ring
forceps is punctured
Puncturing hole is
enlarged to about
twice the diameter of
vas deferens

6. Delivering the vas
out of the
puncture hole

7. Ligaturing the ends
of vas & excising a
small segment
Tied ends are pushed
back into scrotum
Opposite vas is also
manipulated

8. At the end of the
procedure a tiny
puncture hole
results, which
doesn’t require any
closure

9. POST OPERATIVE CARE
 Wear a T bandage for 15days
 Avoid bathing 24hrs after the operation
• Keep the site clean & dry
 Avoid cycling or lifting heavy weights for 15 days
 Use contraceptives until aspermia has been
established
 Have stitches removed on 5
th
day after operation

10. DISADVANTAGES OF NSV
Haematoma formation
Sepsis

11. ADVANTAGES OF NSV
No incision, no stitch
Minimal dissection using only 3 instruments
Chance of complications reduced from 2% th 0.3%
Safer, convenient, acceptable method
Cheaper compared to tubectomy

12. In spite of all these advantages,
male sterilizations account for
only 15% of all sterilizations in
India !!!!!!!