In 2001, a friend of mine in the state of Washington, Dr. Chic Wilson, told me about a new method to perform vasectomies. He claimed it was essentially painless and that soon everyone would be doing it. His innovation to the surgery was the way the anesthesia was delivered. When he told me he could do a complete vasectomy with only 0.2 cc of xylocaine, I thought he was stretching things a bit. In my routine vasectomies, I used 5 to 7 cc's, injected through a small needle. Either way, the procedure only takes about 15 minutes.

What Dr. Wilson developed was a small adapter that fit on to the end of a MadaJet. The MadaJet is the size of a test tube. You cock it somewhat like a BB gun. It creates a pressure which blows the anesthesia into the desired tissues. Because the vas can be isolated right under the skin, Dr. Wilson claimed that just one puff with the instrument over each vas was enough to provide total anesthesia for the surgery. Using this method, he was able to avoid any needles for the procedure.

Over the years I heard of Dr. Wilson presenting to various medical groups. Recently, a urologist from California asked if I would teach a vasectomy course for him. He insisted however that I present the no-needle technique. Since I had the MadaJet in the office already and had used it for many years, I simply obtained the special adapter and began using it to numb the area prior to vasectomy. To my surprise, Dr. Wilson was correct. With literally two painless puffs from this instrument, it was possible to obtain total anesthesia to then perform the no-scalpel method for a vasectomy.

Bleeding is always one of the concerns when performing vasectomy. During the administration of the anesthetic using a needle, vessels can be ruptured. Using this new no-needle technique, there is even less chance of post-operative bleeding.

It is now possible then to anesthetize without a needle and to perform a vasectomy without using a scalpel. The technique seems to be as good as it can get.

Although tubal ligation for women is a good procedure if a couple desires permanent contraception, there are some advantages to a vasectomy. Fourteen women a year die in the United States from tubal ligations, while no man has ever died from a vasectomy. Failure rates for vasectomy range between 1 in 600 and 1 in 1200. Virtually all failures occur in the first three months. For tubal ligations, failure rates are approximately 1 in 200 after the first year and continue to rise after that. With tubal ligation, there is no way to detect the failures. With vasectomy, men can bring in samples which are examined for the presence of sperm. Should sperm be found, a repeat procedure can be performed. Since vasectomy is an office procedure, it is also less costly than a tubal ligation which must be done in the hospital. And now that the procedure itself is essentially painless, vasectomy has an even greater advantage as the preferred choice for permanent sterilization.

A vasectomy does not affect a man's sex drive, his hormones, or sexual performance. It only blocks the transport of sperm from the testicles to the ejaculate. In previous columns, I did discuss the no-scalpel method of vasectomy. This involves a special instrument to puncture the skin. There is only one opening that is about 3/16 of an inch long. No sutures are needed. Interested parties can call the office or go to our website at www.MPCenter.net for that article as well as other information.

To my disbelief, I have to admit, Dr. Wilson was right. It's too bad that sometimes it takes so long to "teach an old dog new tricks"!