Life in the Keyhole

They say that having a vasectomy means you never have to say you’re sorry. I recently realized that this has been true for 20 years now in my practice! That’s how long I have been doing the no-scalpel vasectomy procedure. One dry sack on the rocks please, bartender!

Vasectomy Origins

Nary a surgical procedure has had such a colored past. Practiced in the U.S. for over a hundred years, the vasectomy has quite the checkered past. In the early 1900s, it was promoted as enforced contraception “for criminals and defectives” in several states. In the 1920s it was touted as a method of “rejuvenation” of aged men. Finally, since the invention of oral contraceptives for women in the 1950s, the vasectomy has played a very distant second fiddle to it as the primary birth control method among Americans.

The No Scalpel Vasectomy

And the stories don’t stop there. The no-scalpel vasectomy technique was developed in the 1970s in China by Dr. Li Shunqiang of Sichuan Province, and has since been performed on millions of Chinese men. Its invention was perfectly timed to meet the needs of the new “One Child Law” enforced there since 1979. This family planning policy forbade couples from having more than one child in urban areas. Credited with preventing more than 400 million births, the no scalpel vasectomy also has a darker, civil-rights side, being implicated in cases of forced abortions and infanticide.
In the mid 1980s, a nonprofit group called Association for Voluntary Surgical Contraception (AVSC, now Engender Health) brought the technique to America from China. I remember first seeing it performed by one of my attendings in Philadelphia while I was a fifth-year resident in urology 20 years ago. Because of the sheer elegance and efficiency of the approach, I began it then and have never looked back.

No More Stories

It’s a gimmick, right? You have to get under the skin somehow! Well, maybe the name is a bit hyped, but it really is a significant advance in the field. The specially designed instruments enable it to be done though a keyhole puncture in the skin. Using a precise, almost Zen-like presentation of the sperm ducts, it is really faster, cleaner, less complicated and less painful than the traditional incisional approach. Really.
So, with this technique, the vasectomy “stories” have now ended. Here I am, 20 years and thousands of cases later, very pleased with the good that I have done for those everyday heroes who “take one for the team.”