Why I Am an Early Adopter of the No Scalpel Vasectomy

Although a “no scalpel” anything is vastly more attractive than the alternative, is it really all it’s cracked up to be with a vasectomy? Or is it a marketing ploy to get men in the door? After all, who needs another bait and switch play when it comes to the family jewels? I have to say, in this instance, it’s no gimmick: the no scalpel vasectomy is the best thing to happen to men’s reproductive health since Viagra®.

The Early Years

The first vasectomy was performed in the UK almost 200 years ago. It gained notoriety in the roaring 20s as a male rejuvenation technique undertaken by the likes of Sigmund Freud and Yeats. In the US, its popularity soared after the baby boom that followed WWII. But the single biggest advance in the vasectomy life story was the introduction of the no scalpel approach in China in 1984.

The Difficult Years

China infamously instituted its “One Child Policy” in 1980. What this meant was that after your first child, a vasectomy became mandatory, or state ordered. Ok, there was some leniency: if you had a female child, or if you were a farmer, or you were handicapped, then you could have a second child with the state’s permission. Under that policy (which ended in 2016) it is estimated that 400 million births were prevented.

But while the policy was active, several thousand vasectomies were done daily in Beijing alone. At that time, the vasectomy procedure used worldwide involved making incisions in the scrotum on both sides and “fishing” out the tubes to be tied with old school general surgery instruments that were big, bulky, and inefficient. The enormous volume of procedures necessitated a more refined, efficient, and less invasive approach — and the no scalpel (or incisionless) vasectomy was forged from this need.

The Fruitful Years

In the early 1990s. I was a resident in training at the University of Pennsylvania when the no scalpel vasectomy came to America. I can remember the day when, after doing several hundred incision vasectomies, I watched one of my surgical mentors perform a no scalpel procedure for the first time. Breathless, my reactions were: “brilliant” and “I’m in!” Honestly, it smacked of an almost religious conversion to the other side.

Since that time, and 3,000 vasectomies later, I still think that the no scalpel vasectomy is the cat’s meow. Simple, fast, and essentially pain- and complication-free, it lowers the bar for men’s acceptance of the most reliable contraceptive ever developed. Happy to be a pioneer in any such endeavor.