Local Anaesthetic Vasectomy - The Vasectomist
  • LOCAL ANAESTHESIA

    No Needle Anaesthesia
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PRICKLESS NEEDLE

Which needle is used for no scalpel vasectomy?

Let’s be honest, guys needing the snip don’t want to feel a ‘prick!’

Needle diameter is indicated by the gauge (g) of the needle. The larger the needle diameter gauge the smaller the gauge. A 27g or 30g needle is typically used for no scalpel vasectomy. See this needle comparison chart.

The diameter of a 33G needle is 0.2 mm which is considerably finer than a needle used for taking blood or giving a vaccine. The 33G needle causes minimal to no discomfort.  Bear in mind that the 33G needle is the same diameter as that used by kids for their daily diabetes needles.  You more likely to feel the anaesthetic ‘going in’ rather than the needle itself.

Dr Beatty uses a premium 33g needle which is marketed by the manufacturers as the so-called ‘invisible needle.‘  The manufacturers claim that the needle is ‘the thinnest needle to date.’ What can be stated is that the needle is the finest needle available for clinical use in Australia. Only Finer needles exist in the research setting.

‘NO’ TO NO NEEDLE!

It’s a ‘No’ to No Needle Anaesthesia

Please note that ‘no needle anaesthesia’ is not used in Australia because the no-needle device is not approved by The TGA.

Monash University recently compared no needle with conventional needle anaesthesia in 60 men undergoing surgical sperm retrieval. They concluded that ‘for local anesthesia in patients undergoing surgical sperm retrieval, the device produces less pain and discomfort with quicker time to onset and offset of anesthesia compared with conventional needle injection.’ The study compared ‘no needle’ with a 25g needle which may be considered wide-bore compared to a 32 or 33g ultrafine needle.

Whilst no needle anaesthesia is not used in Australia, ultrafine needle anaesthesia provides an exceptional experience.

Men report that the initial warm fluid applied to the skin feels like a numbing agent. In fact, the fluid is simply warmed-up antiseptic.

WHAT WILL I FEEL?

OK guys, so you now understand the theory but want to know the answer to ‘will it hurt?!’ The truth is that no scalpel vasectomy is very comfortably performed under local anaesthetic.

You will feel:

  • A possible tiny ‘prick’ … from the ‘invisible needle’ (Dr Beatty estimates that half of guys feel this).
  • Movement during the examination and procedure.
  • Some pressure may be felt from the local anaesthetic.
  • A sense of pressure may also be felt for 2-3 seconds as the tubes are accessed. Dr Beatty will count  ‘1,2,3’ to let you know that you may feel some pressure for a couple of seconds.

The typical comment after the procedure is that ‘I felt it much less than I thought.’

There are very few patients who are not nervous about having a vasectomy.

Very anxious guys do have the option for oral sedation at our clinic although this is rarely required. We are experienced in looking after the truly needle-phobic guys. Intravenous sedation, however, is not an answer to needle phobia …

CAN I BE SEDATED?

Intraveous Sedation can be thought of as a light general anaesthetic, making you sleepy but breathing for yourself.

IV Sedation is performed by a specialist doctor (anaesthetist) in accredited ‘day surgery units’ – providing facilities to treat potentially life threatening complications of sedation. Information regarding the risks of sedation are well documented by Queensland Health.

Vasectomy under sedation is expensive compared to vasectomy under local anaesthetic. Private health insurance may cover the hospital fee but you may still have anaesthetist and surgeon gap fees to pay.

The 2015 national US Vasectomy guideline makes a positive recommendation that ‘Vasectomy should be performed with local anesthesia with or without oral sedation’ (statement 5). Intravenous sedation is not required for the vast majority of no scalpel vasectomy. Further, our post-vasectomy feedback questionnaires indicate that satisfaction with local-anaesthetic vasectomy is very high.

Men with very challenging anatomy may be required to have a vasectomy under intravenous sedation. Why? Because men with very challenging anatomy may feel more during the procedure. In addition, the testicles drop by around 2-3 cm during deep sedation. Dr Beatty refers approximately 2% of men for a vasectomy under sedation.

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It’s really simple.