Local Anaesthetic Vasectomy
How do you do the Anaesthetic?
It’s a ‘No’ to No Needle Anaesthesia
Australia’s TGA is the body that regulates use of medical devices in Australia. The No-needle anaesthesia device is not approved for use in Australia.
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, a premium 33g 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. Anaesthetic cream or gel does not help anaesthetise the vas deferens and surrounding tissue.
What type of needle is used?
The 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 are more likely to feel the anaesthetic ‘going in’ rather than the needle itself.
Dr Dick Beatty uses the finest gauge needle available, a 33g needle. As a result, many men don’t feel any prick at all.
Guys getting the snip don’t want to feel a prick!
What will I feel?
There are very few patients who are not nervous about having a vasectomy. The average patient rates their anxiety as 3/10 on their pre-vasectomy questionnaire.
The number one question is, ‘will it hurt?’ The truth is that No-Scalpel Vasectomy is very comfortably performed under local anaesthetic, as confirmed by our google reviews and our survey results.
You will feel:
- A possible subtle ‘prick’ at the beginning.
- Movement during the examination and procedure.
- A sense of pressure is typically 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 during this time.
The typical comment after the procedure is, ‘ I felt it less than I thought I would.’
Very anxious patients have the option for oral sedation at our clinic, although this is rarely required. Dr Dick Beatty ‘niches’ in looking after the truly needle-phobic guys, with high satisfaction levels reported.
The anaesthetic wears off after around three hours. You can take Nurofen for any post-vasectomy discomfort.
Can I get Sedation?
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.
So, who does need sedation?
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.