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Updated: Jul 8, 2026

Optimizing the Modified No-Scalpel Vasectomy Technique
Published on: October 18, 2024
Comparative analysis of effectiveness of two local anesthetic techniques in men undergoing no-scalpel vasectomy
Michael A White1, Thomas J Maatman
1Michigan State University College of Osteopathic Medicine Urologic Consortium, Grand Rapids, Michigan, USA.
Objectives:
To compare the effectiveness of two local anesthetic techniques in men undergoing no-scalpel vasectomy.
Methods:
Before undergoing no-scalpel vasectomy, 50 men underwent separate forms of anesthesia to each side of their scrotum. One vas deferens was anesthetized with a high-pressure spray of 0.3 mL 2% lidocaine using the MadaJet Medical Injector, and the other vas deferens was anesthetized using the traditional vasal block performed with three 1.7-mL ampules of mepivacaine using a 27-gauge needle. The pain of the initial delivery of anesthesia and the pain with the subsequent vasectomy were recorded.
Results:
Fifty men underwent no-scalpel vasectomy with a different anesthetic delivery system to each vas deferens separately. A statistically significant reduction was noted in the visual analog pain scores in favor of no-needle administration of anesthesia, 1.56 of 10 versus 2.12 of 10 (P <0.029). A reduction was noted in the visual analog pain score for the subsequent vasectomy after administration of anesthesia using the no-needle method, but this was not statistically significant (1.68 of 10 versus 1.86 of 10; P <0.66).
Conclusions:
No-needle anesthesia with jet injection reduced the pain associated with traditional delivery of anesthesia to the skin and vas deferens before no-scalpel vasectomy. Additional studies are needed with more subjects to evaluate whether the decrease in procedural pain is statistically significant when comparing the two types of anesthetics.
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