No-scalpel, no-needle vasectomy.

e s asectomy is the safest and most dependable method of permanent contraception available o men today. More than 500,000 vasectomies are erformed in the United States and more than 5,000 in Canada each year. Of American married ouples, 7% to 10% choose vasectomy as their form f birth control. This has made vasectomy the most ommon urologic procedure in North America.1–3 Although vasectomy is a safe and simple proceure for those who are well-trained, it can be techically challenging. Most contemporary surgeons nd urologists have never been formally educated n how to perform a conventional vasectomy hrough a 2 to 3-cm incision or the newer no-scalel vasectomy made through a 2 to 3-mm puncture ound on the scrotum. Many are forced to learn he procedure by trial and error during or after heir residency training. Therefore, many uroloists develop their own techniques that stray from ore superior methods that have fewer complicaions and lower failure rates and may be accomlished with little or no pain. Kendrick and assocites4 illustrated how vasectomy performed by nexperienced hands leads to an increased incience of complications such as bleeding, hemaoma and infection. We discuss the no-scalpel vasectomy and noeedle vasectomy, a unique and nearly painless echnique for anesthetizing the scrotal skin and as. Using a jet injector (MadaJet, Mada Medical roducts, Carlstadt, NJ), the anesthetic solution is prayed through the skin and around the vas using high-pressure injector that patients have decribed as a “gentle snap of a rubber band” against