What Is a No-Scalpel Vasectomy?

Less pain, faster recovery, and as effective as traditional male sterilization

A no-scalpel vasectomy is a male sterilization procedure in which a surgeon makes a small hole in the scrotum and removes part of the vas deferens, the tubes that transport sperm so it can mix with semen.

This procedure differs from a traditional vasectomy in that, as its name suggests, it does not require a surgeon to use a scalpel (surgical blade). Instead, they find and clamp the vas deferens from the outside and use a tool that only punctures the scrotal skin.

The no-scalpel approach is as effective as a traditional vasectomy and takes less time to complete (about 15 to 20 minutes). And because the puncture site is so small, patients usually don't need stitches, have less pain, and heal more quickly.

This article reviews the steps involved in a no-scalpel vasectomy, its advantages and disadvantages, effectiveness, side effects, and more.

No Scalpel (Or Keyhole) Vasectomy

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No-Scalpel Vasectomy Procedure

During a standard vasectomy, two incisions are made in the scrotum to allow the surgeon to reach each of the vas deferens.

The goal of a no-scalpel vasectomy (or keyhole vasectomy) is the same as for a conventional vasectomy—to create a blockage in the vas deferens so that sperm can no longer become part of the semen.

This is done by cutting off a short piece of the vas deferens, removing it, and then ligating (tying-off), clipping or cauterizing (burning) the remaining vas ends.

During a no-scalpel vasectomy, the surgeon uses a hemostat (locking forceps with a sharp tip) to puncture through the skin of the scrotal sac. Each vas (one at a time) is actually lifted out of the single puncture site, and then the occlusion is performed.

Some surgeons may take the additional step of fascial interposition which consists of sewing connective tissue over the free prostatic end of the vas (the end closest to the urethra). This creates a tissue barrier between the vasal ends.

Some research suggests that this additional step decreases failure rates, but the evidence is inconclusive at this time. Then, each end of the vas is allowed to slip back into the scrotum.

During a traditional vasectomy, men may be given the choice to have an “open-ended” procedure. This means that only the prostatic end of the vas is tied or cauterized. The testicular end (closest to the testis) is left open.

The reason for keeping this end open is to allow for sperm leakage. No-scalpel vasectomies also allow for this open-ended option.

Some research has shown that allowing for this leakage prevents the thickening or build-up of sperm because the sperm can flow into and be absorbed by the scrotum. This, in turn, can lead to less pressure—the potential cause of post-vasectomy pain.

The open-ended technique has also been shown to lower complication rates as well as fewer cases of epididymitis (when the epididymis tube at the back of the testicle responsible for storing and carrying sperm becomes inflamed).

No-Scalpel Vasectomy Benefits

Research demonstrates that men who underwent the no-scalpel vasectomy reported:

  • Overall satisfaction in their sexual lives
  • Being able to quickly resume having intercourse
  • Positive postoperative psychological statuses
  • Nominal postoperative pain
  • Few post-procedure complications
  • Quick recovery times

This lends more support for the notion that a no-scalpel vasectomy is a simplified approach to vasectomy. This minimally invasive procedure offers the straightforwardness of a traditional vasectomy while offering many additional benefits.


The general feeling in the medical community is that there should be more of a push to perform no-scalpel vasectomies instead of conventional ones.

There are clear advantages to this technique that support that the incisional approach should be discarded. The implication of a less invasive, no-scalpel procedure can be tempting to more men. This allows men the opportunity to take on a greater role in their contraceptive responsibility.

Since the history of family planning has focused more on women (because it is their health that is directly affected by pregnancy and childbirth), providing men with an appealing and highly effective contraceptive option broadens their limited choices when it comes to birth control options.

When presented with the less “menacing” option of being able to have a vasectomy without a scalpel, men may become reintegrated into contraceptive decisions for their families and relationships and may choose to bear the responsibility for contraception. Among the many advantages:

  • Less invasive
  • Sexual activity may be resumed as soon as you feel comfortable
  • No stitches or scarring
  • 40% to 50% quicker recovery with little pain
  • Doesn't lower sex drive
  • Less chance for bleeding complications
  • Long-term, discreet contraceptive option
  • Highly effective
  • Lower risk of infection (due to smaller wound, no long incision)


  • Still considered a surgical procedure (but is done on an outpatient basis)
  • It requires hands-on training and lots for practice before surgeons gain proficiency in this technique
  • Because sperm may still be present in the vas beyond the point of occlusion, this procedure requires men to use a back-up method of birth control for the first 15 to 20 ejaculations (or about 12 weeks) after the procedure
  • Offers no protection against sexually transmitted infections or HIV
  • Must schedule an additional doctor’s visit to make sure that there are no more sperm present in your semen
  • Right now, tubal ligation is the more popular permanent choice. Around the country, more doctors need to become trained in this simple vasectomy technique, offer it to their patients and increase men’s awareness of this no-scalpel option. For this reason, it may be harder to find a skilled surgeon.
  • Though vasectomy reversal procedures are available, they are technically complex, expensive, and have variable success rates.

Potential Side Effects

Typically, a no-scalpel vasectomy does not have any major side effects and is only linked to a very small chance of infection and little pain. You may experience a reaction to the local anesthesia.

Some men report short-term tenderness and a little bit of bruising after the procedure.

There is a tiny chance of developing sperm granuloma – a hard, sometimes painful pea-sized lump due to the sperm leaking out from the open-ended vas deferens.

The lump is not dangerous, rarely symptomatic and is almost always resolved by the body in time. Plus, it may actually serve a protective feature to the testis and epididymis. The granuloma is rich in epithelial-lined channels that may vent leaking sperm away from the epididymis and protect against increased pressure from sperm blockage.


In general, vasectomies are considered a lower-cost surgical option. You may be charged for an initial consultation as well as for your follow-up visit to have your semen analyzed. But, after these up-front costs, there are no ongoing costs to maintain this contraceptive method.

This procedure is covered by many private insurance plans. Without insurance, depending on your geographical location and the facility you choose to use, a no-scalpel vasectomy will typically cost between $500 to $1,000 (some facilities will bundle all of your visits into one price while others may charge for each individually).


The no-scalpel vasectomy is extremely effective—99.85% to 99.9% effective, but this is based on the man using back-up birth control until he has been cleared by the doctor that there is no sperm left in his semen.

Less than 1 out of 100 women whose partners have had a no-scalpel vasectomy—and follow-up testing to ensure its effectiveness—will get pregnant each year.

Of special note, the no-scalpel vasectomy is not 100% guaranteed to be effective. Even when the procedure is performed perfectly, the possibility of recanalization can occur. This is when sperm manage to find their way across the blocked ends of the vas deferens. The possibility of this occurring is very rare (less than 0.2% of the time).

Recanalization generally happens in the first 2 to 3 months after the no-scalpel vasectomy (incidence 1/500), but it can even occur years after the procedure (though extremely rare, with an incidence 1/4,500).

This is why it is extremely critical that you undergo your semen analyses 6-12 weeks post-vasectomy to be absolutely sure that no sperm are present.

Frequently Asked Questions

  • Is a no-scalpel vasectomy reversible?

    Yes, but the procedure is complex and can depend on a variety of factors, including how long it's been since you had the original procedure. If you are considering a vasectomy reversal, talking to your healthcare provider can help determine whether the procedure is right for you.

  • How long does a no-scalpel vasectomy take to heal?

    Like a traditional vasectomy, healing time for a no-scalpel procedure is usually a week or less. Most patients who undergo the procedure are back to work in a few days.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Li SQ, Goldstein M, Zhu J, Huber D. The no-scalpel vasectomy. J Urol. 1991;145(2):341. doi: 10.1016/s0022-5347(17)38334-9

  2. EngenderHealth. (2003). No-scalpel vasectomy: An illustrated guide for surgeons (3rd ed.). Automated Graphic Systems, Inc: New York.

  3. Errey BB, Edwards IS. Open-ended vasectomy: An assessment. Fertil Steril. 1986;45(6):843. doi: 10.1016/s0015-0282(16)49404-5

  4. Kuan-Chou Chen, Chiung-Chi Peng, Hsiu-Mei Hsieh, Han-Sun Chiang. Simply modified no-scalpel vasectomy (percutaneous vasectomy) — A comparative study against the standard no-scalpel vasectomy. Contraception 2005;71(2): 153-156. doi: 10.1016/j.contraception.2004.07.018

  5. Urology Care Foundation. What is a vasectomy?

Additional Reading

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.