What is the least painful method of vasectomy?

In my opinion, the experience and gentleness of the surgeon are the most important criteria for minimizing pain during a vasectomy. I have performed vasectomies with virtually every technique described in the literature and the comfort of the patient isn’t any different so long as the procedure is performed under adequate local anesthesia, efficiently and without excessive pulling on the vas deferens. The efficiency of performing a vasectomy says a lot about the experience and technique of the surgeon. Most vasectomies can be done in under 10 minutes if the surgeon is well experienced and good at the procedure.

Pain during the procedure arises from one of three reasons: local anesthetic injection, penetration of the scrotal skin and pulling on the vas deferens. These three steps are universal to any vasectomy technique. The local anesthetic causes a slight burning sensation on injection for only a few moments, similar to when we get a shot from our dentist for any dental procedure. This is the same whether a standard or no-needle technique is used. The skin must be penetrated in order to get to the vas deferens. If adequate local anesthesia is used then it isn’t important whether a standard or no-scalpel technique is used. Finally, the vas deferens has to be mobilized and permanently occluded in some way. An experienced vasectomy physician can do this gently and efficiently without causing much patient discomfort.