More men in the Minneapolis and St Paul areas know about no scalpel vasectomy, but not many of them know about the open-ended vasectomy. The open ended technique leaves the testicular end open, which improves reversibility and lessens the chance of long term chronic pain.
In closed-end vasectomy, blocking the normal exit of sperm in a vasectomy can increase the chance of pain due to elevated pressure within your testes secondary to accumulating fluid, thickening sperm debris and swelling (i.e.dilation of seminiferous tubules).
Open-ended vasectomy Technique:
1) Cut the vas. It is unnecessary to remove a segment
2) Cauterize the prostatic end with eye cautery and seal it with surrounding fascia using a clip
3) Do not cauterize the testicular end
Research shows that these potential problems can be avoided if you leave the testicular end open. Granuloma formed at the cut end of the testicular end acts as a natural safety valve because it does not seal completely, which leads to a reduced rate of post vasectomy pain.
The open-ended technique results in less scarring than when cautery is used and provides an easier vasectomy reversal in men who choose reversal later in life.
Concerns with theOpen-ended vasectomy:
1) If the fascia is not adequately closed over the prostate end of the vas, recanalization can occur. It is important to use the proper cautery technique and implement an adequate barrier of fascia between the cut ends of the vas.
2) Elevated serum levels of anti-sperm antibodies could be a little more common, which may cause a very minor effect on vasectomy reversal. But 50-70% of traditionally closed-ended vasectomized men have elevated serum levels of anti-sperm antibodies anyway.