U.S. Department of Veterans Affairs


Date of this Version


Document Type



Urology, Volume 74, Issue 1, July 2009, Pages 77-81; doi:10.1016/j.urology.2008.11.023



To compare the pain during anesthesia and during the no-scalpel vasectomy procedure for local infiltration anesthesia (LIA), LIA supplemented with spermatic cord block (LIA+SCB), and no needle jet anesthesia.


Bilateral no-scalpel vasectomy was performed in 323 patients during 2007. Of the 323 patients, 65 received LIA, 29 received LIA +SCB, and 227 received anesthesia using the no-needle technique with the MadaJet device. The level of pain during anesthesia administration and the subsequent procedural pain was documented for each technique using a pain scale of 0-10.


Pain during the LIA +SCB procedure (mean 1.7 ± 1.6) was significantly less than the pain during LIA (mean 3.3 ± 2.3; P < .01). No statistically significant difference was found between the levels of pain experienced during LIA +SCB and no-needle jet anesthesia (P >> .01 and P >> .05, respectively). Intraoperative pain after LIA +SCB (mean 0.64 ± 1.2) was significantly less than the intraoperative pain after LIA (mean 2.7 ± 2.6; P <<< .01). Also, the intraoperative pain after LIA +SCB was significantly less than the intraoperative pain after no-needle jet anesthesia (mean 2.13 ± 2.0; P <<<.01).


LIA + SCB is an effective and better method of anesthesia compared with LIA alone or no-needle jet anesthesia for reducing the pain during vasectomy. Also, no difference was found in the pain levels during anesthesia for the LIA +SCB, LIA, and no-needle anesthesia techniques.