Is the Madajet injector better than using a needle in No Scalpel vasectomies?

The Madajet Injector spays the anesthetic into the vas and surrounding tissues under pressure.
The Madajet Injector spays the anesthetic into the vas and surrounding tissues under pressure.

There are several reasons why not all urologists use the Madajet “No Needle Vasectomy” technique.

  • They weren’t “trained to do this technique as a resident.”
  • The system is an expense
  • They feel it is all hype and adds no benefit to the procedure or the patient
  • There is a learning curve they don’t want to go through
  • The staff has to learn to prepare the system
  • They will have also buy a ultrasonic sterilizer for the system
  • They feel it will take longer than using a needle
  • They feel that patients are not “really” that afraid of needles
  • They just plain don’t want to change the way they have done for years

I know I have been there.  I started using the Madajet about three years ago. And let me tell you by the time you buy all the instruments, teach the staff, and begin to use and learn to efficiently use the device you do begin to question its efficacy. You see, having a nurse fill a syringe with Lidocane and place on the vasectomy tray and doing something the way you have done with success for years is a lot easier than “change.”

So I have been on both sides and this is my assessment. It is better.  I am now to the point that placing the 6 Madajet injections (three to each vas) is a much improved way to “deaden” the skin and vas for a vasectomy.

  • Less medicine is used so it is easier to identify the vas and to work on it when the actual procedure begins.
  • For those patients who are truly “needle phobic” not using a needle and telling them from the start that there will be no needle is indeed helpful in reducing anxiety. Reducing anxiety is important as it makes the procedure easier for both the patient and the doctor.
  • Once you learn how to use the Madajet the numbing part of the procedure takes less time.
  • The anesthesia is quite good and it is uncommon to need to use a needle for the procedure although this does happen from time to time. This occurs more frequently in patients with thick scrotal skin. (That’s right…not all men’s scrotal tissue is the same and the thicker skin makes it harder for the Madaject to penetrate all the tissue.)

There are YouTube videos of urologists demonstrating the use of the Madajet if it would be of interest to the patient considering a vasectomy.

Summary: Is using the Madajet better? I think so but in the big scheme of things it does not change the basics of the vasectomy (cutting the vas and sealing the ends) but the amount of medicine is less, the anesthesia is good, the vas are easier to work on as a result of the less volume of medicine, and the patient is more relaxed knowing there is no needle.

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