Posts Tagged ‘no needle vasectomy’



When it comes to vasectomies…men don’t quite understand what the procedure does or what it doesn’t do. A primer podcast.


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Second opinions may limit not eliminate poor decision making.

The Real Prostate Cancer Second Opinion Site

Prostate diaries

An angry man is again angry with himself when he returns to reason. ~Publilius Syrus

In my book I mention that a second opinion is a good idea once the urologist tells you that you have prostate cancer. I add that it is probably best to get a second opinion with a radiation therapist, i.e you already have spoken with a urologist.

Well…one of the things that happens now on a routine basis is that folks present to my office for a second opinion about what to do about their newly diagnosed prostate cancer. What happens is the patient searches for information about prostate cancer and invariably they find my book on Amazon or by virtue of Prostate Diaries (which surprisingly has a very large internet footprint)and  then make an appointment for the second opinion. I have seen folks from all over and it has been very rewarding. It is…

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Sarcasm is lowest form of wit, it is usually a futile gesture of the less intelligent.

Sarcasm is lowest form of wit, it is usually a futile gesture of the less intelligent.


If you can’t add to the party…don’t take from it.

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“Nuttin for Christmas” performed by Dr. John McHugh.

How did I do it?  Recorded to Karaoke in normal voice and then increased the pitch. This opens up a whole new ballgame my friend! Watch out Chipmunks!

Nuttin’ for Christmas” (also known as Nothing for Christmas) is a novelty Christmas song written by Sid Tepper and Roy C. Bennett. It became a hit during the 1955 Christmas season when the song showed up on Billboard’s pop charts by a total of five different artists. The highest-charting of the five recordings was released by Art Mooney and His Orchestra, with seven-year-old Barry Gordon as lead vocalist; this version peaked at #6 and became a million-seller. Another notable version was performed by Stan Freberg (with Daws Butler appearing as a burglar helped by the kid at the end). Other charting versions were recorded by The Fontane Sisters, Joe Ward, and Ricky Zahnd and the Blue Jeaners.

The song was revived on the Big Top label by Kenny and Corky and hit the Cashbox Top 100 in 1959.[1]

Other artists who have recorded the song include Eartha Kitt, Homer and Jethro, Relient K, Smash Mouth (featuring Rosie O’Donnell), Sugarland, and The Vindictives. The most recent cover was released in November, 2011 by The Plain White T’s.

In 2009, Rap artist Tony Yayo sampled the original track on his mixtape The Swine Flu on a track titled “Somebody Snitched On Me” as a diss track for the rap artist Rick Ross.


Somebody snitched on me!!!

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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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 Visit Dr. McHugh’s dedicated website about the GreenLight Laser-Gagreenlightlaser.com

green light before and after

When I began my urological practice in Gainesville, Georgia 27 years ago the standard surgical procedure for the prostate was a T.U.R.P. (Some patients refer to the procedure as having a “roto rooter.”)  This procedure at that time took about an hour, and most patients were admitted to the hospital for 2-3 days. It was often times a bloody procedure and as a result patient’s were advised after the procedure to not do any strenuous activity for about a month because of risk of bleeding.

The GreenLight Laser usually takes about half the time of a T.U.R.P. because there is very little bleeding and there are no chips (shaving of the prostate tissue which a T.U.R.P. results in) to irrigate out of the bladder and there is very little bleeding for which the surgeon to contend. In addition this can be done as an out patient, and the catheter remains usually for only one day. The limitations regarding post operative activity is a lot less with the laser.

The Green Light Laser has been used by the Urologists at the Northeast Georgia Urological Surgery Center  for several years. The qualities of the laser demonstrated in the video below make this form of treatment well suited for out patient Ambulatory Surgery.  Patients customarily have the procedure done and are in the recovery room less than an hour, go home with a catheter which can be removed in one to two days.

Northeast Georgia Urological Associates use the XPS GreenLight laser which is the latest version of the GreenLight and is associated with less operating time, less bleeding and fewer post operative symptoms.

If you are a male who is having obstructive voiding symptoms of slow stream, hesitancy, or straining to urinate you may benefit from this procedure. Patients with irritative symptoms of an enlarged prostate such as frequency,  urgency, or getting up at night may also benefit from this procedure.

“A couple of things, says Dr. McHugh. Most men who undergo the GreenLight laser have been tried on oral medications and for one reason or the other failed. Secondly, like any procedure the results are not always perfect. There are patients whose prostate is not well suited to the GreenLight. There are patients who for whatever reason the laser energy is very aggravating to the prostatic urethra and this results in a longer than usual course of  irritative symptoms. I do recommend the GreenLight to my patients, however I want to be sure they have tried the available medications for prostate enlargement and that they understand the potential of the irritative effects of the laser energy on the prostatic urethra.”

Dr. McHugh routinely performs GreenLight Laser surgery in his ambulatory surgery center.

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sweetest girl in the world...

sweetest girl in the world…


It is a point to consider but not a deal maker.

You need to know the nuances of this particular point in making your decision.  Ask the radiation therapist if it is a big deal in the decision.

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