In general, a vasectomy will be performed in your urologist's office or at an outpatient surgical center while you are awake. There are two types of procedures: conventional vasectomy, and no-scalpel vasectomy. During a conventional vasectomy, the urologist makes one or two small cuts in the skin of the scrotum. The vas is cut, and a small piece may be removed, leaving a short gap between the two remaining ends. The doctor then clips or ties the cut ends and closes the scrotal incision with dissolvable stitches. The entire process is then repeated on the other side. During a no-scalpel vasectomy, the urologist feels for the vas under the skin of the scrotum and holds it in place with a small clamp. A special instrument is used to make a tiny puncture in the skin and stretch the opening so the vas can be gently lifted out, cut, then tied or cauterized and put back in place. During a vasectomy, local anesthesia will be injected to numb the area and eliminate pain, but you will be aware of touch, tension and movement during the procedure.