Vasectomy

About the Procedure

A Vasectomy is a male sterilization procedure in which the vasa deferentia, the ducts responsible for transporting sperm from the scrotum during ejaculation, are severed, tied or sealed. Vasectomies are a popular method of birth control especially for men who do not wish to father more children. The decision to undergo a vasectomy is a serious one and should be made jointly with the patient's partner. Because of the ease of the surgery, many men do not give it sufficient thought and some have expressed regret over their decision. Surgery to reverse the vasectomy is a difficult procedure, expensive, and not always successful. A vasectomy does not interfere with a man's sex drive, his ability to have an erection, to ejaculate, or to experience orgasm.

This procedure is performed in an out-patient setting or in a surgeon’s or urologist's office and is completed in as little as 15 to 30 minutes. After cleaning and shaving the area, the scrotum is numbed using a local anesthetic and the surgeon either makes an incision on each side with a scalpel or, in the "no-scalpel technique", uses a sharp hemostat (a surgical tool used for grasping or clamping) to make two very small cuts. The vas deferens of each testicle is located and cut, and then, in most cases, tied off and cauterized. After the procedure is completed the incision is closed with dissolvable stitches.

What to Know Before the Procedure

Vasectomies are considered one of the safest surgical procedures and the risk of complications is low. A condition called Vasitis nodosa, a benign nodular thickening of the vas deferens, occurs in about 66% of patients after a vasectomy and may require surgical treatment. Another chronic and painful condition, post-vasectomy pain syndrome (PVPS), is a complication which can develop at any time after a vasectomy. It can take up to six months for semen to be completely clear of sperm and until the doctor confirms 100% sterility it is necessary to use other birth control methods. There have been cases of the vas deferens reconnecting on there own, resulting in unexpected fertility.

Preparation for this procedure is similar to other operations. A health assessment, blood work, x-rays, adding or changing medications to avoid excess blood loss during the operation, and pre-operative instructions on food and water intake will be provided by the doctor. Patients are asked to bring a jockstrap or a pair of snug underwear to help relieve discomfort and to protect the area after surgery. Advanced planning for a ride at discharge and assistance for the first day is recommended because pain and tiredness are the chief complaints at that time.

What to Know After the Procedure

For a few hours following the procedure, the scrotum remains numb. Minor pain and swelling typically remains for a few days. Bed rest with legs elevated and ice packs regularly applied to the area are recommended for the remainder of the first day. Continuing to wear a jockstrap or snug-fitting underwear helps with the discomfort. Heavy lifting should be avoided for at least a week. Showers can be resumed in one or two days, but no baths should be taken until the physician advises. Many men return to work in a day or two unless the work is strenuous. The patient will be instructed by the physician about resuming sexual intercourse. Follow-up visits to the doctor are necessary until semen tests show an absence of sperm.

If you Need to Travel Outside of your Local Hospital

Vasectomies are a common procedure both domestically and internationally. Selecting a surgeon with excellent technical skills and considerable experience with this surgery minimizes risks and complications, and contributes to a positive outcome. Surgical expertise should be the most crucial part of determining the location of the procedure. If the patient allows time for the recommended two days of rest and leg elevation, long-distance travel in order to receive treatment is a viable option. Speak with several doctors and compare their level of experience with overall costs when making a decision on where to have this procedure done.