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Premier Medical Group

Vasectomy

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What is a vasectomy?

A vasectomy is one of safest and most effective methods of permanent birth control. It is much safer and less expensive than the other most common contraceptive surgery, tubal ligation. At Premier Medical Group Urology Division, vasectomy is a simple 10-minute procedure performed in the doctor’s office using a local anesthetic. The objective is to prevent sperm from entering the semen.

To understand vasectomy, it is helpful to understand the male reproductive system and how it functions. The testicles, or testes, are the sperm- and testosterone-producing organs. They are located in a sac at the base of the penis called the scrotum. Each testicle is connected to a small, coiled tube called the epididymis, where sperm are stored for as long as 6 weeks while they mature. The epididymis is connected to the prostate gland by a pair of tubes called the vas deferens.

The vas deferens is part of a larger bundle of tissue, blood vessels, nerves, and lymphatic channels called the spermatic cord. During ejaculation, seminal fluid produced by the prostate gland mixes with sperm from the testes to form semen, which is ejaculated from the penis.

Is a vasectomy for you?

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In general, vasectomy is one of the safest simplest forms of birth control. The scalpel-free vasectomy is a less invasive technique with minimal down-time. In fact, most men return to work and full activity in just two days.

A vasectomy should be considered permanent

Before you make your decision, speak with your partner and make certain it’s what you both want. Most men choose vasectomy as a form of birth control because their family is complete. Other men chose vasectomy because it’s a reliable form of birth control.

Whatever your reasons, you need to consider many factors:

  • Are you certain you don’t want more children?
  • What if you enter into a new relationship and you both decide you would like children together.
  • Be sure you have no doubts before you choose a vasectomy.

How is a vasectomy performed?

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To prevent sperm, the vas deferens are cut and sealed off during surgery. Your testes will continue to produce sperm, but because there is nowhere for the sperm to go, they die and are absorbed into your body. Since a very minor part of your semen is made up of sperm, you will not notice a visible difference.

Traditional Vasectomy

During a conventional vasectomy, one or two half inch scrotal incisions are made to gain access to the tubes. These incisions are later closed with sutures, which remain in place for about 5 days until they dissolve or are removed. An anesthetic solution can be injected with a tiny needle to numb the scrotal skin and the vas tubes, or a pressure spray applicator can be used to numb the skin and vas tubes without using any needles.

Scalpel Free Vasectomy

The scalpel free vasectomy is an incision-less approach and is performed in the office in about 10 minutes. A surgical clamp is used to hold the vas deferens while a puncture incision, instead of a cut, is made with special forceps. The forceps then are opened to stretch the skin, making a small hole through which the vas deferens is lifted out, cut, sutured or cauterized, and put back in place. At Premier Medical Group Urology Division we recommend the no-scalpel method because we find it is quicker and minimizes post-operative discomfort and the risk of bleeding and infection.

Preparation

  • Wash your scrotum well and shave the underside of the penis and the front wall of the scrotum, preferably a day before the procedure.
  • Use no powder or deodorant in the genital area on the day of your procedure.
  • Bring an athletic supporter or tight underwear with you.
  • Arrange to have someone drive you home
  • Plan to do nothing but recline at home (sofa or bed) on the day of vasectomy.
  • Do not take aspirin or anti-inflammatory drugs such as ibuprofen for 2 weeks prior to procedure.
  • Do eat a normal breakfast to avoid getting light-headed.

How do I care for myself after a vasectomy?

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It’s important to wear an athletic supporter after the procedure  To reduce swelling, use an ice pack on your scrotum. Usually you need to wait 48 hours before bathing and avoid heavy lifting or exercise for at least one week. To relieve any discomfort, Tylenol is recommended; do not take aspirin or ibuprofen. Stay off your feet as much as possible for the first 2 days; lying down is suggested.

Sterility

It can take numerous ejaculations before there is no active sperm in your semen. You need to use other birth control during this time to prevent pregnancy. After 20 ejaculations, the doctor will ask you to collect a sample of semen at home and bring it in to a lab to be checked under a microscope. Until this sample shows no indication of sperm, you are not sterile.

Complications

As with any surgical procedure there are always some risks. These can include bleeding, infection or inflammation  Sometimes a small granuloma a harmless lump, may develop. In rare cases the vas deferens reconnects itself warranting a routine post-procedure semen analysis. After your surgery, if you experience swelling, increasing pain in the scrotum, black and blue areas, lump, fever, chills, redness, or trouble urinating, call your doctor immediately.

Sex after a vasectomy

After your vasectomy, the portions of the vas tubes within the pelvis still contain live sperm. About 95 percent of men are sperm free after 20 ejaculations and 8 weeks. In 5 percent of men, the semen may still contain some sperm (usually few in number and not active) for months, so it is important to have a semen sample checked and to use other forms of birth control until it is confirmed by microscopic examination that the semen is sperm free.

A vasectomy does not affect your ability to have sex, erections, or orgasms. It does not change the visual appearance of semen. Nor does a vasectomy cause health problems related to the prostate or heart. Your sex drive will not be affected by a vasectomy. Your hormone levels remain the same.

Having a vasectomy is a decision that should be well thought out. It ends your ability to father a child. It’s not a decision one should make under stress. Keep in mind that a vasectomy will not protect a person from sexually transmitted diseases.

Can a vasectomy be reversed?

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After vasectomy, it may be possible for the vas deferens to be sutured back together and sperm restored to the semen. This doesn’t always work, so vasectomy should be considered permanent. However, within the first 3 years of a vasectomy, reversal restores sperm to the semen in over 97% of cases. Even when the interval between vasectomy and reversal is 15 years or more, the sperm recovery rate remains about 70 percent.