What is it?

Vasectomy is a minor surgical procedure for male sterilization or permanent contraception used for family planning purposes. It consists of interrupting the passage of sperm cells by cutting and occluding both vas deferens, which are the tubes that permit passage of the sperm cells from the testicles to the urethra during ejaculation. By doing so, pregnancy is no longer possible as there is the absence of sperm cells in the sperm.

Indications:

The procedure is regarded by the medical profession as a permanent form of sterilization because even though vasectomy reversal is possible, it is a costly procedure, often does not restore the male’s sperm count and/or sperm motility to prevasectomy levels, and above all does not guarantee pregnancy. Vasectomy ensures sterility after confirmation of success by semen analysis following surgery. Please note that the procedure is solely used as a contraception method and does not protect against sexually transmitted infections. Failure rates are extremely low and cases are rare

How is the intervention performed?

There are several methods by which a surgeon might complete a vasectomy procedure, all of which occlude (i.e. “seal”) at least one side of each vas deferens. The procedure is performed under sterile conditions to prevent infection after the intervention. You will be awake and conscious during the surgery. A local antiseptic and sterile drape will be applied to the genital area. A local anesthetic is injected in the midline scrotum which might cause mild burning that lasts for a few seconds. Once the area is frozen and numb, you will no longer experience pain but will still feel the urologist touching you.

A tiny hole is performed through which both vas deferens on either side is then occluded. Rapidly resorbable stiches will be used to close the small incision and a transparent liquid bandage applied over them. The stiches will start to go away in 7 to 10 days. Due to the simplicity of the surgery, a vasectomy usually takes less than twenty minutes to complete and there is generally no need for any recovery period at the office. Wearing tight underwear after will help in reducing discomfort. You will be able to leave the office quickly by your own means. Although you may wish to be accompanied it is not obligatory. You may take a shower 24hrs after.

Is it painful?

The effect of the local anesthetic will last a few hours, and once normal sensation returns, pain will vary from one patient to the other. Pain is often minimal and will often be proportional to the degree of swelling; therefore, application of ice to the scrotum for about 10-20 minutes at a time 5-6 times per day for 1-2 days is highly recommended to limit swelling, which in turn will limit pain and speed up recovery. Extrastrength Tylenol or a mild narcotic prescribed by your urologist is usually sufficient to control pain which usually greatly subsides over the course of 1 to 3 days.

It is best to avoid any intense physical activity, lifting heavy objects, or sports during the first week which could cause bleeding or swelling. Because the procedure is minimally invasive, many vasectomy patients find that they can resume their typical sexual behavior within a week, and do so with little or no discomfort. It is very important that you are not sterile immediately after the vasectomy as the remaining sperm cells in the ejaculatory system need to be expulsed first. This generally takes from 8 to 12 weeks for the majority of men undergoing vasectomy and definitive sterility will need to be confirmed with the semen analysis. During this period, you need to maintain another form of birth control as pregnancy is still possible. You will be able to stop other methods of contraception only after confirmation by your urologist that sterility has been achieved.

What do I need to do before the exam?

There is no special preparation necessary prior to the procedure. Shaving of the scrotal area is recommended but not mandatory. Although the operation lasts only less than 20 minutes, you have to make yourself available for 30 to 45 minutes at the clinic.

You may want to be accompanied but this is not absolutely necessary. Please arrive on time for your appointment. Any anticoagulants (blood thinners) should be discontinued prior to the surgery as per your urologist’s recommendations and any allergies noted.

Written consent is mandatory.

What are the risks?

Although complications are possible, these are generally mild and self-limiting. Short-term possible complications include infection, bruising and bleeding into the scrotum resulting in a collection of blood known as a hematoma. Certain men experience persistent pain up to a few months which usually disappears with time without any specific treatment but may persist in very rare cases.

Spontaneous recanalization of the tubes is possible during the healing period but is also very rare, in which case a new vasectomy will be required. Note that a vasectomy does not alter sexual function and there is no need to think that it may cause other health problems.

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