Vasectomy

What is a vasectomy?

  • Vasectomy is one of the most simple, safe, and effective methods of birth control. Over 500,000 vasectomies are performed each year in the United States.
  • Vasectomy is a minor office procedure during which the small tubes carrying sperm from the testicles (vas deferens) are divided on each side of the scrotum.
  • In order to decrease the risk that the tubes will re-connect, a small segment of the vas is usually removed and the ends are cauterized.
  • Cutting these tubes does not affect the strength of erections, sexual desire, the size of the testicles, or a noticeable change in semen volume.
  • The procedure takes roughly 10-20 minutes to perform and is done through a very small skin opening (2-3 mm) that is virtually invisible after it heals.
  • Vasectomy should be considered permanent and not a means of temporary birth control. However, vasectomy reversal is successful in up to 75% of men if undertaken in the first 10 years after the procedure is performed.

How to prepare for a vasectomy

  • Do not take aspirin or aspirin-like products (Motrin, Ibuprofen, Aleve, Advil, etc.) 10 days prior to the procedure. Tylenol is fine to use.
  • Bring someone else to drive you home if you take Valium or some other pre-medication for the procedure. You do not have to fast for this procedure, but it may be a good idea to eat light foods that day.
  • On the day of the procedure, scrub the genital area with antibacterial soap and water for 5 minutes.
  • Unless the physician says otherwise at the end of your initial consultation, shave the scrotal sac around the base of the penis.
  • Bring an athletic supporter or tight fitting brief underwear to the procedure to wear home.

After the procedure

  • Go home and rest for the remainder of the day, staying mostly in a reclining position.
  • There will be tenderness in the scrotal area for a few days. Wear your athletic support or snug briefs until the tenderness resolves.
  • Place ice packs for 20 minutes every 2 hours for 24 hours following your vasectomy (20 minutes ice, 2 hours no ice, while awake).
  • You may shower the next morning unless told otherwise.
  • No heavy lifting, strenuous activity, vigorous exercise, or sex for one week after the procedure.
  • You should not engage in unprotected sex until a semen analysis indicates that your ejaculate is free of viable sperm.

Are there potential complications?

  • Swelling: Following vasectomy, most men experience swelling of the scrotal area. This will resolve over time and can be greatly reduced by going home, resting, and using ice packs for the first 12 to 24 hours.
  • Bleeding: Life-threatening bleeding is extremely rare from vasectomy. Bleeding into the scrotum (hematoma formation) is also very rare. This would manifest as large, tender swelling of the scrotum. This can usually be prevented by inactivity, wearing an athletic supporter, and icing the area.
  • Infection: Infection of the wound or underlying structures is possible anytime scrotal surgery is undertaken. The risk of infection is rare, occurring in 1-2% of patients. This usually would manifest as pus coming from the incision, spreading skin redness, or fever.

Are there any long-term risks?

  • Sperm granuloma: A small percentage of men will develop a small, pea-sized lump at the vasectomy site. This is the body’s reaction to the vasectomy and the presence of sperm in the area. This is completely benign and non-dangerous.
  • Post-vasectomy pain: About 10% of men will develop an episode of scrotal pain at some point after a vasectomy. This is most likely due to the congestion of sperm after the vas deferens have been cut. Ninety percent of these men will get better with conservative measures (anti-inflammatory medications, rest, etc.). The other 10% (i.e. 1% of all vasectomy patients) may have episodic pain. This could require an operation to remove the remainder of the vas tube or even reversal of the vasectomy.
  • Failure rate: While vasectomy is considered a permanent sterilization technique, cases of regrowth of one of the divided vas tubes have been reported. This can happen early on after vasectomy or years later. The risk of this is roughly 1/5000 vasectomy patients, making vasectomy the most effective form of birth control.

The “No-Scalpel Vasectomy”

no-scalpel-vasectomy

  • The No-Scalpel Vasectomy is an advanced technique used to perform the vasectomy through one small opening (2-3 mm) in the scrotum, which requires no cutting or sutures.
  • It is a safe and minimally invasive procedure with a much lower complication rate and faster recovery time than conventional vasectomy.
  • Over 15 million men have undergone the No-Scalpel Vasectomy procedure. This safe and simple technique has gained worldwide popularity due to its effectiveness and extremely low rates of post-operative bleeding and pain.

The VasClip System

vas-clip

  • The VasClip is a locking plastic band designed to close the vas deferens and block the flow of sperm from the testicles in a manner that reduces tissue damage.
  • The main difference between VasClip and conventional vasectomy techniques is that the vas deferens is not cut. Instead, the vas deferens is left intact and a clip is placed over it.
  • Use of the VasClip eliminates all cutting, suturing, and cauterizing of the vas deferens.

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