Vasectomy

A vasectomy is a surgical procedure performed on males in which the vas deferens (tubes that carry sperm from the testicles to the seminal vesicles) are cut, tied, cauterized (burned or seared) or otherwise interrupted. The semen no longer contains sperm after the tubes are cut, so conception cannot occur.The testicles continue to produce sperm, but they die and are absorbed by thebody.

The purpose of this operation is to provide reliable contraception. Researchindicates that the level of effectiveness is 99.6%. Vasectomy is the most reliable method of contraception.

Vasectomies are often performed in the doctor's office using a local anesthesia. The patient's scrotum area will be shaved and cleaned with an antisepticsolution to reduce the chance of infection. A small incision is made into thescrotum (the sac containing the testicles that produce the sperm). Each of the vas deferens (one from each testicle) is tied in two places with nonabsorbable (permanent) sutures and the tube is severed between the ties. The ends may be cauterized (burned or seared) to decrease the chance that they will leak or grow back together.

Sterility does not occur immediately after the procedure is finished. Men must use other methods of contraception until two consecutive semen analyses confirm that there are no sperm present in the semen. This will take 4-6 weeks or 15-20 ejaculations to clear all of the sperm from the tubes.

"No scalpel" vasectomies are gaining popularity. Instead of an incision, a small puncture is made into the scrotum. The vas deferens are cut and sealed ina manner similar to that described above. No stitches are necessary and thepatient has less pain. Other advantages include less damage to the tissues, less bleeding, less risk of infection, and less discomfort after the procedure.

In some, cases vasectomies may be reversed. However, this procedure should beconsidered permanent as there is no guarantee of successful reversal.

No special physical preparation is required. The physician will first assessthe patient's general health in order to identify any potential problems thatcould occur. The doctor will then explain possible risks and side effects. The patient is asked to sign a consent form which indicates that he understands the information he has received, and gives the doctor permission to performthe operation.

Following the surgery, ice packs are often applied to the scrotum to decreasepain and swelling. A dressing (or athletic supporter) which supports the scrotum can also reduce pain. Mild over-the-counter pain medication such as aspirin or acetaminophen (Tylenol) should be able to control any discomfort. Activities may be restricted for 1-2 days, and sexual intercourse for 3-4 days.

There are very few risks associated with vasectomy other than infection, bruising, epididymitis (inflammation of the tube that carries the sperm from thetesticle to the penis), and sperm granulomas (collection of fluid that leaksfrom a poorly sealed or tied vas deferens). These are easily treated if theydo occur. Patients do not experience difficulty achieving an erection, maintaining an erection, or ejaculating. There is no decrease in the production ofthe male hormone (testosterone), and sex drive and ability are not altered. Vasectomy is safer and less expensive than tubal ligation (sterilization of afemale by cutting the fallopian tube to prevent conception).

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