VASECTOMY

Vasectomy is a form of male sterilization, or “permanent contraception”. In this procedure, the vas deferens (sperm duct) is either blocked or partially removed on both sides. Thus, sperm from the testes no longer reaches the ejaculate, and no longer enters the female reproductive tract to cause pregnancy.

The patient is positioned on an exam table, and the scrotal skin is cleaned. On each side of the scrotum, the site of interest is numbed with local anesthetic, and a small (3-5mm) opening is made in the skin (by incision or puncture). Here at Hopkins, we perform the “no-scalpel” puncture technique, as this heals well without stitches and may be associated with less bleeding.

The vas deferens is gently separated from surrounding tissues, then cut and sealed. A small segment of the vas deferens is often removed as well. All structures are then returned to their normal position within the scrotum. The skin incisions are so small that stitches may not be used. If used, the stitches will dissolve on their own. Some ointment and/or gauze may be placed on the wounds.

Typically, the procedure itself takes around 15-30 minutes. However, the office visit will be longer due to the time necessary to get positioned and cleaned for the procedure. If general anesthesia is administered in the operating room, this can add a few hours of recovery time as well.

It is greater than 99%. In rare instances, the sperm can reform a path between the ends of the vas deferens. This is called recanalization, and leads to pregnancy in 1 out of every 2000-3000 patients that get a vasectomy. Vasectomy is still considered among the most effective and safe forms of permanent contraception.

Patients should consider vasectomy permanent.

If your objective is merely to space out pregnancies, or if you have even the slightest reason to believe that you might want to have children in the future, then a vasectomy will not suit your purpose and should not be considered.

Cryopreservation (sperm banking or freezing) before vasectomy is available as an option for those men considering vasectomy, though they should understand that use of the sperm requires professional assistance. Although we do not recommend sperm banking for all couples, some couples may elect to pursue this. Vasectomy reversal is also an option, but should not be taken lightly, as this can be costly and is not 100% effective.

You probably won’t need to wait long before you can return to normal activities after vasectomy.

A vasectomy is an outpatient procedure in which your surgeon cuts and closes off the tubes that deliver sperm from your testicles into your semen. Most vasectomies can be done in a urologist’s office. The procedure itself is quick, taking about 30 minutes or less.

Full recovery time is about eight to nine days for many people. Keep in mind this may vary depending on your individual perception of pain and ability for tissue healing.

It will take longer until you can ejaculate without sperm in your semen.

There are risks for every surgery. A sperm granuloma occurs in 15 to 40 percent of men who undergo vasectomy. A sperm granuloma is a mass that develops over time as a result of the body’s immune reaction to sperm leaking from the cut end of the vas. It is typically treated with an anti-inflammatory medication, such as ibuprofen. Post-vasectomy pain syndrome – This condition is thought to result from a buildup of fluid in the epididymis leading to a chronic dull ache in the testes.

Apply ice packs intermittently to the scrotum the night of your vasectomy and as much as possible the following day. Do not apply for more than 20 minutes at a time. Remove all dressings–except one or two clean gauze pads–from inside the athletic supporter after 24 hours.

As partners, you may need to support your partner after the surgery.