Vasectomy is a minor operation that lasts about 30 minutes, and results in male sterilization. The whole procedure is usually done at a doctor's office or a clinic, and the patient is awake during the surgery.
You may have heard about a special method called no-scalpel vasectomy. This procedure is also possible, and it was originally developed in China. The doctor doesn't use a scalpel at all, because after the anesthetic is injected, he pierces the skin of the scrotum with a sharp instrument.
This is followed by gently stretching the opening so that the tubes can be reached and blocked. The advantages of this technique are less pain and bleeding. For couples who have made the decision not to have any more children, vasectomy is the safest and easiest form of surgical sterilization.
Anatomy of the male reproductive system
Of course, in order to understand the vasectomy procedure, it is necessary to understand the male reproductive system and how it functions. The testicles are the sperm- and testosterone-producing organs located in a sac at the base of the penis, called the scrotum. Not too many know that a testicle is connected to a small, coiled tube called the epididymis, which is also connected to the prostate gland by a pair of tubes called the vas deferens. That’s the target tissue of the operation, because this structure is a part of a larger bundle of tissue, blood vessels and nerves called the spermatic cord. Normally, when a male ejaculates, seminal fluid mixes with sperm from the testes to form semen.
Semen is the combination of sperm and glandular fluid released by the urethra when a man ejaculates; normally a mixture of less than 1% sperm and 99% seminal fluid. That’s why, if this structure is blocked somehow, the sperm wouldn’t come out from penis at all, which is the basic principle of this birth control method.
Preparations for the operation
Some preparation is required prior to undergoing vasectomy.
- The scrotum should be washed or even shaved before the operation, to prevent infection.
- Tight-fitting underwear or athletic supporters should be worn immediately after the operation to support the scrotum and minimize swelling.
- The patient should minimize all kinds of exertions and movement that could exacerbate swelling and cause pain
- Before and after the operation, the patient should strictly avoid anti-inflammatory drugs because these medications can cause excessive bleeding
As mentioned earlier, an urologist performs a vasectomy on an outpatient basis, and the whole procedure lasts no more then 30 minutes. Patient is awake but the scrotum is numbed with one or more injections of local anesthetic such as Lidocaine. Then the tissue called vas deferens is gathered under the skin of the scrotum, and a small incision is made.
This is followed by the pulling out of the vas deferens through the incision, cutting in two places, and removing a 1-centimeter segment. Each end of the vas deferens is surgically tied off or clipped, and placed back in the scrotum. The incision is sutured and the procedure is repeated on the other side of the scrotum. The procedure is completely painless and the patient can go home immediately after.
Can vasectomy cause any medical problems?
All medical experts including the World Health Organization have confirmed that vasectomy is a safe procedure. To illustrate this, we should mention that a number of large-scale, well-designed epidemiological studies have examined the long-term health effects of vasectomy and most of them showed that vasectomized men are no more likely than other men to develop heart disease, testicular or prostate cancer, immune complex disorders, or other illnesses.
Emotional effects are present and every potential patient should be aware of them. –Sterilization is a hard decision for any man, and some may feel a little uncomfortable about ending the part of life involved with creating a family. It can also bring about aging concerns and the like, but these feelings usually pass with time.
Vasectomy and masculinity
Many men are confused, and wonder if the operation will affect their masculinity. The answer is a definite no. The body will continue to produce the characteristic male hormones, and no masculinity will be lost. This applies to sexuality as well. The male’s sexual drive will not change at all, and erections and climaxes will stay the same.
Safety and possible complications of a vasectomy procedure
The overall statistics say that the early failure rates of vasectomy are below 1%, but the effectiveness of the operation and rates of complications vary with the level of experience of the surgeon. Complications are possible, and most common early complications are hematoma, infection, and sperm granulomas. Most men will experience minor bruising in the scrotum for 3 to 5 days following the operation.
The incidence of chronic post-vasectomy pain is estimated to be between 5% and 30%. Unfortunately, although the common perception is that vasectomy is safe and simple, the experiences of many men have been otherwise. The inconvenience of other forms of birth control must be weighed against the possibility of severe and chronic genital pain after the operation!
Problems that might occur after a vasectomy include
- mild inflammatory reaction
There is a risk is that the ends of the vas deferens may find a way to create a new path to one another, though this doesn't occur very often.
Other possible side effects are:
- It is possible for sperm to leak out of the cut tubes and collect in surrounding tissues; in this case hard lumps, called sperm granulomas, can form. They are not harmful, and can be treated with anti-inflammatory medicines
- A small percentage of men develop long-term testicular pain
- Some men develop a full feeling in their testicles which usually goes away after a few weeks
- Very rarely there is a verysmall risk the tubes can rejoin naturally, and you become fertile again
Effectiveness of vasectomy
Vasectomy is definitely the most effective long-term contraceptive method. Sterilization is a popular birth control method, especially among older men. But how to tell a young couple that the best birth control method for them is total sterilization? Where is the motivation for the procedure?
Here are a few advantages of the procedure that can be used as motivation:
- The low cost and simplicity of vasectomy
- Fewer complications compared to most methods of female sterilization
- The lower mortality rate of vasectomy
- The fact that almost all men who had the procedure are satisfied with the results
Most clinics treat vasectomy as a non-reversible process, but this isn’t entirely true, it’s just that men considering vasectomies should not think of them as reversible. There is one procedure to reverse vasectomies, called the vasovasostomy, a form of microsurgery. However, it is not effective in all cases, success rate depending on such factors as the method used for the vasectomy and the length of time that has passed since the vasectomy was performed.
Alternatives to vasectomy
Vasclip®: Vasclip® is an alternative to vasectomy that does not involve cutting or cauterizing the vas deferens. It is a rather simple procedure in which a small plastic device is clamped around the vas deferens to prevent sperm from entering the semen. Because the vas deferens is not cut or cauterized, Vasclip may result in a shorter recovery time and fewer complications than traditional vasectomy.
Female sterilization: Female sterilization is an alternative to male sterilization. The operation is called the female tubal ligation and it seals or cuts the fallopian tubes. Eggs can then no longer be fertilized by sperm. It should be considered a permanent operation.
Another option is called the the levonorgestrel intra-uterine system (IUS). A device is a placed inside the uterus that slowly releases a hormone called levonorgestrel, which prevents fertilization.