Vasectomy
Vasectomy
is a surgical form of male sterilization. It is over 99% effective at
preventing pregnancy. The procedure can be performed either in the
office with local anesthesia, or in the surgery center under mild
sedation. Dr. Green will discuss which option is better for you at your
initial office consultation.
The vas deferens is the tube that carries sperm from each testicle to the urethra. Dr. Green divides and clips each vas deferens through one small opening in the scrotum, generally using the “no-scalpel” technique. The opening in the scrotum is closed using small, absorbable sutures that do not need to be removed.
Only about 2-3% of the total ejaculate is sperm. The rest is seminal fluid that is created by the prostate and seminal vesicles. Because of this, the quality and quantity of the ejaculate fluid is unchanged after vasectomy, except for the lack of sperm. Vasectomy does not alter your sex drive, ability to have erections, sensation of orgasm, or ability to ejaculate. Many men enjoy sexual relations even more after the risk of unplanned pregnancy is eliminated.
After the procedure, the body continues to make sperm. They are reabsorbed without consequence. This is similar to what happens to sperm that are not ejaculated after a while, regardless of whether or not there has been a vasectomy performed.
Although in many cases vasectomy can be reversed, because there is no guarantee of success, the decision to undergo a vasectomy should be considered a permanent one.
A man is not sterile as soon as the vasectomy is over. In general, it takes 20 ejaculations to remove the all of the sperm from the body. In some cases it can take up to 3 months for all of the sperm to disappear from the ejaculate after vasectomy. A man is considered fertile, and can father a child, until there are absolutely no sperm in the semen.
Many insurance plans cover vasectomy. As such, out-of-pocket expense for the procedure varies between patients. Our office can provide you with all the information you need to determine what your cost will be.
PRIOR TO THE PROCEDURE
- OFFICE: You will be given two prescriptions to start prior to vasectomy. One is an antibiotic, and the other is an analgesic. Take both about one-hour prior to your appointment. You should gently clip or shave the scrotal area prior to the procedure. Please eat a small meal the morning of the procedure, and keep yourself well hydrated.
- SURGERY CENTER: The biggest difference in the preoperative instructions for patients having their vasectomy in the Surgery Center is that they may not eat or drink anything for 8 hours prior to the procedure. They also do not need to shave, as the O.R. staff does this as part of the operative preparations.
DURING THE VASECTOMY
As you would expect, the experience is different for men who have the procedure in the office as opposed to the Surgery Center.
- OFFICE: Once you are comfortably positioned on the bed in the Procedure Room, the scrotal area is cleansed with an antiseptic soap solution. Sterile drapes are placed around the area. Dr. Green locates one of the vas deferens by touch. Local anesthesia is injected into the area, and you might feel a slight burning sensation. You may feel a pulling sensation during the procedure, but should not have any pain once the local anesthesia takes effect. Dr. Green dissects the vas, divides it between clips, and cauterizes the ends. The procedure is mirrored on the other vas, using the same opening in the scrotum. The skin opening is closed with stitches that dissolve and do not need to be removed. The entire procedure generally takes 15 minutes.
- SURGERY CENTER: In the pre-operative waiting area, a nurse will insert an IV. Once we are ready to proceed, you will receive a sedative through the IV. Most men do not remember anything until they awaken in the Recovery Room. Dr. Green performs the same procedure the same way as in the office, but with you sedated.
POST-VASECTOMY EXPECTATIONS AND INSTRUCTIONS
After the procedure, the scrotum will be numb for 1 to 2 hours. As the anesthesia wears off, you might feel some discomfort. The use of a scrotal support, such as a jock strap, is recommended for the first few days after the procedure. Application of ice packs, or a package of frozen vegetables, to the scrotal area will ease any discomfort and decrease the chances of swelling. (Please apply the cold pack over the scrotal support. Never apply ice directly to the scrotal skin.) You may see some mild oozing of blood from between the sutures. This is nothing to be concerned about.
Generally, any swelling or pain resolves after 1 or 2 days, and you can return to work (unless your job is very strenuous.) Avoid heavy lifting or straining for a week. You may resume sexual intercourse when you are comfortable. Generally speaking, that is about a week after the vasectomy.
You are fertile until your semen has no sperm in it. That can take up to 3 months in some cases. You must use another method of birth control until we check a semen analysis and confirm that the sperm count is zero. Dr. Green provides the semen analysis after vasectomy at no extra charge.
RISKS
All surgical procedures have an element of risk. The risk of complications after a vasectomy is very low. Some complications are:
- Bleeding within the scrotum that can lead to swelling or bruising
- Pain that lasts longer that a few days, rarely this can be chronic
- Infection of the skin or testicles
- Inflammation of the epididymis, the tubes that drain the testicles into the vas.
- Recanalization of the vas, resulting in restored fertility (very rare)
- Sperm leaking from the vas into the surrounding tissues can lead to a “sperm granuloma.” This can present as a small lump that is generally of no consequence. If a granuloma becomes painful, it can be removed easily with a brief surgical procedure.
If you have any other questions, or would like to schedule a consultation, please contact us at 941-309-7000 or at joshua.green@usa.genesiscare.com
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