Vasectomy

Vasectomy is the most common procedure that is used for male sterilization. A vasectomy is a minor surgical procedure where the vas deferens are isolated, cut, and ligated, thereby disrupting the flow of sperm into the ejaculate. After follow-up semen analyses demonstrate no persistent sperm after the vasectomy, a man should no longer be able to father children.

Indications

  • Desire for permanent male sterility

Procedure

Patients that undergo vasectomy in our office are given conscious sedation. The scrotum is cleansed and prepped with an antiseptic solution and is then covered with a sterile fenestrated drape. (If the scrotum was not shaved prior to surgery, this will be completed before the skin preparation). Local anesthesia is injected into the skin over the vas deferens  and into the cord itself. This allows for excellent pain control. Although the patient will be aware of some movement and pressure, this “cord block” relieves operative and post-operative pain for several hours. The vas deferens is then isolated.
We remove a small segment for pathologic confirmation, cauterize the vas lumen, and tie or place titanium clips on the ends. The incision or incisions are then closed with small dissolvable sutures.

Advantages

  • Outpatient office procedure
  • Less expensive than female sterilization
  • Generally more safe and reliable than female sterilization

Side Effects

For the first several days after the vasectomy, the patient will most likely have some discomfort and heaviness in the testicles, particular with activity. This will decrease week by week, and has usually resolved by 2 to 3 weeks. There is commonly some swelling and some bruising in the scrotum, and wearing a scrotal supporter or tight underwear for several days as instructed will decrease this. The pliable and thin skin tissues of the scrotum can occasionally allow the formation of a hematoma. Superficial skin infections around the stitches and incisions can occur and may require antibiotics and/or drainage in the office. In approximately 1/100 cases, a chronic pain syndrome can occur and may require vasectomy reversal for treatment. As with any surgical procedure, vasectomy has risks and benefits, and a small percentage of vasectomies “fail” due to re- canalization, or re-growth of the sperm channels.