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Vasectomy

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Definition

A vasectomy is a permanent, surgical form of male birth control. This surgery is intended to prevent a man from being able to get a woman pregnant.

Description

A vasectomy is performed by cutting the tubes that the sperm travel through to leave the testicles. This tube is called the vas deferens. Vasectomy is typically performed under local anesthesia (the patient is awake), but procedural sedation or even general anesthesia may need to be considered in certain circumstances, such as deeper location of the vas deferens in the scrotal sac.

There are several techniques for the performance of a vasectomy, which depend primarily on physician’s preference and experience.

The standard method typically involves the following steps:

  • The doctor will make one or two small cuts into the scrotum in order to get to the vas deferens.
  •  A small section of the tube is cut out and removed.
  • The physician may cauterize the ends and then tie the ends with stitches.
  • Separating the two ends of the interrupted vas deferens by a small portion of patient’s tissue (“tissue interposition”)
  • The same procedure will then be performed on the other vas deferens.
  • When the vas deferens has been tied off, the doctor may use a few stitches or skin “glue” to seal the opening(s) in the scrotum.

“No-scalpel” method:

  • A small puncture is make on one side of the scrotum.
  • The health care provider will locate the vas deferens under the skin and pull it through the opening.
  • The tube is then cut and a small section is removed.
  • Tissue interposition as described above.
  • The ends are then either cauterized or tied off and then put back into place.
  • Then the procedure is performed on the other vas deferens.

No stitches are used in this method because the holes that are made are so small.

Effectiveness

A vasectomy typically takes about three months before it is fully effective. Your health care provider will test your semen to make sure there is no sperm in it. You should continue to use another method for contraception until your semen testing shows no sperm cells.

The procedure is occasionally reversible, but not always.

Although a vasectomy is an effective form of birth control, it does not protect against sexually transmitted diseases (STDs). Men who have undergone the procedure should still practice safe sex in order to avoid being infected with an STD.

Risks

Even though a vasectomy is a safe and effective procedure, any man considering the procedure should be aware of the risks that come with it. There are surgical risks and other risks that can occur over time.

Surgical risks

  • Hematoma - Bleeding under the skin that can lead to painful swelling.
  • Infection - Fever and scrotal redness and tenderness are signs of infection.

Other risks

There is a very small risk that other problems will occur, such as:

  • A lump in the scrotum called a granuloma. These form when sperm leak out of the vas deferens into the surrounding tissue.
  • Postvasectomy pain syndrome, pain in the testicles that doesn’t go away
  • Vasectomy failure
  • Risk of regret, having second thoughts about the procedure

Talk to your physician

This article is for general information and does not replace the need for formal counseling by a health care provider regarding this procedure.