For many men, a vasectomy can be a major traumatic event. Having the right information will help relieve some of your fears and anxiety. You can be much better prepared on what to expect.
In order to educate our patients we utilize this website, both text and video, to explain the procedure in detail. Here you can learn about the procedure, the preparation, the technique, the risks and benefits. Then you can take your time in deciding if this procedure is right for you. I am the surgeon that will perform the actual procedure on you. You will not come to the office not knowing who will do the procedure.
All vasectomies are done in the office, the majority done under local anesthesia. If requested, general anesthesia is available.
It is currently estimated that annually 500,000 men in the USA undergo the procedure, and about 12% of the male population between 18 and 65 years of age have had a vasectomy.
Vasectomy should be considered permanent. It’s not a method of birth control that can be turned on or off as required, therefore is not the right choice for everybody and you must be absolutely sure that this is what you want before signing the consent form. The men who are most likely to gain from vasectomy are men in couples where both partners agree they have all the children they want, and both do not want to use (or are unable to use) other methods of contraception.
Points to Remember
Most of the time, I can do the procedure with one small opening in the midline. Occasionally, if the scrotal sac is tight, I may have to make one small opening on each side. I can use either a scalpel or a pointed forceps (as in “no scalpel technique”) to create the opening. The opening on the skin is approximately one fourth of an inch. Of course, local anesthesia is injected to minimize any discomfort.
Note: “No scalpel technique” can be misleading making you think the procedure is done without a skin opening. An opening on the skin is always needed, the difference being the hole is made with a sharp tip instrument, not a blade. Either way, the opening is the same size.
There are various techniques in doing a vasectomy. I have had extensive experience over the years and have reviewed all the guidelines provided by our national association in regard to bilateral vasectomy. In my opinion, the best technique to use is open ended vasectomy with facial interposition. In this technique, the vas end coming from the testis is left open, it will close slowly over time. This allows the vas end to gradually seal and the testis has time to adapt to the blockage. The other end of the vas is sealed then separated from the other end by interposing a layer of tissue in between. This essentially results in each end of the cut vas in separate “rooms”. It has the least complications and the highest success rate. This technique minimizes the post-op swelling that can occur from sudden occlusion of the vas end coming from the testis. This is the procedure I use for all my patients.
A common misconception is that after vasectomy men no longer ejaculate. This is not true, as sperm represent only approximately 3% of the ejaculation, with the other 97% coming from various fluids stored in the prostate. Another common misconception is that after vasectomy, men become less masculine. Again, this is not the case. The male hormone testosterone produced by the testicles is still produced in the same quantity after vasectomy. So you are not going to get a higher voice and lose all your body hair!
As regards satisfaction with the procedure, in general satisfaction rates are high, with 95% plus of men glad they did it, and men often report that their sex lives are better due to having no worries about pregnancy after unprotected sexual intercourse.
In common with all medical procedures, as well as the benefits there are risks to be considered too. The most common post surgery after effects are bruising, swelling, discomfort, post procedure infections and scrotal hematoma. These complications are routine, and usually easy to resolve. It is generally accepted the risk of infection or hematoma to be 1 to 2 percent. There is also a risk of chronic scrotal pain also at 1 to 2 percent.
Recovery usually takes a few days. The general advice is to wear supportive underwear, keep the area iced for about 8 hours the first day, and to rest and stay off your feet for two days not counting the day of the vasectomy. If you have a desk job, you normally can get back to work after that. If you have a physical job, you may have to set aside more days off, possibly 5 days. Similarly, if you are an active sportsman then try and schedule the procedure for “off season” if possible, and make sure that you discuss with your doctor when it will be possible to fully resume your sporting activities. Do your best to follow the period of rest to avoid any swelling.
The majority of men are able to start having unprotected intercourse after about 20 ejaculations / 2-3 months, however some men will take longer due to a variety of factors. If you are taking longer that this to clear – don’t worry about it. It’s not as unusual as you think! Have a chat with your doctor, and keep ejaculating regularly to help clear the tubes of all sperm. Remember that you are not sterile until you have had two semen analysis showing no sperm present. These are done a month apart. You must use an alternative method of contraception until then.
It’s generally accepted that the failure rate for vasectomy is about 0.05%. This compares to approximately a 0.5% failure rate for female sterilization. The FDA puts the failure rates for condoms at 11%, but this figure can vary dramatically depending on a variety of factors including infrequent/incorrect use.
Over the years, there has been some suspicions associating vasectomy with some illnesses, including hormone changes, cardiac disease, prostate cancer, dementia, testis cancer. All of these have been studied in depth and today, the studies show NO relationship or connection to any of these diseases.
Here is a video I have created that may help you understand a vasectomy.
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