A surgical procedure that severs the ducts that carry sperm
from the testicles to the penis. A vasectomy is becoming
one of the most popular methods of permanent prevention
of pregnancy for modern couples. It is affordable, effective
and (especially when compared with methods available to
the female partner) relatively free of risk.
Methods women can use to prevent pregnancy include:
Using birth control hormones to interrupt their monthly
Installing a device (an IUD) in the uterus that prevents
a fertilized egg from implanting itself there.
Placing a barrier (a condom or diaphragm, both of which
unreliable) between the penis and uterus.
Opening the abdominal cavity to reach and sever the tubes
that carry eggs from the ovaries to the uterus}
In contrast, a vasectomy opens only the skin of a man' scrotum,
through which the sperm ducts can be easily reached and
Anatomy: Sperm are produced in the testicles, which
also produce the male hormone testosterone, which is largely
responsible for male muscle and drive.
Sperm mature in a structure at the back of each testicle
called the epididymis and travel on to the seminal vesicles,
where they are stored in a nutrient broth.
During orgasm and ejaculation, the seminal vesicles contract
and squeeze sperm out into the prostate, which produces
the seminal fluid that floats the sperm along as they swim
toward their target.
As ejaculation continues, semen is pushed into the urethra
(the single tube which also lets urine exit the body) and
out through the penis.
The tubes that conduct sperm from each epididymis to the
seminal vesicles are called the vas defer ens and can be
felt on each side of the scrotum.
Surgically severing the vas deferens prevents sperm from
reaching the seminal vesicles and the prostate. It does
not stop the testicles from producing sperm or testosterone.
It does not stop the seminal vesicles and the prostate from
producing their fluids. It does not lower sex drive and
it does not change the nature of orgasm. It merely changes
the content of ejaculation. In fact, many couples report
that with the worry over surprise pregnancy remove, sex
becomes more playful and spontaneous, and therefore ultimately
As with any surgical procedure, there is a risk of swelling,
bruising, and infection following vasectomy, but for a person
in generally good health, without any serious underlying
conditions, the risk in minimal.
If you have diabetes mellitus, problem with the heart valves,
or a sexually transmitted disease such as Herpes, gonorrhea,
syphilis, genital warts, or HIV, please let the physician
know so that precautions can be taken to safeguard you health.
Also, please the physician know if you regularly take Aspirin
or a prescription blood thinner, if you have any know allergies
(especially allergies to anesthetics such as Novocain),
or if you have ever had any injury to the genital area.
Some studies have reported what seemed to be slightly increased
risk of cardiovascular disease or prostate cancer in men
who have had a vasectomy. Other studies have found just
the opposite. Feel free to discuss any concerns you have
with the physician.
on Permanent Sterilization: Perhaps the greatest risk
following vasectomy is that your life circumstances could
at some point change, prompting you to want to father another
child. Although vasectomy can in some cases be reversed,
the reversal is not simple, inexpensive procedure and the
success rate is not particularly good. Therefore, the decision
to seek permanent sterilization must not be made lightly.
You and your partner should thoroughly explore your plans,
your feelings and your worries about this permanent method
Procedure: During you initial vasectomy consultation
the physician will have examined you to confirm that your
vas deferens can be easily reached through a single incision
in the center of the scrotum. He will prescribe a mild relaxant
(Valium) that you should take a half-hour to an hour before
you appointment. (Because the Valium will slow your reaction
time, you should not plan on driving to or from your surgery.)
Start to finish, the whole procedure will take about 20
to 30 minutes. The procedure will begin with the shaving
the scrotum (if necessary) and then washing the skin with
antibacterial soap. The physician will inject three spots
on the scrotum- the center line and both sides- with Novocain.
(This is the only painful part of the vasectomy, and feels
much like the sting of having your mouth numbed for dental
work.) The Novocain takes effect immediately, and though
you will feel some pressure and an occasional "tug"
you will feel no more pain.
The physician makes a single short incision in the midline
of the scrotum (some of our physicians may make two). Through
the incision(s) he locates each vas and brings it to the
surface. A section of the vas is clamped off and removed,
and the cut ends are cauterized. Each end is then tied off
and sewn back on itself, making it highly unlikely that
the ends could ever reconnect.
When the vas on each side has been clamped, cut, cauterized,
tied and sewn back, the physician settles the tubes comfortably
back inside the scrotum. He then closed the incision with
cat gut sutures. (The sutures are designed to dissolve (on
their own) in about three to five days.) The area is washed
with hydrogen peroxide, an antibacterial ointment applied,
and a gauze pad is placed over the incision. (It is to be
noted that each physician does he procedure uniquely and
should explain his process at the time of the vasectomy
With that, the procedure is over and you will be ready to
dress and leave. Remember to bring or wear a jock strap
or tight fitting jockey underwear.
the Procedure: Your recovery will go smoothly if you
use good judgment and follow this advice:
much as possible, stay off your feet the rest of the
day. This will lessen any possible bruising or swelling,
with their accompanying discomforts.
Keep an ice pack on the scrotal area for the rest of
the day. (A bag of frozen peas works well because it
can be "molded" to fit.)
Wear a jock strap or tight-fitting jockey underwear
for the next several days to give the scrotum good support.
Do not try any activity (such as weight-lighting, wood-splitting,
or Jeep riding) that would strain or put pressure on
your scrotum until you feel fully recovered.
Refrain from sex at least three days or longer if you
are not comfortable.
The Novocain will wear off in about two hours and you
will probably need to take the pain medication that
the physician prescribed for you (plain Tylenol should
be sufficient to relieve any discomfort over the next
day or so.
Take a shower the next day and gently pat the incision
(s) dry. Again apply the antibiotic ointment, the gauze
pad, and close-fitting underwear. Follow this same procedure
as long as there is any oozing from the incision(s).
If there is any sign of infection (redness, heat, or
swelling that seems to be getting worse, or any sign
of pus of foul odor) call the physician.
green light: You will need to use some form of birth
control until your semen has been confirmed free of sperm.Sperm
produced before the vasectomy was done would have been stored
in the seminal vesicles and could still be ejaculated and
reach their target.
commonly takes 10 ejaculation or more before the stored
sperm have been completely eliminated. After the 10th ejaculation,
bring a specimen into the office to be checked under microscope.
(We will give you the specimen cup. Make sure you label
it clearly with your name, number and the date.) You will
also need to bring in another semen sample between 3 and
6 months after the procedure to make sure the ends of the
vas deferens have not rejoined.
the physician is looking for the absence of sperm, rather
than for their health of vigor, there is no time limit on
how quickly the specimen must reach our office, other than
within a day or so.
Concerns: If anything is causing you real concern,
please do not hesitate to contact our office.
Many men grow concerned when the cat gut sutures dissolve
and the incision seems to be opening up. Unless there is
any increase in pain, bleeding, oozing, redness, swelling,
or bruising, there generally is nothing to worry about.
The skin of the scrotum heals quickly, and will shortly
begin to knit together on its own, as would any cut, even
some ointment and a small piece of gauze or a band-aid on
the area will reduce any "prickly" feeling you
may have during the healing process.
Many couples also want to know what happen to the sperm
now that the testicles continue to produce. In short, when
they reach the end of their normal life span, the sperm
disintegrate into their component proteins and are reabsorbed
by the body.
Occasionally a small "knot" forms where the vas
has been cut. This is generally insignificant, but any unexplained
lump should always be evaluated by you doctor.
physicians and staff are here to help answer any questions
or concerns you may have regarding this procedure.