Definition

A vasectomy is a surgery to sterilize a man. This is done by blocking the tubes through which sperm normally pass on their way from the testes to the penis. These tubes are called the left and right vas deferens.

Male Reproductive Anatomy

male reproductive organs

© 2008 Nucleus Medical Art, Inc.

Parts of the Body Involved

  • Scrotum
  • Vas deferens

Reasons for Procedure

A vasectomy is done as permanent birth control. This option is for men who are sure they will not want to father a child. Surgery to reverse the procedure is not always possible or successful.

Risk Factors for Complications During the Procedure

  • Local infections
  • Bleeding disorders

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Medical history
  • Review of medications
  • Discussion of the effects of this procedure

In the days leading up to your procedure:

  • Do not take aspirin, aspirin-containing medications, or nonsteroidal medications such as ibuprofen for one week before the procedure. Discuss this with your doctor prior to your procedure.
  • Arrange for a ride to and from the procedure.
  • The night before, eat a light meal and do not eat or drink anything after midnight, unless your doctor says otherwise.
  • Wear comfortable clothing and tight-fitting underwear.
  • Take any medication ordered by your doctor. A mild sedative before the procedure may be recommended.
  • Shower before leaving home.
  • You may be asked to clip your scrotal hair.

Anesthesia

Local anesthesia

Description of the Procedure

There are three techniques for a vasectomy:

  • Conventional approach—The doctor makes one small cut in the skin on each side of the scrotum. He brings the vas deferens through the opening. The tube is cut, and a small piece may be removed. The ends are sealed off with stitches, clips, or cauterization (using an electric needle to destroy the tissue). The vas deferens is placed back in the scrotum and the incision is closed with stitches.
  • No-scalpel vasectomy—The doctor locates the vas deferens under the scrotal skin and attaches a clamp to hold it in place. Using a special instrument, the doctor punches a small hole in the skin and stretches it open to pull the vas deferens through. The tubes are cut and sealed the same way as in the conventional approach. The holes heal without stitches.
  • Vas clip vasectomy—The doctor locates the vas deferens in either of the two manners mentioned above. Once the vas deferens are delivered through the skin, specially designed clips are placed around each vas deferens and cinched in place. This blocks the flow of sperm beyond the position of the clip.

Conventional Approach

vasectomy

© 2008 Nucleus Medical Art, Inc.

After Procedure

You will rest at the doctor's office for a short time.

How Long Will It Take?

Conventional vasectomy takes about 30 minutes. No-scalpel procedures take about 20 minutes.

Will It Hurt?

Anesthesia prevents pain during the procedure, but you can expect some soreness for a few days after. Take pain medication given by your doctor. Do not take aspirin or anti-inflammatory pain medications without your doctor's approval.

Possible Complications

  • Infection
  • Swelling
  • Bruising
  • Bleeding
  • Inflammation
  • Anesthesia-related problems
  • Chronic pain in and around the testes
  • Sperm granuloma (lumps due to immune system response to sperm leaking from the reproductive organs)
  • Swollen, painful testes occurring during the year following a vasectomy
  • Continued fertility, or rejoining of the ends of the vas deferens resulting in renewed fertility, potentially resulting in pregnancy in a sexual partner
  • Psychological issues related to lack of fertility

Average Hospital Stay

None

Postoperative Care

  • Apply ice packs, covered with a towel, on and off during the first eight hours.
  • Rest in bed for at least one day and at home for a couple of days.
  • You may shower the next day.
  • Wear an athletic supporter, if recommended by your doctor.
  • Keep the area clean and dry.
  • Cover the incisions with clean gauze for three days or as directed by your doctor.
  • A small amount of blood on the gauze pads is normal. Tell your doctor if you have excessive bleeding or need to change the gauze pads more that 2-3 times daily.
  • Your doctor may give you antibiotics for several days following the procedure.

Outcome

Most men may feel fine to go back to work in a few days. They may also feel ready for sexual activity in about a week. Ejaculation may cause some discomfort in the groin and testicles until the tissues heal. Do not lift heavy objects or participate in sports for 2-3 weeks. You will have two tests, 4-6 weeks apart, to check to make sure that no sperm are present. Until both tests are complete, you will need to use an alternate method of birth control for 2-4 months.

Call Your Doctor If Any of the Following Occurs

After you leave the hospital, call your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Difficulty urinating

RESOURCES:

American Society of Reproductive Medicine
http://www.asrm.org/

National Institutes of Health
http://www.nih.gov/

CANADIAN RESOURCES:

Health Canada
http://www.hc-sc.gc.ca/

Men's Health Centre
http://www.menshealthcentre.net/

References:

National Institute of Child Health and Human Development. National Institute of Child Health and Human Development website. Available at: http://www.nichd.nih.gov/. Accessed July 19, 2008.

Pfenninger JL, Fowler GC. Procedures for Primary Care Physicians. 1st ed. Philadelphia, PA: Mosby-Year Book; 1994.

Vasectomy. Planned Parenthood website. Available at: http://www.plannedparenthood.org/health-topics/birth-control/vasectomy-4249.htm. Updated June 25, 2008. Accessed July 19, 2008.



Last reviewed March 2008 by Ronald Nath, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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