…a simple, most say ‘painless‘ procedure that prevents sperms from getting into the semen so that the man cannot get a woman pregnant.
It is a:
choice of contraception for men who are sure that they do not want to father any, or any more children.
Vasectomy Southeast uses the:
technique where no tissues are removed.
Developed as a means of contraception last century, and popular (500,000 procedures per year in the USA and 15,000 in Ireland) since the 1950’s, vasectomy is a dependable method of birth control for men who think they will never want any or any more children. It is a simple 30 minute procedure performed in a doctor’s office or clinic with a local anaesthetic. The objective is to prevent sperms from entering the semen, 95% of which is support fluid made by glands called the prostate and seminal vesicles, located in the pelvis behind and beneath the bladder (anatomy diagrams).
Be her hero!
Sperms are made in the testes. From each testis, sperms move through a long curled-up tube behind the testis (the epididymis) wherein they become mature. From there, they swim up a foot-long tube (the vas) which guides them up to the channel (urethra) through which men urinate and ejaculate. Just before entering the urethra, the left and right vas tubes are enlarged, and it is here, behind the bladder, where many sperms are stored between ejaculations. The easiest place to access the vas tubes is just above the testes where the vas tubes are just beneath the thin scrotal skin, easy to feel and very mobile.
Methods… (Our preferences are below):
Anaesthesia: An anaesthetic solution is delivered using a spray applicator. This numbs the skin and the vas tubes, without using any needles.
Access: During conventional vasectomy, one or two 1/2-inch scrotal incisions are made to gain access to the vas tubes. These incisions are later closed with sutures, which remain in place for about 5 days until they dissolve or are removed.
During no-scalpel vasectomy (NSV) as performed by Dr. Osman, special instruments are used to perform the procedure through a single tiny opening rather than an incision on the front side of the scrotum. The 1/4-inch opening usually seals within hours, so no stitches are needed.
Blocking the vas tubes: Whichever technique of accessing the vas tubes is used, each vas (left & right) is divided about one inch above each testis, where it is just beneath the thin scrotal skin and very easy to reach. What is done with the ends of the divided vas tubes depends on the preference of the person performing the vasectomy. Some operators remove a piece of vas; others don’t. We do not remove any tissues. Some tie off one or both vas ends using permanent or absorbable sutures or use small clips to stop bleeding blood vessels as in any other type of surgical procedure. Others cauterise the ends so that they will seal by scarring. Still others simply place the divided ends out of alignment, or close the vas sheaths between the 2 ends with a suture or tiny clips so the ends won’t grow back together. We only cauterise one end and apply a single clip to separate the two ends. SIMPLE !
The portions of the vas tubes within the pelvis still contain live sperms until they are all released. About 98% of men are sperm-free after 20-30 ejaculations and 12 weeks. In 5% of men, the semen may still contain some sperm (usually few in number and not active) for months, so it is important to have a semen sample checked and to use other forms of birth control until it is confirmed by microscopic examination that the semen is sperm-free.
Sperms are still made by the testes but can no longer pass up through the vas tubes (anatomy diagrams). So the body adjusts: white blood cells ingest and digest the retained sperm, recycling the proteins back into the system for use in other body functions. Men usually notice:
>> No change in the semen
>> No change in sex drive
>> No change in climax sensation
>> No change in the testes or scrotum
>> No change in erections
Bleeding: can occur during or after vasectomy by either method, but it is less common with NSV (non-scalpel vasectomy). If this occurs within the scrotum, drainage of a scrotal haematoma (blood clot) in a hospital operating room could be necessary. Smaller haematomas do not require surgical drainage, but tender swelling can last for 2 to 4 weeks. Both large and small haematomas are very rare. If the scrotal skin bleeds at the vasectomy access site, the scrotum can become discolored (black and blue) for about a week; this is more common than swelling, but painless. Extreme care when separating the blood vessels around the vas during the procedure significantly reduces this risk.
Infection: is also a rare complication. Of the procedures performed by Dr. Osman to date, no infections have occurred (infection rate 1 in 4000). Patients can, however, sometimes have prolonged discomfort associated with progressive swelling. Generally speaking, most infections will respond to oral antibiotics. Should that rare infection mature to a painful walnut-sized abscess, it will require office drainage through a half-inch incision followed by a two-week period of local wound care. An un-compromising sterile field for surgery, and proper sterile instruments, are without doubt invaluable in reducing this risk.
Sperm granuloma: is a pea-sized (sometimes tender) lump seen with some men on the vas tube at the vasectomy site, almost never requiring treatment. Some consider sperm granulomas beneficial, as they may increase the likelihood of success with vasectomy reversal. Periodic tenderness usually responds to an anti-inflammatory medication like ibuprofen, but so far only 2 men have been so troubled by chronic tenderness that they chose to undergo removal of the lump, an office procedure performed under local anaesthesia similar to the original vasectomy.
Congestion: a tender build-up of sperms and white blood cells upstream from or at the vasectomy site, can occur anytime after vasectomy, but usually resolves with the use of an anti-inflammatory drug such as Ibuprofen. About one in 2000 patients will experience chronic post-vasectomy discomfort (PVPS or Post-Vasectomy Pain Syndrome) severe enough that he will seek vasectomy reversal or neurolysis (division of the sensory nerves coming from the testes). A larger percentage may have milder forms of chronic pain that can affect quality of life but not severely enough to seek vasectomy reversal.
Recanalisation: is the development of a channel for sperm flow between the two cut ends of the vas. If this happens during the healing process, early, the semen never becomes sperm-free until the vasectomy is repeated. If recanalization happens late (months or years after a man’s semen has been examined and declared sperm-free), an unplanned pregnancy could result; but the odds of this occurring is far less after vasectomy than the odds of pregnancy with any other form of birth control including birth control pills and tubal ligation (female sterilization). Failure rates of vasectomy vary with the technique used to obstruct sperm flow through the vas tubes. In our practice, the early failure rate is about one in 2000 and the late failure rate is one in 4,000.
There are no proven long-term health risks (neither cancer nor cardiovascular disease) associated with vasectomy, but since questions have been raised, they are addressed in our page of Frequently Asked Questions.
The risks of men NOT having a vasectomy are all borne by their partners. And they are considerable!
Dr. Osman can discuss in detail these risks during consultation.
Limitations of Vasectomy…
- Not 100% reversible.
- Must use other forms of birth-control until sperm-free.
- Does not prevent transmission of sexually transmitted infections (STI’s).
Advantages of Vasectomy…
- Low one-time expense often covered by insurance companies.
- More dependable than any other form of contraception including female sterilization.
- Eliminates risks associated with birth control pills or injections and the IUD.
- Vasectomy reversals are less costly and more successful than tubal ligation reversals (see Vasectomy Reversal).
- No need for inconvenient and less dependable methods, so there are…
no more worries!!!!