Vasectomy

Overview

A vasectomy is a form of permanent male sterilization. The procedure involves dividing the vas deferens in order to interrupt the flow of sperm out of the testicles. It is the most common form of male sterilization, with more than 500,000 procedures performed per year in this country. The testicles also make the male hormone testosterone, which is not affected by this procedure. Also, since the testicles produce only 5-10 percent of the ejaculate volume, the semen volume will appear the same.

There are two techniques used to perform a vasectomy. The conventional method utilizes a scalpel and 1-2 small incisions to divide the vas, while the no-scalpel technique utilizes a small "puncture" to perform the same task. Both procedures are performed under local anesthesia in the office. The procedure is detailed below.

No-scalpel vasectomy 

A no-scalpel vasectomy is a minor surgical procedure which results in male sterilization. During the procedure, a tube called the vas deferens is blocked, restricting the passage of sperm from the testicles. As with a conventional vasectomy, a no-scalpel vasectomy can be performed under local anesthesia in the urologist’s office or in an outpatient surgery center and the patient can go home the same day.

In a no-scalpel vasectomy, the area is first cleaned with an antiseptic solution and then the urologist feels for the vas located under the skin of the scrotum. It is then secured in place with a small clamp. A special instrument is used to make a tiny opening in the skin where the vas deferens are retracted and cut. After tying or cauterizing, it is put back in place with no stitches required.

Patients can use ice, a support garment, and pain relievers to minimize discomfort. They should avoid strenuous activity right away.

While patients can resume sexual activity in a week, it’s important to remember that vasectomy results are not immediate. An urologist will need to determine if the ejaculate is completely devoid of sperm by conducting a semen analysis. Complete elimination of sperm can take several months. Until confirmation is received that no sperm remain in the system, other forms of birth control should be used to prevent pregnancy.

While a no-scalpel vasectomy is considered to be a safe, minor surgical procedure, there are risks. Those experiencing significant enlargement of the scrotum, fever, scrotal redness, or tenderness should be evaluated by the surgeon as this may indicate an infection.

What To Expect

We ask that you shave your scrotum the night before the procedure. Prior to the procedure, we will cleanse the scrotum with an antiseptic solution. The scrotal skin and each vas are then anesthetized with local anesthetic. The vas is grasped using either a small incision or a no-scalpel clamp. The vas is then isolated from the surrounding structures and occluded by several small clips. A segment of the vas is also removed. The opposite side can usually be clipped and divided through the same small opening in the scrotum. A small absorbable suture may be necessary to close the scrotal opening. Typically with the "no scalpel" technique, a suture is not required.

After the procedure, we recommend that the patient rest comfortably at home with intermittent icing of the scrotum. Most men will have minimal discomfort, which is treated with Tylenol^® or Advil^®. It is common to have some mild "aching" of the testicles for a few days along with some "black and blue" areas of the scrotal skin. Normal activity can usually be resumed within 24 hours.

Sexual relations can be resumed in about one week. Other forms of birth control must be utilized until a semen sample shows no evidence of sperm. Because it takes at least four months for all the sperm to "clear the system," we ask that you not bring a specimen to the lab for at least that length of time. It may require several semen analyses before a man is cleared.

It must be emphasized that unprotected intercourse is not allowed until a semen analysis shows no sperm. There must be no sperm present in the ejaculate analyzed in two separate samples at least two weeks apart.

Our office offers both the conventional and the no-scalpel technique, depending on the patient's preference.

Frequently Asked Questions

What information do I need before I schedule a vasectomy?

We’re happy to provide you with a packet of information that describes the procedure in detail. Contact us to request a packet.

What is a non-scalpel vasectomy?

The non-scalpel vasectomy has become very popular in the U.S. because of the decreased discomfort that men experience with this particular technique. Our group performs the no-scalpel vasectomy, and we would be happy to provide you with more information about this procedure. Contact us for more details.