What is a vasectomy?
Vasectomy is a surgical procedure that renders a man sterile. What you may not know are the specifics of the procedure and the period of time that follows. This literature is designed to give you a better understanding of both -- before the surgery takes place.
To begin with, you should have some basic knowledge of the anatomy and physiology of the male reproductive system as shown in the image above. During intercourse, sperm cells travel from the testicles through the vas deferens, become part of the seminal fluid (which is produced by the seminal vesicles and prostate gland), and are ejaculated through the penis. When the surgeon performs the vasectomy, he cuts through the vas deferens and ties off the two remaining ends. The object of the procedure is to make it impossible for the sperm to become a part of the seminal fluid. Since conception cannot take place in the absence of sperm, a vasectomy results in permanent male sterilization.
Will I be sterile as soon as the procedure is over?
No. Contrary to what many people believe, you may not be sterile immediately after the operation. This is because there are some sperm residing above the area where the vas deferens is cut during the procedure. Until all of these sperm have been ejaculated, you will still be fertile. In general, it takes between ten and 12 ejaculations following vasectomy for sperm to disappear. Most physicians who perform vasectomies require that their patients bring a sample of seminal fluid to the office about six to eight weeks after the surgery or after about 20 ejaculations have taken place. The physician will examine the seminal fluid under a microscope to be sure that no sperm are present. Only when it is confirmed, can you be sure that the surgery is a success.
Are the effects of the surgery permanent?
Yes. For all intents and purposes, once the surgery has been declared successful, you will be permanently sterile. The chances of the two cut ends of the vasectomy being spontaneously rejoined are extremely rare, probably not more than 1/10th of 1 percent (1 in 1000). For this reason, it is most important that you are completely sure that you want no more children before you consent to surgery.
Suppose I change my mind later on. Can the procedure be reversed?
Your physician can reconnect the two ends of the vas deferens, and once this is done you may possibly be fertile again. However, after the procedure, called a vasovasostostomy, fertility is restored in fewer than 50 percent of the patients on whom it is performed. Therefore, you should consider vasectomy to be an irreversible procedure.
Will the procedure affect my sex life?
Although the vasectomy will make you sterile, it will have no effect whatsoever on your potency-- that is, your ability to have sexual intercourse. In fact, many couples find that their sex life improves after the vasectomy because they no longer have to worry about an unwanted pregnancy.
Will I ejaculate in the normal manner?
Yes. Most of the seminal fluid which the male ejaculates during sexual intercourse is produced by the seminal vesicles and the prostate gland. Only a small amount of the seminal fluid consists of sperm. Therefore, after a vasectomy, ejaculation will take place in the same way as it did before. The only difference is that there will be some less fluid ejaculated and this difference is barely noticeable.
I've heard that the vasectomy can be performed in the physician's office. Is this true?
This is a matter to be discussed with your physician, and you should follow his recommendation. The procedure is relatively uncomplicated and can be performed with minimal difficulty in the physician's office.
Is a vasectomy painful?
As with any operation no matter how minor, there will be some discomfort associated with it. However, with proper anesthesia, this discomfort will be kept to a minimum. Your physician will discuss the type of anesthesia to be used. In almost all cases, local anesthesia is all that is required. In rare cases, general anesthesia may be needed.
Are there any complications associated with a vasectomy?
The problems that occur after the operation are usually quite minor. There will be some pain and tenderness in the area where the surgery is performed. There may also be some swelling and discoloration (black and blue marks). Your physician will prescribe some medication to keep the post-procedure discomfort to a minimum. As with any surgery, the possibility of an infection is always present. However, this is usually quite rare following a vasectomy. In a small percentage of patients, a blood vessel inside the scrotum continues to bleed after the operation. If this happens, the scrotum will swell and become very tender. Should you experience this problem, contact your physician. He may have to re-open the scrotum to tie off the "bleeder". This could require a hospital visit and the administration of general anesthesia.
Are there any long term complications?
A result of a recent study suggests that there is no apparent association of coronary artery disease or prostate cancer with prior vasectomy. Aside from sterilization, the only known long term side effect of the operation is that there may be a slight scar on each side of the scrotum where the incision is made, or a possible spermatocele (sperm filled cyst).
How soon after the operation can I have sexual intercourse?
You may resume your normal sexual activities as soon as you feel well enough to do so. Remember however, that you may not be sterile until some time after the operation, and therefore should continue to use some form of birth control until your doctor confirms that all sperm have disappeared from your semen.
Is there anything special that I should do before surgery?
Once you have decided to have surgery you should discuss it with your physician. He may recommend the following: On the evening before the surgery takes place, shave the area around your penis and testicles. After showering, be sure to shower and wash away any loose hairs. Your physician will ask you to purchase an athletic supporter before the operation takes place. He will probably require that you purchase one that does not have leg straps. You will need someone to accompany you to the office on the day of the vasectomy to drive you home after the procedure.
What about after the procedure?
Once again, this is up to your physician. Many physicians will suggest the following: Wear the athletic supporter for the first 24 hours after the operation. After that, you need only wear it is it makes you feel more comfortable. Do not engage in any strenuous physical activity for the first day, and work your way back to a normal routine of a period of about one week. You may shower on the day after the surgery. Be sure that you wash the scrotal area gently, and rinse with warm water. When you dry the scrotum, do so by blotting the area with a soft towel. If your physician uses stitches to close the incision, they will dissolve themselves and you will not have to return to have them removed. However, because the incisions are so small, many physicians do not use stitches. In such case there may be a slight discharge from either or both of the incision sites. This need not concern you. Simply place a small sponge or gauze pad over the incision, replacing it on an as-needed basis, until the wound is completely healed. Even with such a discharge, you may still shower each day.
One final word...
Discuss any questions you have about the procedure with your physician before the surgery takes place. Follow all of his instructions completely. Be as certain as you possibly can that you want no more children before you consent to the surgery.
Vasectomy Pre-Procedure Instructions:
Pick up the prescriptions early, take the valium prior to the procedure and save the pain medication if needed during your recovery.
On the evening before the vasectomy, shave the area around your penis and testicles. After showering, be sure to shower and wash away any loose hair.
The morning of the procedure, please shower, carefully washing the groin and scrotum.
Bring someone with you to drive you home after the procedure.
The procedure takes approximately 30 minutes, but you will be in the clinic approximately 1.5 hours.
You should plan to take the rest of the day off from work.
Bring an athletic supporter, if you do not we will supply one, but you will be charged for it.
Post Procedure Instructions:
- Apply ice to the scrotum the first afternoon and evening
- Use hair conditioner to relieve the itching that occurs with the scrotal hair growing back.
- Obtain semen analysis at 2 and 6 months
- No tub bathing or swimming for 5 days
- No lifting greater than 20 lbs for 3 days
- No sex for 3 days
- You are fertile and should use other contraception until informed otherwise by our office
You can expect:
- Some bruising and swelling of the scrotum
- Some discomfort which will last about a week, take the medication prescribed for you as directed
- Swelling behind the testis is normal and the discomfort will resolve over a couple of weeks if this occurs
You should call the office:
- If the swelling becomes excessive (larger than a tennis ball)
- If the pain gets worse over several days
- If the pain or tenderness in the skin incision gets worse.
- If you develop a temperature of 100.6 or greater