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.
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.