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What is a Vasectomy?

what is a vasectomy?What Is a Vasectomy?

What is a vasectomy? Although some people may already know that a vasectomy is the most reliable form of birth control or sterilization for men, other facts about the procedure may be a mystery.

Yet every year, approximately 600,000 men in North America undergo a vasectomy, and about 20% of men older than 35 have had the procedure.

What is a vasectomy? It is considered to be a safe, effective procedure among people in the medical community. However, some men are uncertain or squeamish about it. To help clear up any myths, misconceptions, or questions you may have about a vasectomy, it is helpful to understand the journey sperm take in a man’s body before we answer the question, “What is a vasectomy?

Sperm are produced in the testes (testicles) and leave to enter the epididymis, an extremely narrow coiled tube that is about 10 feet long and located behind the testicles. Sperm mature and are stored in the epididymis. The sperm’s journey through the epididymis takes about 7 days. When a man ejaculates, the sperm leave the epididymis and travel through a long tube called the vas deferens until they reach the prostate. At the time of ejaculation, sperm are mixed with seminal fluid from the prostate and the male sex glands, the seminal vesicles, before they are expelled from the urethra during ejaculation.

What is a Vasectomy Procedure Like?

Men are typically most squeamish when it comes to the question, “What is a vasectomy procedure like?” A vasectomy is an outpatient procedure that takes about 15 to 30 minutes to perform, depending on the type of vasectomy. If you and your doctor choose a scalpel vasectomy, local anesthesia is injected into the scrotal region. The surgeon the makes one or two small incisions in the scrotum to access the vas deferens.

At that point, the surgeon cuts the tube, ties the ends, and seals them with heat (electrocautery) or uses tiny clips. From that point on, sperm are no longer able to leave the epididymis nor leave the penis at ejaculation. A few dissolvable stitches are used to close the incisions, and you can go home after a short recovery in your doctor’s office.

If you select the no-scalpel vasectomy, the doctor will numb the procedure area on the scrotum by injecting a freezing solution into the scrotal skin or using a needle-less pressurized jet spray. The surgeon then feels for the vas deferens under the skin by hand and holds it in place with a tiny clamp. Pointed forceps are used to puncture the skin over the vas deferens until a tiny opening is formed. The vas deferens is lifted out and cut, then tied, clipped or cauterized. Because the opening is smaller than an incision and can close on its own, your surgeon may not suture it. Once again, you can go home shortly after the procedure.

What is a Vasectomy Effectiveness? 

A vasectomy is 99.85% effective in preventing pregnancy if you follow post-vasectomy instructions about birth control. Pregnancy may occur within the first few weeks or months of undergoing a vasectomy if you and your partner do not use a backup form of birth control. It generally takes 8 to 10 weeks for a man’s sperm level to reach zero after a vasectomy. You will have the sperm tested during follow-up visits. Doctors often recommend having a follow-up sperm check as much as one year after having a vasectomy just to make sure no sperm have gone astray.

One misconception about a vasectomy is that it eliminates a man’s ability to produce sperm. Men still produce sperm after a vasectomy. However, the route through which the sperm travels to combine with semen fluids is severed during a vasectomy. Therefore, the sperm accumulate in the epididymis and at the end of the vas deferens below the vasectomy point, where they disintegrate and are absorbed by the body.

What is a Vasectomy Side Effects and Risks?

After undergoing a vasectomy, you may experience some swelling and discomfort in the scrotal region for a few days. Some painless bleeding may also occur and collect under the skin. This will make the scrotum and penis appear swollen and/or bruised. Because the scrotum skin is very thin, the bruising can appear worse than it actually is. Application of cold packs to the area can reduce these symptoms. Wearing a jock strap or snug underwear can provide relief. Severe pain is rare and should be reported immediately to your doctor.

In 5% of cases or less, men experience any of the following side effects. Your chances of encountering these problems are greatly reduced or eliminated if you carefully follow your doctor’s post-operative instructions.

  • Allergic reaction to the local anesthesia, which can happen with any injection of anesthesia for any reason
  • Bleeding under the skin that forms a hematoma in the scrotum. This is rarely serious, but report it to your doctor.
  • Chronic orchialagia, in which the epididymis becomes congested with dead sperm and fluid and causes a dull ache in the testicles. This rare condition typically disappears on its own within six months.
  • Epididymitis, swollen and inflamed epididymis, is one of the more common complications of a vasectomy, but it is not serious.  Heat and use of anti-inflammatory medications, and sometimes antibiotics as well, usually resolve this issue within a week.
  • Immune reactions are common and occur when the immune system recognizes the absorbed sperm cells as foreign invaders and produces antibodies. This immune response is believed to be harmless.
  • Infection at the incision site or in the scrotum occurs in less than 5% of cases. Antibiotics and heat therapy typically resolve this reaction within a week.
  • Sperm granulomas (lumps containing leaked sperm) may form if sperm leaks from the cut end of the vas deferens. Granulomas are typically small and painless and resolve by themselves.
  • Post vasectomy pain syndrome (PVPS) is characterized by aching in the testicles that worsens with intercourse. Some studies say PVPS occurs in less than 0.01% of men, while others say some lingering discomfort occurs in up to one-third of men. Discuss the possibility of PVPS with your surgeon.
  • Spontaneous rejoining of the vas deferens occurs in about one in 10,000 cases.

For several years, there was speculation that a vasectomy increased a man’s risk of cancer (prostate and testicular cancers) and heart disease, but research has not found any significant link between them. Vasectomy does not protect against HIV/AIDS or other sexually transmitted diseases.

What is a Vasectomy Impact on Sex Drive?

Having a vasectomy does not have any negative impact on a man’s sex drive, ability to achieve an erection, sensation during orgasm, or the ability to ejaculate. In fact, having a vasectomy can relieve any stress or worries a man may have felt about getting his partner pregnant and thus improve the quality of his sexual experiences.

What Is a Vasectomy Reversal?

Despite what you may have heard, a vasectomy may be reversible in many cases. However, a vasectomy should be viewed as a permanent form of birth control.

If you want your vasectomy reversed, the procedure should be done by a microsurgeon who specializes in vasectomy reversal. A vasectomy reversal is an outpatient operation, but it takes about 3 hours or longer to complete. It also takes longer to recover from a vasectomy reversal than from a vasectomy.

The success of a reverse vasectomy depends on how skillful your surgeon is, and what she finds once the vas is opened and the vas fluids are examined. At this point, the surgeon can decide which microsurgical procedure will provide the best chances of success:

  • Microsurgical vasovasostomy, in which the two cut ends of the vas deferens are reconnected
  • Microsurgical epididymovasostomy, in which the surgeon connects the cut ends of the vas deferens to the epididymis. This is the more difficult of the two procedures.

What is a vasectomy? Until development of a male birth control pill, besides abstinence, a vasectomy is the most effective and safe form of birth control for men.

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About Dr. Larry Lipshultz, M.D.

Dr. Lipshultz is Professor of Urology and Chief of the Division of Male Reproductive Medicine and Surgery at the Baylor College of Medicine in Houston, Texas . He is an internationally acclaimed fertility specialist and a pioneer in the field of urologic microsurgery, specializing in male infertility, erectile dysfunction, microsurgery, genetic causes of infertility, and age-related changes in male hormone levels (androgen replacement). He was a founder of the Society for the Study of Male Reproduction and is a Past President of the American Society for Reproductive Medicine. In addition, he has served on the FDA Advisory Committee for Reproductive Health Drugs. He was the first AUA Research scholar and was awarded the prestigious Hugh Hampton Young Award at the 2005 AUA Annual Meeting. More on Dr. Lipshultz

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Site last updated 21 December, 2014

  
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