Additional Info for Vasectomy
Patient Vasectomy Information
Is a Vasectomy Right for You?
A vasectomy is a safe and effective form of birth control. Approximately one-half million men in the United States undergo this surgical procedure each year. The decision to have a vasectomy should be considered a permanent one. You may wish to consult your doctor regarding alternative forms of birth control if you are unsure about making this permanent decision. If you were to change your mind about wanting more children after a vasectomy, a vasectomy reversal is possible. However, this is a more significant operation that does not guarantee your ability to father a child and most insurance companies do not cover the expense of a vasectomy reversal.
The Effects of a Vasectomy
This operation prevents sperm from traveling from the testes to the penis.
The rest of your reproductive system remains unchanged. The testes will continue to produce testosterone and sperm, but the sperm will die and are absorbed by your body.
Semen continues to be produced by the prostate and the seminal vesicles. Orgasm and ejaculation will not feel or look different. Your male hormone levels, sex drive, and ability to have an erection will remain unchanged after this procedure.
What to expect with your vasectomy
A vasectomy is an outpatient procedure that is usually done in a doctor’s office, clinic, or surgery center. You will be asked to sign a consent form stating you understand the nature of this operation and the possible risks and complications. The procedure, although highly successful, is not guaranteed to make you sterile.
Prior to the Surgery
Be sure to stop taking aspirin or any other blood thinners for 5 to 7 days prior to surgery, or as directed by your surgeon. Shave your scrotum as instructed to do so by your doctor. You may eat a light snack, but you should not have a full meal prior to the procedure. If you are given a medication to help you relax during the procedure, take it as instructed by your surgeon. Bring a pair of compression shorts or athletic supporter with you to the doctor’s office. You should arrange for someone to drive you home after the vasectomy.
During Surgery
Once you are undressed and lying on the exam table, your scrotum will be cleansed and covered with sterile drapes to reduce the risk of infection. The scrotal skin is then injected with local anesthetic. One or two small incisions are made on the scrotal skin with a scalpel or a pointed clamp (no scalpel technique) and the vas deferens are lifted and brought out through the incision(s). The vas deferens are usually cut, sealed closed and a segment removed. You may feel a pulling sensation in your groin during the procedure. The opening to each end of the vas deferens are occluded by cautery (heat), ties, and/or clips. Once the procedure is complete, the incisions may be closed.
After Surgery
The local anesthetic should wear off in approximately one hour. The pain is usually mild, but your doctor may prescribe a pain medication if needed.
Staying off your feet as much as possible for the first 24 to 48 hours can reduce swelling. Applying an ice pack intermittently to the scrotum during the first 36 hours will also reduce swelling and discomfort. You can shower 48 hours after the procedure. Avoid heavy lifting or vigorous exercise for 7 days. There may be a small amount of bloody discharge from the incision site. Some slight bruising and swelling of the scrotum for the first week after surgery is normal. You should abstain from sexual activity for a week.
Semen Analysis After Vasectomy
You and your partner must continue to use some form of birth control after your vasectomy until your doctor tells you that there is no more sperm in your semen. Approximately 90% of patients will no longer have any sperm in their semen after 15 ejaculations. A semen analysis is performed 3 months after the vasectomy. It is important that you continue to use birth control until you attain a semen analysis with no sperm.
Possible Risks and Complications
Although rare, complications after vasectomy can occur. Be sure to contact your doctor if any of the following problems or concerns arise.
Infection usually presents with signs of fever, chills, pus-like drainage from the incision site, and increasing pain and redness and pain at the incision site.
Internal bleeding in the scrotum usually occurs within the first 2 days after surgery. This can present as excessive swelling and pain in the scrotum, or a rapidly enlarging black and blue area in the scrotum.
Recanalization occurs when the cut ends of the vas deferens reconnect. This occurs in less than 1% of patients and can cause return of fertility. Most recanalizations occur within 12 weeks after the vasectomy and are detected by the post vasectomy semen analyses, although they can occur after the semen tests have been performed. Patients with persistent motile sperm in the semen analysis at 6 months may be advised to undergo a repeat vasectomy. A vasectomy does not guarantee sterilization.
Vasectomy and Prostate Cancer
In the past controversial reports linked vasectomy to an increased risk of prostate cancer later in life. As a result, the National Institute of Health (NIH) formed a panel of experts to assess these reports. The consensus of the NIH panel was that there is insufficient evidence of a real association between vasectomy and prostate cancer. There is no conclusive evidence that a vasectomy causes an increased risk of prostate cancer.
Congestion caused by sperm left in the epididymis can produce some achiness in the testes, but it usually resolves without treatment. Chronic testicular discomfort lasting for several months or even years after the procedure can rarely occur.
Sperm granuloma is a lump caused by leaking sperm at the site where the vas deferens is cut and occluded. This can occur in 1-10% of patients. This lump may dissolve on its own, but surgery is occasionally needed to remove it and revise the vasectomy.
Sperm antibodies are formed by the body as a response to the absorbed sperm. These antibodies cause no harm.
