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Vasectomy

What is a vasectomy?
A vasectomy is a minor surgical procedure designed to interrupt the sperm transportation system between the testicle and the penis.

Under normal circumstances, the testicles, located in the scrotum at the base of the penis, produce sperm and testosterone. Once produced, the sperm exit the testicle through a tube called the epididymis, where they stay until they are fully matured. Each epididymis is connected to the prostate by a tube called the vas deferens. During ejaculation, seminal fluid produced by the prostate mixes with sperm to form semen.

With a conventional vasectomy, an urologist makes one or two small cuts in the skin of the scrotum. The vas deferens is cut, and a small piece may be removed leaving a short gap between the two remaining ends. Next, the urologist ties the cut ends with suture material and closes up the scrotal incision with dissolvable stitches. The entire procedure is then repeated on the other side.

In general, vasectomies are performed in the urologist's office. However, the procedure may be done at an ambulatory surgery center or in a hospital setting if the patient and urologist have determined that intravenous sedation is preferred. That decision may be based upon the patient's anatomy, anxiety or the need for associated surgical procedures.

What should the patient expect after a vasectomy?
The urologist will provide specific recommendations for self-care after a vasectomy. It is generally wise to return home immediately after the procedure and avoid strenuous or sexual activity. Swelling and discomfort can be minimized by placing an ice pack on the scrotum. Most patients can expect to recover completely in less than a week and many are able to return to their job as early as a day after the procedure. Sexual activity can usually be resumed within a few days.

A vasectomy, even though successful, is not effective immediately. The effectiveness of the vasectomy must be proven by having the patient submit at least one semen sample for analysis. The time until disappearance of sperm from the ejaculate varies from patient to patient. Most urologists recommend checking the semen for sperm after about two months. If sperm continue to be present, the patient must continue to use contraception. The patient should not assume that a vasectomy is effective until semen analysis demonstrates the absence of sperm.

Technically, a vasectomy is irreversible; however, it is possible for a spontaneous re-connection to occur, which may result in pregnancy.