A surgical procedure for permanent male sterilization that severs the ducts that carry sperm from the testicles to the penis. This procedure is becoming more common for modern couples as a permanent method of birth control due to its affordability, effectiveness, and low-risk factors (when compared to methods available to the female partner).
Sterilization for a female involves opening the abdominal cavity to reach and sever the tubes that carry eggs from the ovaries to the uterus. In contrast, a vasectomy only involves opening the skin around the scrotum, through which the sperm ducts can be easily reached.
Deciding on Permanent Sterilization: This decision must not be made lightly. You and your partner need to discuss openly your feelings, worries, and future plans about permanent sterilization prior to making this big decision. There maybe circumstances in the future where you may change your mind and want to father another child. A reversal is possible but it is not simple and the success rate is not very high. If you need additional guidance consult your doctor or maybe talk to other couples who have gone through with the surgery and get their point of view.
The Procedure
Your physician will have already determined that your vas deferens can be easily reached through a single incision during your initial consultation. The day of your surgery you will be prescribed a mild relaxant, such as Valium, that will be taken approximately a halfhour prior to your appointment. Because this medication will slow your reaction and this is an outpatient procedure, you should not drive to or from your surgery.
The procedure will start with the shaving of the surgery site, the scrotum, and then the skin will be washed with an antibacterial soap. The physician will inject Novocain in three spots on the surgery site, and the Novocain will take effect immediately. The only pain you will feel is the sting from the Novocain needle. You may feel occasional pressure or a “tugging” feeling, but otherwise the surgery site will be numb and you will feel no pain.
The physician will make one or two incisions, depending on your situation, where he will locate each vas and bring it to the surface. A section of each vas will be clamped off and removed, and the cut ends are then cauterized. Each end of the vas is then tied off and sewn back on itself, making it highly unlikely that the ends could ever reconnect. Then the vas is comfortably put back inside the scrotum. The incision(s) will be closed with cat gut sutures. These sutures are designed to dissolve on their own in about three to five days. Then the surgery area is washed with hydrogen peroxide, an antibacterial ointment is applied, and a gauze pad is placed over the incision(s).
From start to finish, the entire procedure should only take about 20 to 30 minutes. When the procedure is over, you will be ready to get dressed and leave.
After the Procedure
The Novocain will wear off in about 2 hours and you will probably need to take some pain medication such as Tylenol over the next day or so. You should stay off your feet for the rest of the day and keep an ice pack on the scrotal area for the rest of the day as well. It is a good idea to wear a jock strap or tight-fitting underwear for the next several days to provide support. Do not attempt any activity that involves straining or putting pressure on your scrotum until you feel fully recovered. You will need to refrain from sexual activities for at least three days or longer. You can take a shower the following day and gently pat the incision area dry and then reapply antibacterial ointment and a fresh gauze pad.
Risks
As with any surgical procedure, there is a risk of swelling, bruising, and infection. Generally, for a person in good health without any serious underlying conditions, the risk is minimal. If you have diabetes, mellitus, problems with the heart valves, or any sexually transmitted disease, please let the physician know so that precautions can be taken to safeguard your health.
You will also need to let your physician know if you take aspirin or a prescription blood thinner, if you have any known allergies (especially to anesthetics such as Novocain), or if you have any injury to the genital area.
Getting the Green Light: It commonly takes at least 10 ejaculations to eliminate all the stored sperm. Prior to the procedure, sperm was produced and stored in the seminal vesicles. This sperm could still be ejaculated and reach their target if not completed eliminated from the vesicles. So, after the 10th ejaculation, bring a specimen into the office to be checked under a microscope. You will also need to bring in another sample 3 to 6 months after the procedure to make sure the ends of the vas deferens have not rejoined. So, you will need to use some form of birth control until your semen has been confirmed free of sperm.
