Vasectomy is a common office procedure performed with the intent of achieving permanent sterilization. An office consultation, with the patient’s wife in attendance, is required before a vasectomy can be scheduled. Approximately 500,000-750,000 vasectomies are performed annually in the United States
The Male Reproductive Tract
Sperm are produced in the testicle and travel into the epididymis (a small crescent shaped organ attached to the back of the testicle) where they are stored for two weeks. After they leave the epididymis, sperm are discharged into the vas deferens that delivers them into the urethra at the time of ejaculation. Live sperm are stored along the entire length of the vas deferens and sperm constitute less than 1% of the total volume of the ejaculate. Men have one testicle, epididymis, and vas deferens on each side, although in rare cases the vas deferens may be absent on one side.
After suitable preparation, which includes showering with an antibacterial soap and shaving the scrotal area, a local anesthetic (Xylocaine) is administered into the scrotal area and a quarter inch segment of each vas deferens is removed through a small skin incision on each side. The cut ends of each vas are cauterized (sealed) and separated from each other. The scrotal incisions are closed with one or two absorbable (doesn’t require removal) sutures. Although it is common to be apprehensive, the procedure is usually quite painless and takes about 30-45 minutes.
After the Vasectomy
Patients undergoing a vasectomy should be driven home since they will have taken a pre-operative sedative (Valium). The local anesthetic will usually wear off in an hour, after which most patients experience mild to moderate discomfort in the scrotum, groin, or lower abdomen. Prescription pain medication is rarely required, although it is available should severe pain occur. It is best to lie down for 4 to 6 hours after the vasectomy and to place an ice pack on the scrotum during that time. The following day one can assume "normal" daily activities, however it is best to refrain from any physical activity (lifting, jogging, etc.) or sexual activity for 3 to 5 days. After that, patients may resume full activity provided it does not result in increased pain. It is not uncommon to experience mild intermittent discomfort in the scrotum for several weeks after the vasectomy due to congestion of sperm in the epididymis.
After the vasectomy, three regular follow-up visits will be required:
At 7 to 10 days for a "wound check"
At 6 weeks for the first semen check
At 12 weeks for the second semen check
Since sperm are stored along the entire vas deferens, a vasectomy does not result in immediate sterility. Several ejaculations are required to evacuate all sperm. Therefore, patients must continue with strict birth control for at least three months after a vasectomy. If no sperm are present at the 6 and 12 week semen check, birth control can be safely discontinued. Please note that the patient himself must appear for scheduled post-operative appointments. Semen samples will be checked and the results reported immediately. Samples should be collected at home in a clean glass container and cannot be more than six hours old.
Complications occur in about 5% of patients undergoing a vasectomy, but usually resolve without treatment.
Semen collected before a vasectomy can be frozen and stored in a sperm
bank for an extended period of time. However, pregnancy following
insemination with frozen semen is certainly not guaranteed.