A vasectomy prevents the release of sperm when a man ejaculates. During a vasectomy, the vas deferens from each testicle is clamped, and the cut, or sealed. This prevents sperm from mixing with the semen from the prostate. This then results in semen with no sperm being ejaculated from the penis. An egg cannot be fertilized when there are no sperm in the semen. The testicles continue to produce sperm, but the sperm are reabsorbed by the body. Because most of the ejaculate volume comes from the prostate and not the testicles you ejaculate about the same amount of fluid. A vasectomy is considered a permanent method of birth control. Only consider this method when you are sure that you do not want to have a child in the future. Vasectomy is a very effective (99.85%) birth control method. Only 1 to 2 women out of 1,000 will have an unplanned pregnancy in the first year after their partner has had a vasectomy.
It usually takes several months after a vasectomy for all remaining sperm present prior to the vasectomy to be ejaculated or reabsorbed. During this time you must use another method of birth control until you have a semen sample tested and it shows no sperm. If you fail to use contraception during this time there is a significant possibility of pregnancy in your partner.
During a vasectomy, your testicles and scrotum are cleaned with an antiseptic and possibly shaved, each vas deferens is located by touch, and a local anesthetic is injected into the area. Your doctor makes one or two small openings in your scrotum. Through an opening, each vas deferens tube is cut. The two ends of the vas deferens are tied, stitched or sealed. Electrocautery and sutures may be used to seal the ends. Scar tissue from the surgery also helps to block the tubes. The vas deferens is then placed inside the scrotum and the skin may be closed with stitches that dissolve and do not have to be removed. The procedure takes about 25 minutes and is performed in the office.
What to do before the Procedure:
Wear supportive shorts, either briefs or compression short to the procedure. Do not wear boxer shorts. Supportive briefs or compression shorts should be worn for the first week following the procedure.
Start taking Tylenol 500mg every six hours (starting the night before the procedure and continuing for 48 hours afterward). This will help with pain control.
Valium will be prescribed to be taken one hour prior to the procedure. This helps decrease anxiety and improve relaxation during the procedure. If you choose to take the medication, you must have someone drive you to and from the procedure. It is also recommended that you do not drive or make important decisions for the rest of the day. If you choose not to take valium, you may drive yourself to and from the procedure.
What to Expect After Surgery:
Your scrotum will feel numb for 1 to 2 hours after the vasectomy. You may have some swelling, bruising and minor pain in your scrotum for several days after the surgery. Unless your work is strenuous, you will be able to work in 2 or 3 days. Avoid heavy lifting for a week. You can resume sexual intercourse as soon as you are comfortable, usually in about a week. However, you can still get your partner pregnant until your sperm count is zero.
You must use another method of birth control until you have a follow-up sperm count test known as post-vasectomy semen analysis (PSVA) 3 months after the vasectomy. Once your sperm count is zero, no other birth control method is necessary. The office will provide you with the necessary lab orders and instructions to have the semen analysis performed. We usually recommend Reproductive Medical Asssociates (RMA) in Stamford for this testing however other options are available including at home testing.
A vasectomy will not interfere with your sex drive, ability to have erections, sensation of orgasm, or ability to ejaculate. Typically, there is no noticeable change in the ejaculate volume. For a more comprehensive list of potential side effects and risks see our standard consnt form and inofrmation packet. A review of The American Urological Association's Best Practice Guidelines regarding vasectomy is also available here.
Risk of Failure:
Risks of failure are stimated to be between 0.25 and 0.4 percent and will usually be found at the first post vasectomy semen analysis. Also, in delayed manner months to years later, spontaneous reconnection of a vas deferens can occur, allowing the sperm the mix with the semen again. This is very rare.
Postoperative Risks:
The risk of complications after a vasectomy is very low. Complications may include, but are not limited to the following:
bleeding
hematoma formation (a large bruise)—which sometimes requires surgery
infection
chronic pain (pain that lasts for a long time or forever)
sperm granuloma (sperm leaking from a vas deferens into the tissue around it and forming a small lump called a sperm granuloma. This condition is usually not painful, and it can be treated with rest and pain medication. Occasionally, surgery may be needed to remove the granuloma)
Inflammation of the tubes that move sperm from the testicles called congestive epididymitis.
In rare cases, the vas deferens grows back together, called recanalization, and the man becomes fertile again, which would require the vasectomy procedure to be repeated
Vasectomy
Drs. Nurzia and Santarosa have been providing vasectomy as a means of birth control since beginning their practice and have performed thousands of these procedures. To schedule a vasectomy, please contact us for a pre-procedural consultation. For your convenience, you may schedule both the consultation and the procedure prior to seeing the physician. Most men will schedule their appointment at the end of the week so that they may rest over the weekend before returning to work, but our physicians will perform the procedure during any scheduled office hour session. Please see our necessary registration forms, and of course our vasectomy information and consent form.