Vasectomy is permanent birth control for men. It is a minor surgical procedure, usually performed in the office, to interrupt the sperm transportation system. The decision to proceed with vasectomy is a very personal one. A vasectomy is chosen by men who have completed their families or by men who do not want children. It is important that you have an understanding of the procedure to decide whether or not a vasectomy is an appropriate form of contraception for you.
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In the immediate postoperative period, there is a risk of bleeding into the scrotum. If you notice a significant increase in the size of the scrotum or significant discomfort, you should contact your urologist immediately. If you experience fever, scrotal redness, or tenderness, you should be evaluated for an infection. Discomfort is usually minimal and should respond to mild pain medications which will be prescribed at the conclusion of your procedure.
More severe pain may indicate infection or other complications. You may notice a small bump or benign lump in the area that may develop over time called a sperm granuloma. This is caused by leakage of sperm from the cut end of the vas deferens into the scrotal tissues. It may occasionally be painful or sensitive to touch or pressure.
In very rare cases, a post-vasectomy pain syndrome may occur. This is chronic pain that follows a vasectomy and usually happens in less than 1/200 patients. The cause of this syndrome and its incidence are unclear, it is generally treated with anti-inflammatory agents and, in some cases, patients will elect to undergo vasectomy reversal to help with this severe pain.
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In general, vasectomies are performed in the urologist's office. In rare cases, the procedure may be done in the operating room under light sedation or anesthesia. The decision to proceed for surgery may be based on your anatomy, anxiety level, and need for other surgical procedures.
On the day of the procedure, you will be asked to sign a surgical consent form. You will need to shave the scrotum and you will be brought into the procedure room. You will have an antiseptic solution applied to the scrotum and a local anesthetic will be injected to numb the area. You will still be aware of some pulling and tugging sensation during the procedure, but the local anesthetic should eliminate any sharp pain.
You are awake during the procedure and, if you are extremely anxious, additional medications may be provided. With the no-scalpel vasectomy, a small incision is made with a special clamp. The instrument is then used to make a tiny puncture in the skin and stretch the opening so that the vas deferens tube may be lifted out, cut, cauterized, and clipped to help complete the procedure.
You should return home immediately after the procedure and avoid strenuous activity or sexual relations. Swelling or discomfort may be minimized by placing an ice pack on the scrotum for 20-30 minutes each hour for the first 4-6 hours after the procedure. Most patients can expect to recover completely in less than a week and many are able to return to work or activity within 1-2 days after the procedure.
Vasectomy is not immediately effective. Sperm remains in the system beyond the blocked tubes. You must use other birth control until the sperm are used up. Sexual activity can be resumed within a few days following vasectomy, however, it is important to realize that, even with a vasectomy, there will still be sperm present for up to 12 weeks after the procedure.
A simple test called a semen analysis is used to show when there is no more sperm in the seminal fluid. Two semen analyses are obtained at 6 and 12 weeks after the procedure. At least one of these specimens should demonstrate that there are no sperm present in the ejaculate. The time until disappearance of sperm from the ejaculate varies from patient to patient, but it takes at least 10-15 ejaculations to clear the system. If sperm continues to be present in the ejaculate, the patient must continue to use some alternative form of barrier contraception. The patient should not assume that his vasectomy is effective until the semen analysis testing has been completed.
The Urological Institute of Northeastern New York is a unique hybrid private and academic practice urology group committed to superior urologic care. Our group is an affiliate of Albany Medical Center, Community Care Physicians, and the Stratton VA Medical Center.
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