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All You Need to Know About a Vasectomy

October 19, 2018

Sperm microscopic view

A vasectomy is one of the safest, easiest and most effective birth-control methods for men. Yet fear, uncertainty, resistance and misconceptions about this procedure abound.

It’s important to weigh the pros and cons to decide on a vasectomy.

Good reasons for having a vasectomy:

·      If you are 100% sure that you do not want more children.

·      If you or your partner carry hereditary disease genes.

·      If a pregnancy would threaten your partner’s health or life.

What is a Vasectomy?

It is a one-time, permanent male contraception or sterilization procedure. A minor operation, it stops the production and journey of fertile sperm and is almost 100% effective.

It involves surgically cutting or blocking the vas deferens, the tubes that carry sperm from the testicles to the penis to fertilize an ovum. A vasectomy prevents the sperm from reaching the egg, hence preventing pregnancy. A vasectomy can be performed at any age.

Vasectomy Facts Success Rates

One in every 2,000 to 3,000 vasectomies re-canalize (tubes re-attach). This can restore fertility. The risk is highest–one in 400–in the first few months post-surgery.

It is Painful

A vasectomy is not completely pain-free, but 95% patients report only mild or minimal pain. The surgery is performed under local anesthesia and pain can be mitigated with painkillers.

Effects aren’t Immediate

Sterilization doesn’t take effect until after an average of three months or 15-20 ejaculations, when semen finally clears from the vas deferens. It’s imperative to use conventional birth control methods until then.

Reversing the Procedure

The processes of reversing a vasectomy are vasovasostomy and

Vasoepididymostomy to reconnect or bypass the severed tubes. This involved microsurgery lasts about 90 minutes.

Although vasectomy reversal is possible it’s crucial that patients make an informed choice and go in with a “permanent” mind-set. Vasectomy reversals are not 100% successful, cost is often high, and it’s imperative to utilize a highly experienced urological surgeon.

Sperm Production

The body keeps producing semen although the testicles contribute only 1%; other glands produce the rest. The amount of semen ejaculated remains the same. Your body absorbs the sperm.

Effects on Libido

It is a misconception that a vasectomy diminishes a man’s sex drive and libido. A vasectomy causes no disturbance to nerves and blood vessels in the testicles. Erection, orgasm and ejaculation aren’t impacted, ensuring normal sex lives a week after the procedure.

Many men experience a surge in virility as the anxiety of unwanted pregnancies is allayed.

Sports and Physical Activities

It’s recommended to refrain for a few weeks after the operation, especially with hard, strenuous sports. Wear close-fitting trunks and jockstraps in the first month to support the scrotum.

Safe Sex

Next to total abstention, a vasectomy is the safest way of preventing pregnancies, but it’s not a ‘safe sex’ option. It offers no protection against sexually transmitted diseases and AIDS.

The Procedure

The procedure is conducted on an out-patient basis-medical office, hospital, or clinic-and takes 20-30 minutes. The scrotum is anesthetized, one or two small incisions are made with a scalpel near the base of the penis. The vas deferens is exposed, snipped and severed ends are tied back or cauterized.

Some urologists cauterize with an electrical current from a type of soldering iron. Others seal only one end and leave the other to heal naturally. The tube is then replaced and the scrotum is stitched-up. This is known a conventional vasectomy.

In a no-scalpel vasectomy, the vas deferens are held in place by a small clamp. The physician makes a small hole in the skin of the scrotum through which he cuts out a piece of the vas deferens before sealing it up. There is no need for stitches. This procedure is becoming more popular due to its lower risk of complications.

Side Effects

A safe operation, a vasectomy does pose some risk of short and long-term side effects and potential complications. In most cases, these symptoms can be alleviated with prescription medications.

Side-effects:

 

•          Swelling.

•          Mild general discomfort or pain.

•          Blood in the semen.

•          Bruised scrotum.

•          Bleeding and clotting inside the scrotum.

Call your doctor if:

•          You have a fever.

•          Swelling persists or gets worse.

•          You have difficulty urinating.

•          A lump forms in the scrotum.

•          Bleeding from the incision doesn’t stop.

Recovery

The procedure is minimally invasive, so most men do not experience significant side effects. An ice pack and painkillers help reduce pain and swelling.

It’s advisable to wear close-fitting underwear or a jock-strap for support. The genital area must be kept clean. The Centers for Disease Control and Prevention (CDC), recommend a waiting time of at least a week before sex to allow for healing.

Most men can return to work after 1 to 2 days, but should get plenty of rest and avoid heavy lifting for a week or more.

Risks

The risks are minimal and few:

Pregnancy: odds are about 1 in 2,000. In rare cases, there’s a ”spontaneous reconnecting” or reopening of one of the tubes.

You’re not immediately sterile:  20-30 ejaculations are needed to clear out existing sperm reserves. Follow-up PVSA(post-vasectomy semen analysis) tests will confirm if semen is sperm-free.

Infections or Hematoma: accumulation of blood in the scrotum. It may take a few weeks to subside, or you may need a second, small procedure to address the problem.

Prostate Cancer: according to a 2014 study at the Harvard School of Public Health, men are one-and-a-half times more likely to develop prostate cancer after a vasectomy.

 

Heart Attacks: there’s a small risk for heart attacks. In rare cases anti-sperm antibodies produced post-vasectomy may clog arteries in an immune response.

Other Diseases: rheumatoid arthritis, juvenile diabetes, multiple sclerosis and several other diseases may be linked to such immune reactions.

Sperm Granuloma: sperm that may get loose during surgery may cause a mild inflammatory reaction.

If you are considering a vasectomy or need more information call for a consultation with board-certified urologist Dr. Desi Avila at (480) 961-2323. Or request an appointment online.

Filed Under: Vasectomy Procedure Tagged With: permanent male contraception, Sterilization, Vasectomy, Vasoepididymostomy, vasovasostomy

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Dr. Avila focuses on all aspects of men's health, including vasectomy, vasectomy reversal, male infertility, low testosterone, erectile dysfunction, penile prosthetic surgery, Peyronie’s disease, prostate health, and robotic urological surgery.