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Vasectomy

Male Sterilization

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Updated November 22, 2006

Vasectomy is a surgical procedure during which the vas deferens - the tubes that carry sperm from the testes - are severed. Vasectomy is a very safe and permanent means of male contraception, though it can be reversed should the need arise.

Although the written consent of a partner is not required, it is important to discuss the operation with a partner. Responsible doctors will discuss the details of the vasectomy procedure and its effects. Many will then suggest you take some extra time, often 30 days, to reflect on whether this is the contraceptive method you really want.

A vasectomy is a relatively quick procedure that takes about 30 minutes and is performed using a local anesthetic. This reduces post-operative recovery time and minimizes the side effects sometimes associated with a general anesthetic. Local anesthetic also reduces costs. After the procedure a man can go home the same day and be back to work within two or three days.

The Vasectomy Operation
A local anesthetic is administered prior to the operation. The vas deferens are operated on one at a time. A very small incision is made and the tube is cut then sutured, cauterized, or clipped, in order to close them off.

In a no-scalpel vasectomy, a special forceps punctures (rather than cuts) the skin. In the one tiny puncture both tubes are tied off, cauterized or blocked. This procedure does not require any sutures.

Both types of vasectomy have the same result: the man becomes sterile because sperm is kept out of the seminal fluid. The sperm continue to be produced in the testes but are absorbed into the body with no ill effects. What this means is you will still ejaculate fluid as before, but without the sperm in it, and there is no danger of an unwanted pregnancy.

The World Health Organization (WHO) recommends that couples continue to use alternative contraception for 3 months after the procedure. Two samples of ejaculate from about 12 weeks (or after about 12 ejaculations) will confirm that no sperm are present.

Pictures of Vasectomy Procedure

Vasectomy Side effects and Surgical Complications
As with any surgical procedure, there can be some side effects, but major complications are very rare.

  • Pain. Any pain or discomfort should stop after about a week. Most pain will respond well to mild analgesics.

  • Infection A small amount of redness, bruising and swelling is normal. If, however, you develop a temperature, if the swelling does not go down, increases or becomes very painful, always seek medical advice.

  • Granulomas A benign (non-cancerous) lump may develop as a result of leakage of sperm from the cut end of the vas into the scrotal tissues resulting in an inflammatory reaction. This lump may be painful or sensitive to touch or pressure and is generally treated with anti-inflammatory agents. In a very small number of cases, sperm granulomas cause more serious complications; reversal of the vasectomy may be attempted to resolve this problem.

  • Epididymitis occurs when inflammation at the site of the vasectomy can causes swelling of the epididymus (the tightly-coiled tube connecting the efferent ducts from the rear of each testicle to its vas deferens). Swelling should subside within about one week.

  • Abscesses are rare; they are the result of infection from the operation, or may be picked up post-operatively.

  • Erectile dysfunction or decreased sexual desire can occur in the form of impotence, premature ejaculation or painful intercourse. The cause may be mostly psychological in nature; the vasectomy may exacerbate previous difficulties and problems between sexual partners. Counseling may be required to resolve difficulties.
  • Pregnancy Following a Vasectomy
    In rare cases, pregnancy has occurred following vasectomy. The causes include a failure in the surgical procedure, the man not using additional contraceptive methods in the three months following the procedure, or complications following the vasectomy.

    The U.S. Agency for International Development states that failure rates for vasectomies range from 0.2 to 0.4 percent. The Centers for Disease Control have estimated a probability of failure in 11 per 1,000 procedures over two years. Half of the failures occur in the first three months after the vasectomy. Recent research shows that men often do not go for follow-up semen analysis after their vasectomy.

    Article Sources:
    Jacobstein, Roy. "Vasectomy: Safe, Convenient, Effective and Underutilized." Global Health Technical Briefs. 01 May 2005. John Hopkins University. 15 Nov 2006 <http://www.maqweb.org/techbriefs/tb7vasectomy.pdf>.

    Unintended Pregnancy Prevention: Vasectomy. 09 Jun 2006. Centers for Disease Control and Prevention. 15 Nov 2006 <http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/Vasectomy.htm>.

    "Use of Contraception and Use of Family Planning Services in the United States: 1982-2002." National Center for Health Statistics. 2004. Centers for Disease Control and Prevention. 18 Nov 2006 <http://www.cdc.gov/nchs/data/ad/ad350FactSheet.pdf>.

    "Vasectomy and Vasovasostomy (Reversal Surgery)." About. ADAM Healthcare Center. 15 Nov 2006 <http://adam.about.net/reports/000037_7.htm>.

    Dhar, Nivedita Bhatta, Bhatt, Amit, Jones, J. Stephen. 2006 Determining the success of vasectomy. BJU International 97 (4) 773-776.

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