Conditions Treated / Vasectomy
Vasectomy
Overview. A vasectomy is a minor outpatient surgical procedure to make a man sterile by closing off the tubes that deliver sperm from the testes to become part of the semen. It is one of the most popular forms of birth control, sought by more than 500,000 men per year in the United States . Vasectomy is considered very safe and is effective nearly 100 percent of the time, with rare complications and no change in sexual function. A man’s sex drive, ability to achieve an erection, ejaculation and sexual enjoyment are not affected. Male hormone levels and secondary male characteristics do not change. A vasectomy is much less expensive and less invasive than tubal ligation, the sterility procedure performed on a woman. It is also more easily reversed, although it should be considered permanent.
Treatment. The vasectomy is often done in a doctor’s office and takes about 15-30 minutes. After the patient is numbed with a local anesthetic, one or two small incisions are made in the scrotum to access the two tubes, known as the vas deferens, that transport sperm from the testicles into the semen. Each vas is lifted, cut and sealed off before being returned to the scrotum.
In recent years, an increasing number of vasectomies are using the “no scalpel” method, in which the same procedure is performed through a pinpoint puncture in the middle of the scrotum, resulting in less tissue disruption and no need for suturing. This procedure may reduce postoperative discomfort and the risk for bleeding and infection. An alternative to the vasectomy, the Vasclip, involves no cutting or cauterizing; instead, a small plastic device is clamped around the vas deferens to prevent the sperm from entering the semen. Although recovery time might be shorter, some studies have shown the method to be less effective than the vasectomy.
The risk of complications after a vasectomy is low. For at least 2-3 days following the procedure there is likely to be tenderness, slight swelling and pain that is usually experienced as a dull ache, but most patients are able to resume nearly all of their normal activities within a week. In some men, pain can last longer, particularly if there is a temporary buildup of pressure within the vas deferens. An infection at the site of the incision can occur, and in rare cases sperm that leaks from a vas deferens into the surrounding tissue can form a small lump that will usually heal itself. Contrary to some fears, there is no evidence that a vasectomy increases a man’s risk of prostate cancer.
Only 1-2 women per 1,000 have an unplanned pregnancy in the first year after their partner has had a vasectomy. It is important to remember that the effect of the procedure is not immediate – it may take up to 20 ejaculations before the sperm is cleared from the semen, so other forms of birth control should be used until semen samples have been tested and found to be absent of sperm. Spontaneous reconnection of a vas deferens is possible, but very rare. For men who later decide they want to reverse the vasectomy’s effects, a microsurgical procedure is often able to restore the flow of sperm, though it is best to assume that the effects of the vasectomy will be enduring.
|
