Vasectomy

Vasectomy is a procedure that creates permanent sterility (the inability to have children) in a man. During the procedure, the two vas deferens are blocked in order to obstruct the flow of sperm out of the testicles. It is performed on an estimated 500,000 U.S. men per year. It does not affect a man’s ability to perform sexually or achieve orgasms and doesn’t visibly change semen.

Two techniques are available to perform a vasectomy. The traditional method uses a scalpel; the modern method is called the “no scalpel vasectomy.” Both methods are safe and effective when performed by an experienced physician.

Pain management

Regardless of the method used, the procedure is typically performed under local anesthetic (numbing medicine) in a doctor’s office or procedure clinic. The procedure typically takes 15 – 30 minutes. Majority of recovery takes a few days, but slightly longer for the return to more strenuous activity and exercise.

Some Spokane Urology physicians can provide nitrous oxide also known as N2O or “laughing gas” to help you relax before the procedure begins. Other physicians offer a medication such as valium to help you relax.

The procedure

During the procedure, the vas deferens is cut and the ends are sealed. Typically, a piece of each vas deferens is also removed. At a minimum, the ends of the vas deferens are sealed with cautery and the ends are normally physically separated. Some surgeons also use a combination of clips and/or sutures during the procedure.

With the no-scalpel method, the physician uses special instruments (instead of a scalpel) to create a small opening in your body to reach the vas deferens. These instruments allow the procedure to be done with less manipulation of the body’s tissues.

After you’ve had a vasectomy, your prostate and seminal vesicle glands (which produce components of semen) will continue to make fluids, so the semen looks the same. However, the sperm, with nowhere to go, are reabsorbed by the body.

Also, hormone levels are unaffected, so hair distribution, voice pitch, and sexual drive and sensations are unchanged.

Preparing for a Vasectomy

• Stop taking all aspirin, Motrin (ibuprofen), Aleve (naproxen) or other blood thinning products one week prior to your vasectomy. Your physician may provide you with additional instructions.
• Arrange, in advance, to rest and be off from work for a minimum of 2-3 days after the vasectomy.

The day of your vasectomy:

• Carefully shave all the hair from your scrotum.
• Wear or bring close-fitting/supportive underwear that will support the scrotum.
• You may drive yourself home from the procedure if you do not require any anxiety medication, but if you do be sure to have someone drive you home from the procedure.

Post-vasectomy instructions:

• Wear close-fitting/supportive underwear for 2-3 days after your vasectomy to hold the bandages in place.
• Use an ice pack on your scrotum to minimize swelling for the first 24 hours (30 min on / 30 min off).
• Take acetaminophen as needed – continue to avoid aspirin, Motrin (ibuprofen), Aleve (naproxen) or other blood thinning products for one week after your vasectomy.
• We recommend lying down for six to eight hours after the procedure and placing an ice pack on the incision. Even though you may feel fine after your procedure, it’s important that you remain inactive and use an ice pack as instructed by your physician. You may experience swollen, achy testicles for a week or so after the procedure, as well as bruising in the scrotum.
• You should avoid heavy lifting, exercise, and sexual intercourse for at least one week after the procedure, or longer if directed by your physician. A small, bloody discharge from the incision site is normal for a day or two.
• You may take showers beginning the day after the procedure, but avoid soaking the scrotum in baths, swimming pools or hot tubs until the sutures completely dissolve (usually 10 days).
• Limit activity for the first 48 hours following procedure, avoid any heavy lifting, pushing or straining.

• You can expect some bruising and redness at the site of the incision. The sutures in your incision will dissolve and fall out within about 10 days. There may be some yellow or white discharge from the incision as the sutures dissolve, this is normal.
• You may notice a small open gap at the site of the incision after the sutures fall out, this is normal and will close over time.
• You may notice some firmness in and around the incision site, it will soften, flatten and return to normal within a few weeks.
• Once healed your ability to perform sexually or achieve orgasm should not be affected.

Follow-Up Semen Test:

A vasectomy does not make you immediately infertile. It may take a little over 3 months (or as many as 30-40 ejaculations) for all the sperm to be cleared out of the ejaculatory system. To be declared clinically sterile you must have semen analysis performed demonstrating there are no sperm present.

IT IS CRITICAL THAT YOU USE ANOTHER FORM OF BIRTH CONTROL UNTIL YOU HAVE HAD SEMEN TESTING SHOWING NO SPERM.

Contact our office immediately if you experience any of the following complications:

• Fever (taken by mouth) above 101.5°F
• Significant increase in scrotal size
• Redness or swelling that does not subside
• Difficulty urinating
• Blood spot on the dressing larger than a quarter

The following complications might occur in the first few days after surgery:

• Hematoma: Though rare, a small blood vessel may leak in the scrotum, forming a clot. A small clot typically dissolves with time, but a larger one may require reopening and draining the scrotum.
• Infection: Signs of infection include fever, chills, redness and swelling around the incision site.