Vasectomy

Vasectomy is a form of birth control that has become steadily more common in recent years. It has spread quickly because it is over 99.9% effective at preventing pregnancy and is very safe. The essential aim of a vasectomy is to prevent sperm from combining with the other fluids that make up semen, and so from leaving the body during ejaculation. Vasectomy — known as the male method of birth control — and tubal ligation in women can be described as corresponding, similar procedures.

The question “Can a vasectomy be reversed?” comes up often, and men considering the procedure should understand the answer fully. Although reversal is possible, it should be remembered that a vasectomy is to be regarded as permanent and should only be chosen by men who want permanent birth control.

The subject is a sensitive one, and vasectomy is a method turned to with increasing frequency worldwide. Its mechanism therefore needs to be understood correctly. Let us focus together on the question men ask most often: what is a vasectomy, and how is it performed?

What Is a Vasectomy and How Is It Performed?

Before going into the details, I would like to explain the basic mechanism by which this operation produces its result.

Sperm and the male sex hormones are produced in the testicles. Sperm produced by the precursor cells in the testicles mature in coiled tubular structures called the epididymis. Between these tubes and the prostate gland lies the vas deferens, the main sperm duct. It is this main sperm duct that is targeted during a vasectomy. Once it is blocked, sperm can no longer combine with the other ejaculatory fluids and so are not expelled from the body during ejaculation.

With that explanation in place, we can turn to the operation itself. A vasectomy can generally be carried out in a clinical setting, though it may also need to be performed in an operating theatre — particularly if it has to be combined with other surgery, or if general anaesthesia has been decided upon.

A vasectomy can be performed under local or general anaesthetic; doctor and patient decide together on the most appropriate method. The choice is planned according to the patient’s anatomy, their expectations, and — as noted above — whether the procedure is to be combined with other operations.

Vasectomy Techniques

A vasectomy can be performed using two different techniques.

The first is conventional vasectomy. In this method two small incisions are made in the scrotum and the vas deferens is reached. The vas deferens is cut and a small section removed so that the cut ends cannot rejoin. The ends of the tubes are tied off and the incisions closed with self-dissolving sutures, completing the operation.

The other technique is known as “no-scalpel vasectomy”. Here no incision is made in the scrotum. The vas deferens is felt through the scrotum and held with a clip. Small openings are made in the skin, and the skin is stretched so that the vasa deferentia can be lifted. They are then cut, and the cut sections tied and sealed as in conventional vasectomy.

Recovery After a Vasectomy

Which technique is used is decided by the patient and surgeon together. Whichever is chosen, the operation is completed in around 30 minutes and requires no hospital stay. The likelihood of side effects in the post-operative period is close to none.

In general we remind our patients that they need to rest for a few days after a vasectomy. Recovery is complete in under a week. Many men have the operation on a Friday and return to work on Monday. There may be some pain in the first few days, which can be controlled with painkillers. It is important to follow the doctor’s advice and take the prescribed medication as directed.

Sperm May Remain in the Semen in the Early Period

Vasectomy is a highly effective form of birth control for men who do not want children and who are certain of that decision. It has no side effects, does not cause hormonal changes and does not create male sexual dysfunction. On top of that it offers protection at the very high rate of 99.9%.

Even so, there are a few important points to be aware of. After a vasectomy men continue to ejaculate, and semen continues to leave the body. That fluid, however, contains no sperm cells, living or otherwise. But…

For the semen to be free of sperm, 10 to 20 ejaculations need to take place after the operation. Otherwise sperm may remain. For this reason, birth control must be used during intercourse throughout the recovery period (for one month). The most definitive answer as to whether any sperm remains comes from semen analysis — a spermiogram. When a spermiogram performed one month after the vasectomy, and repeated twice in succession, shows no sperm cells at all, the procedure’s protection has begun.

A Final Word

Vasectomy is a safe method that men who do not want children may choose. It does not affect orgasm or the process of ejaculation, and erection problems do not arise as a result of it.