By Alejandro Miranda-Sousa, M.D. and Kailen Gonzalez, PA-C
Vasectomy provides permanent male birth control by severing the tubes through which sperm pass to mix with semen.
These tubes are called the vas deferens. Sperm are produced in the testicles and stored in an adjacent structure called the epididymis. During sexual climax, the sperm migrate from the epididymis through the vas deferens and mix with other components of semen to form the ejaculate material.
The easiest way of eliminating the sperm but leaving everything else the same is to interrupt the vas deferens. The vas deference is easily accessible though the scrotum because it is directly under the skin. No cut is made in the scrotal skin. The technique of no-scalpel vasectomy uses a special surgical instrument to grasp the vas through the scrotal skin and hold it in place directly under the skin. Another instrument is then used to make a small perforation in the skin over the vas and spread the tissue. The vas is then pulled up and all the tissue around it is separated and cleaned to isolate the tube. This is an important step because all the nerves must be moved away from the vas before it is clipped. Once the vas is clear, clips are placed to block the vas on either side. The vas is cut with a cauterizing tool between the clips and then separated. A small segment is removed to prevent the vas from growing back together. The vas is then placed back into the scrotum and the perforation is sealed without the need for sutures. A simple dressing is placed. The actual procedure takes less than 10 minutes to perform.
Studies show that the no scalpel method produces less pain and fewer complications than the conventional method. There is less bleeding, bruising, and risk of infection. In addition, no-scalpel vasectomy permits a faster return to sexual activity. There is no change in erection, sensation, or orgasm after vasectomy, and the amount of semen remains the same, though free of sperm.
Things to consider and special instructions post-vas include avoidance of sexual intercourse and refraining from heavy weightlifting, running, or other strenuous activities for at least a week. Most patients return to work and normal activities within 48 hours. There are some potential side effects after vasectomy procedure that include but are not limited to: bleeding, infection, pain, sperm granuloma, formation of antibodies against sperm, recanalization of the vas and chronic testicular pain. There may be some redness, swelling, or oozing from the scrotum immediately after procedure. Taking an NSAIDs may help ease some of the discomfort and reduce inflammation after the procedure.
A no-scalpel vasectomy can be an effective and safe form of long-term birth control. Failure rate can be as low as 0.1 percent. Because it is meant to be permanent and because a vasectomy reversal isn’t a guarantee, you and your partner should strongly consider the implications of the operation before having it done.
Alejandro Miranda-Sousa, MD
Dr. Miranda-Sousa is a board certified urologist. He is an author and co-author of multiple research and clinical peer-reviewed medical articles. He received Best Abstract from the American Urological Association in 2007 and is Fellowship Trained in Urodynamics and Neurourology.
Our providers are highly-qualified, skilled experts in the area of urinary and bladder disorders, pelvic floor prolapse, prostate cancer, along with many other related disorders Dr. Miranda-Sousa and his staff are ready to answer any of your urological questions and concerns, as they treat all of their patients with the utmost of care.
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