Vasectomy

What Is a Vasectomy?

A vasectomy is a popular form of birth control for men who do not want to have any more children. This 15 minute procedure performed in the office results in the permanent removal of sperm out of the ejaculate.

How Does a Vasectomy Work?

In men, two testicles produce sperm which are responsible for fertility. Sperm make their way to the penis through a long tube, called the vas. The vasectomy simply is a procedure that closes the vas tubes so that the sperm doesn’t leave the testicles. Sperm are still made by the testes but can no longer pass up through the vas tubes.

There are various methods to block the vas tubes. At the Broward Urology Center, our physicians have been trained to employ multiple methods to guarantee success. The “no scalpel” vasectomy is performed with a portion of the vas tubes removed, remaining edges are burnt and closed with permanent titanium clips or sutures to guarantee that the two ends do not grow back together.

What the Vasectomy Is NOT?

A vasectomy is NOT the removal of testicles and does NOT affect the testosterone hormone levels. Thus, there is no change in your sex drive, no change in erections, no change in the testicular size. You will still ejaculate with orgasms but the ejaculate will be more clear.

How Long Does the Procedure Take?

Typically, a vasectomy is about a 15-20 minute procedure.

Is a Vasectomy Painful?

Mild pain is expected. The vasectomy is done under a local anesthetic that is injected with a very tiny needle to numb the scrotal skin and the vas tubes. You may feel a very brief stinging and burning from the injection and at times tugging during the procedure. Afterwards, the area will be numb for several hours but afterwards, a dull ache is common. Pain control is then managed by keeping ice on the scrotum and a few doses of pain killers, if needed.

How Is a Vasectomy Done?

No scalpels are used in the procedure. After an injection of a numbing medication in the scrotal skin, a very small opening in the skin is made. Through this opening, the vas tubes are found, cut, burnt and clipped or sutured. The incision is typically very tiny and seals within hours. Most of the time, no stitches are needed on the skin.

What Are the Risks of a Vasectomy?

Risks of a vasectomy include:

  • Bleeding may occur during the procedure but is typically very small amount that is controlled with either a machine that we use to burn any blood vessels and some stitches. Minor oozing of blood at the skin is common and typically resolves with mild compression. Sometimes, this results in bruising that clears up in a week. Rarely (2% of cases), bleeding may occur after the procedure which results in some bruising or swelling of the scrotum (hematoma). Small hematomas are typically absorbed by the body in several weeks, but rarely large blood collections may be drained in the operating room.
  • Infection is also a rare complication (3% of cases). Careful shaving of the scrotal skin prior to the procedure may help reduce risk of infection. Every patient has the cleaning of skin with an iodine soap around the scrotum and penile area during the procedure. Sterile technique is used during the procedure and patients take a few days of antibiotics to reduce risk of infection.
  • Sperm granuloma is a pea-sized scar on the vas tube at the vasectomy site, almost never requiring treatment. Periodic discomfort is may be seen in rare cases that often respond to Aleve or Ibiprofen and rarely require surgical removal.
  • Chronic post-vasectomy pain is a rare condition (<5%) where patients have chronic pain of the testicles. This condition is typically treated with either a vasectomy reversal or sometimes the cutting of the nerves that produce this pain.
  • Recanalization is the development of a connection between the two cut ends of the vas that allows the sperm flow through resulting in the failure of the vasectomy. This can happened early in the healing process or late. The chances of the vasectomy failure then are quoted about 1/1000 in the early period and the 1/3500 in the late periods after a vasectomy.

Is a Vasectomy Reversible?

About 6% of men undergoing a vasectomy eventually seek reversal surgery. Reversing a vasectomy is possible, however the success rate is not 100%, thus you should always consider it a permanent form of sterilization.

Will the Vasectomy Protect Me from HIV or Other STD’s?

The vasectomy does NOT protect you from any sexually transmitted injections.

What Is the Recovery After a Vasectomy?

Most men need just a few days of rest for recovery. Most of the vasectomies we perform are typically scheduled on Thursday or Friday so as to give men the weekend for recovery and return to work next Monday.

Am I Immediately Infertile After the Vasectomy?

NO! Though the connection between the penis and testes is closed after a vasectomy, there are parts of the vas tubes that still contain live sperm. About 98% of men are sperm-free after 20-30 ejaculations and 12 weeks. In 5% of men, the semen may still contain some sperm (usually few in number and not active) for months, so it is very important to have a semen sample checked and to use other forms of birth control until it is confirmed by microscopic examination that the semen is sperm-free. You will get two sterile cups into which you will ejaculate a sample for us to examine under the microscope at 6 weeks and at 8 weeks after the vasectomy.

Is It Possible for Me to Store My Sperm Before I Have a Vasectomy?

Sperm banking is a great option for men to store sperm prior to having a vasectomy. Though sperm may be retrieved directly from the testicles in the future after a vasectomy, freezing the sperm is another safeguard if you ever change your mind about having more kids. Frozen sperm may be thawed and used in in vitro fertilization procedures. More information may be found by contacting the following companies:

ReproTech, Ltd
www.reprotech.com
888-953-9669

Xytex Corporation
www.xytex.com
1-800-353-5748

Instructions Before the Vasectomy

  • Please stop any Ibuprofen, Aleve, Advil, Aspirin, Motrin 7 days prior to your procedure. If you take Coumadin, Warfarin, Heparin or any other blood thinning medications, please let the doctor and our office staff know.
  • Please stop any herbal medications especially Vitamin E, Fish Oil.
  • If your insurance company or HMO requires authorization, be sure to bring it or call our office (954-463-6408) a day or two before your vasectomy to see whether we have received it.

Day Before Procedure

  • Please trim the hair on the front fo the scrotum with a shaver.

Day of the Vasectomy

  • Please eat a light meal. Don't come into the procedure hungry or dehydrated as this may cause you to be too weak.
  • If you wish to get an anti-anxiety medication, we may provide a dose at the office, just let us know ahead of time. You make take this medication about 30-60 minutes prior to the procedure.
  • Arrange transportation from the office, especially if you are planning to take an anti-anxiety medicine.
  • Please shower the morning of your procedure and wear loose fitting clothes.
  • Recommend that you wear either briefs or boxer/briefs (jockey) underwear to keep pressure on the scrotum after the procedure and decrease swelling.

Instructions Following Vasectomy

When You Get Home

  1. Have a restful evening after the vasectomy just relaxing on the couch or recliner. Keep an ice pack in the groin area to decrease swelling and also reduce some pain.
  2. Ice your scrotum for 20 minutes at a time every two hours when awake for 24 hours. This will reduce the chance of scrotal swelling and may help with pain.
  3. Wear cotton, boxer briefs or briefs under shorts for increase support and comfort.
  4. Avoid heavy lifting or vigorous exercise for seven (7) days after surgery.
  5. Driving is ok one day after the vasectomy as long as you are not taking any narcotic pain medicines.
  6. You can shower 36 hrs after surgery. Avoid rubbing the scrotum when drying. No baths, swimming, hot tubs for 10 days, or when skin looks completely healed.
  7. Sexual activity can begin one week after your vasectomy when scrotal swelling and tenderness subside.
  8. CONTRACEPTIVE PRECAUTIONS ARE ABSOLUTELY NECESSARY UNTIL THE SEMEN ANALYSIS PRODUCES NEGATIVE RESULTS.
  9. Six to eight (6-8) weeks after your vasectomy, you need to do a Semen Analysis twice.
  10. Please call our office immediately if you have any concern including: severe scrotal skin redness, drainage, fevers with a temperature of >101F, poorly controlled pain, severe bleeding.

General Expectations

You can expect some bruising (black and blue) and mild redness at the site of the incision. The sutures in your incision will dissolve and fall out within 5-10 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 up 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.

A vasectomy does not make you immediately infertile, it takes 6-8 weeks (30-40 ejaculations) for all the sperm to leave your body.Blood in the semen within the first month or two after the vasectomy is expected. Instructions will be provided the day of your procedure for follow up semen testing.

Pain Control

Tylenol (acetaminophen) for pain relief is acceptable. You may take two extra strength or three regular strength tablets every 6 hours. It is the safest of all the pain relievers. Either ibuprofen (Advil or Motrin) 600mg every eight hours or naproxen (Aleve) one tablet twice a day may be taken instead of Tylenol if you prefer, but since these medications increase chances of bleeding, we recommend that most patients take them at least 24 hours after the procedure. The doctor will also provide a narcotic medication as well.