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PROCEDURE INFORMATION

Vasectomy Procedure

Dr Majid Alinia provides responsible and compassionate specialist care.

Vasectomy procedure is performed under local anaesthetic. Inoculating anaesthetic can be done either by a very small gauge needle or a special needle-free instrument called Pharmaject that injects anaesthetic into scrotum without a needle.

It requires two small incisions (about 1 cm). The area is infiltrated with local anaesthetic and two small incisions are performed a few centimetres above testes. After incision, vas deferens is approached and can be cut. In open-end method the testicular side of vas deferens is left open. This will let sperm move out into scrotum cavity to prevent build up of pressure and congestion from continuous sperm production in testes. The released sperm will disintegrate in scrotum, later testes will continue sperm production.
The other end of vas deferens (prostatic end) is sealed with a suture and by using “Fascial Interposition” technique is placed in a different level of scrotum. A suture is used to position the stump of the prostatic end outside of the fascial sheath and the stump of the testicular end inside the fascial sheath away from the prostatic end. This reduces the risk of tube rejoining later and prevents sperm travelling through this end toward semen or seminal vesicles. Beside local anaesthetic, a form of intranasal sedative can be used to help patient reduce anxiety before and during the procedure.

DURING THE PROCEDURE

Vasectomy
Vasectomy is the most common form of surgical permanent sterilisation for men. Vasectomy is a procedure that involves cutting vas deferens to prevent sperm entering semen. There are different methods of vasectomy: no-scalpel vs scalpel vasectomy and open end vs traditional vasectomy.

How does a vasectomy work?
Sperm which are produced in testes are sent up to seminal vesicle through two small tubes called vas deferens. During vasectomy these two tubes are cut to stop sperm travelling up to semen. As a result, semen becomes infertile by not having sperm in it. Sperm constitutes 2-5% of semen. Sperm and testosterone production will continue in testes and sexual function (including amount of semen and ejaculate) and libido will not be affected by vasectomy.

Complications
There is a small risk of bleeding (haematoma) after vasectomy. This small risk could be largely prevented by careful control of bleeding during the procedure. There is also a small risk of infection. Infection can be treated with oral antibiotics in majority of time. Long standing pain can happen which is very rare and might be related an immune system reaction to sperm called sperm granuloma. As any surgery carries risk of complications, after your Vasectomy if you experience any swelling, pain or discomfort after two weeks post procedure please see your Doctor.

Vasectomy failure
Studies show that there is a small chance of failure after clearance. This could happen when the doctor misses the vas deferens during the procedure, and the tube will regrow. Studies have shown that less than 1 percent of men will need to have a repeat Vasectomy.

AFTER THE PROCEDURE

After the procedure the area will be painful for a few days mainly the first 2 days. To reduce pain and post surgical inflammation, it is better to apply an ice pack for couple of hours. Also wearing supportive undergarment is helpful. Patient should avoid sex and strenuous activities for a week.

Sex can be resumed after a week but remember that semen is still fertile and it takes about 20 ejaculations or 3 months to clear semen from sperm. At this stage (3 months after vasectomy or after 20 ejaculations) the sperm analysis test will identify if sperm is still present in your semen.

For some men it might take longer to achieve this clearance. Obviously you need to have a form of contraception until you get your clearance in semen analysis test.