Overview
Vasectomy is a nearly painless surgical procedure to cut and close off the tubes (vas deferens) that deliver sperm from the testes; it is usually performed as a means of contraception. The procedure typically takes about 10 minutes. There is no change in sexual function after a vasectomy.
Vasectomy techniques have evolved to include the less painful and less invasive No Scalpel Vasectomy and No Needle Vasectomy. About 500,000 vasectomies are performed annually in the United States. A vasectomy is less invasive than a tubal ligation (the procedure used to prevent a woman's eggs from reaching the uterus) and more easily reversed. An increasing number of couples choose it as a means of permanent birth control.
New advances in vasectomy, including anesthesia with the new No Needle Vasectomy method, result in a faster, nearly painless procedure. The No Scalpel vasectomy technique is thought to result in less pain and faster healing. Associated Urologists of Orange County is proud to be one of the first groups in California using the No Needle No Scalpel vasectomy technique.
Male Reproductive System
To understand a vasectomy, it is helpful to understand the male reproductive system and how it functions. The testicles, or testes, are the sperm- and testosterone-producing organs. They are located in a sac at the base of the penis called the scrotum. Each testicle is connected to a small, coiled tube called the epididymis, where sperm are stored for as long as 6 weeks while they mature. The epididymes are connected to the prostate gland by a pair of tubes called the vas deferens. The vas deferens are part of a larger bundle of tissue, blood vessels, nerves, and lymphatic channels called the spermatic cord. During ejaculation, seminal fluid produced by the prostate gland mixes with sperm from the testes to form semen, which is ejaculated from the penis.
Preparation
1. Arrange to have the day off of work.
2. You should have someone drive you home from the procedure.
3. Bring an athletic supporter (to support the scrotum and minimize swelling)
4. Avoid anti-inflammatory drugs, such as ibuprofen and aspirin, before surgery
(they thin the blood and can cause increased bleeding).
Procedure
A urologist performs a vasectomy on an outpatient basis in the office. The procedure takes about 10 minutes. The patient typically remains clothed from the waist up and lies on his back. The scrotum is numbed with local anesthetic. In our office, this is usually administered with the "No Needle Technique." The vas deferens is gathered under the skin of the scrotum, and a small opening (usually 1 centimeter or less) is made.
Associated Urologists of Orange County now perform No Needle Vasectomy. Anesthesia can be given without a needle, resulting in a nearly painless procedure.
When a no-scalpel vasectomy or standard vasectomy is done, the vas deferens is then pulled through the small opening or incision, cut in two places, and a 1-centimeter segment is removed. Each end of the vas deferens is surgically tied off or clipped, and placed back in the scrotum. Most urologists cauterize the ends of the vas deferens, but others find that cauterization complicates reversal and is unnecessary. The incision is sometimes sutured and the procedure is repeated on the other side of the scrotum.
No-scalpel Vasectomy
In the no-scalpel vasectomy, a surgical clamp is used to hold the vas deferens while a puncture incision (instead of a cut) is made with special forceps. The forceps are opened to stretch the skin, making a small hole through which the vas deferens is lifted out, cut, sutured or cauterized, and put back in place. The puncture incision does not require suturing. Some urologists recommend the no-scalpel method because they find it is quicker and minimizes postoperative discomfort and the risk for bleeding and infection.
