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Item ID: nht00037   Source ID: 2

Description: Vasectomy Definition A surgical procedure to sterilize a man by blocking the tubes through which sperm normally pass on their way from the testes to the penis. These tubes are called the left and right vas deferens.

Parts of the Body Involved Scrotum, vas deferens

Reasons for Procedure A vasectomy is done as a means of permanent birth control. This option is only appropriate for men who are certain they will not want to father a child. Surgery to reverse the procedure is not always possible or successful.

Risk Factors for Complications During the Procedure Bleeding disorders Local infections What to Expect Prior to Procedure

Your doctor will likely do the following:

Discussion of the effects of this... More

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Vasectomy Definition A surgical procedure to sterilize a man by blocking the tubes through which sperm normally pass on their way from the testes to the penis. These tubes are called the left and right vas deferens.

Parts of the Body Involved Scrotum, vas deferens

Reasons for Procedure A vasectomy is done as a means of permanent birth control. This option is only appropriate for men who are certain they will not want to father a child. Surgery to reverse the procedure is not always possible or successful.

Risk Factors for Complications During the Procedure Bleeding disorders Local infections What to Expect Prior to Procedure

Your doctor will likely do the following:

Discussion of the effects of this procedure Medical history Physical exam Review of medications In the days leading up to your procedure:

Arrange for a ride to and from the procedure Do not take aspirin, aspirin-containing medications, or ibuprofen for two weeks before the procedure; discuss this with your doctor prior to your procedure Shower before leaving home Take any medication as ordered by your doctor; a mild sedative before the procedure may be recommended The night before, eat a light meal and do not eat or drink anything after midnight, unless told otherwise by your doctor Wear comfortable clothing and tight fitting underwear You may be asked to clip your scrotal hair During Procedure – Anesthesia

Anesthesia – Local

Description of the Procedure - There are two techniques for a vasectomy, the conventional approach and the no-scalpel vasectomy.

Conventional approach: The doctor makes one or two small cuts in the skin of the scrotum and brings the vas deferens through the opening. The tube is cut, a small piece may be removed, and the ends are sealed off with stitches, clips, or cauterization (using an electric needle to destroy the tissue). The vas deferens is placed back in the scrotum and the incision closed with stitches. The procedure is repeated on the opposite side.

No-scalpel vasectomy: The doctor locates the vas deferens under the scrotal skin and attaches a clamp to hold it in place. Using a special instrument, the doctor punches a small hole in the skin and stretches it open enough to pull the vas deferens through. The tubes are cut and sealed using the same methods as in the traditional approach. The holes heal without stitches.

After Procedure - Rest at doctor's office for a short time

How Long Will It Take? Conventional vasectomy takes about 30 minutes, no-scalpel procedures take about 10 minutes.

Will It Hurt? Anesthesia prevents pain during the procedure, but you can expect some soreness for a few days after. Take pain medication as ordered by your doctor. Do not take aspirin or anti-inflammatory pain medications without the approval of your doctor.

Possible Complications:

Anesthesia-related problems Bleeding Bruising Chronic pain in and around the testes Continued fertility, or re-joining of the ends of the vas deferens resulting in renewed fertility, potentially resulting in pregnancy in a sexual partner Infection Inflammation Psychological issues related to lack of fertility Sperm granuloma (development of lumps due to immune system response to sperm leaking from the reproductive organs) Swelling Swollen, painful testes occurring during the year following a vasectomy Some possible complications are still controversial within the medical community. For instance, researchers are trying to determine if vasectomy leads to a higher risk of atheroclerosis, rheumatoid arthritis, and blood clotting problems. Other conditions being studied include osteoporosis, kidney stones, and prostate cancer.

Average Hospital Stay– None

Postoperative Care:

A small amount of blood on the gauze pads is normal. Report excessive bleeding or the need to change the gauze pads more that two to three times daily. Apply ice packs, covered with a towel, on and off during the first eight hours Keep the area clean and dry, and cover the incisions with clean gauze for three days or as directed by the doctor Rest in bed for at least one day and at home for a couple of days Wear an athletic supporter, if recommended by your doctor You may shower the next day Outcome Most men feel up to returning to work in a few days and ready for sexual activity in about a week. Ejaculation may cause some discomfort in the groin and testicles until the tissues heal. Avoid lifting heavy objects or participating in sports for 2–3 weeks. For 2–4 months, use an alternate method of birth control until two tests, 4–6 weeks apart, show that no sperm are present.

Call Your Doctor If Any of the Following Occurs Difficulty urinating Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site Signs of infection, including fever and chills Last reviewed: August 2003 by Reena Karani, MD.

RESOURCES: American Society of Reproductive Medicine http://www.asrm.org/ National Institutes of Health http://www.nih.gov/ Sources: National Institute of Child Health and Human Development. Planned Parenthood. Procedures for Primary Care Physicians, 1st ed. Mosby-Year Book;1994.

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