Definition of Vasectomy
"Vas" in vasectomy refers to the vas deferens, tiny tubes through which the sperm navigate from the testicles to the seminal vesicles. The "ectomy" part of the term means to cut or excise. Therefore, vasectomy is the term used to describe the surgical procedure to block the path between the location where sperm are created and the storage place to which they migrate and later mix with semen. If sperm cannot get to the semen, they cannot be ejaculated, and therefore, the man cannot father a child. A vasectomy, then, is a method of contraception.
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Anatomy
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The testicles are contained in the scrotum. Inside the testicles, sperm are created. After the sperm are mature, they maneuver through tiny tubes called the vas deferens as they make their way to the seminal vesicles where they are stored. Upon ejaculation, the sperm are mixed with semen made in the prostate gland.
Procedure
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The procedure is often done in a doctor's office. The doctor injects a local anesthetic into the scrotum. While waiting for the area to become numb, he may shave the scrotum before applying antiseptic to prevent infection. He makes a small incision in the scrotum under the penis and locates one of the vas deferens leading from the first testicle. He ties the tube in two places with permanent sutures and cuts the tube between the sutures. He may or may not cauterize the cut ends to prevent them from growing back together. The doctor then repeats the procedure on the other vas deferen and finally sutures the incision in the scrotum. A no-incision method has been used in the United States. since 1990, and involves using a small puncture instead of a traditional incision, resulting in less pain and faster healing for the patient.
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Recovery
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Immediately after the procedure, a patient goes home and rests, often with orders to maintain an ice pack on the wound to reduce bleeding and swelling. The doctor may also advise him to take acetaminophen to relieve any pain. Patients are advised to rest for a day or two, to avoid lifting anything heavy for the first week, and to refrain from sexual intercourse for three to four days. The patient will still have live sperm in his ejaculate for up to six weeks, and he must return to the doctor's office two or three times after the surgery to have his sperm levels checked.
Risks
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A patient may experience some bruising and swelling in the affected area, but these problems are minor and easily treatable. Patients have no change in their ability to get or maintain an erection, according to the UCLA Urology Dept. Likewise, ejaculations are also normal but since they may contain live sperm for up to six weeks, patients must use other methods of birth control during that time. Vasectomies are much safer, far less invasive, and cheaper than female tubal ligations. They are also more than 99 percent effective in preventing pregnancies.
Reversals
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If a man decides later that he wants to father a child, he may elect to have the procedure reversed (a "vasovasostomy"). A doctor removes the cauterized ends of the vas deferens as well as the permanent sutures and reconnects the ends of the vas deferens. This procedure is successful 40 to 50 percent of the time, so doctors recommend that a vasectomy be considered a permanent procedure.
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