Bilateral Vasectomy

"No Scalpel" Technique

Bilateral vasectomy is a safe and effective means of achieving permanent sterility. All patients considering vasectomy should be familiar with the procedure, including limitations and potential complications.

Bilateral vasectomy means the removal of a small segment of each vas deferens. The vas deferens is a tiny duct which carries the sperm from the testicles.

Sexual performance, sensation, and ejaculation are not altered by vasectomy. The amount of semen emitted during orgasm will not be noticeably diminished after a vasectomy but will no longer contain sperm.

The procedure is done in the office under local anesthesia. The "no scalpel" technique will be used. First developed in China, the "no scalpel" vasectomy is done through a tiny puncture in the scrotum. By avoiding an incision, there is less discomfort and swelling than after the standard method.

Before surgery you should carefully shave the pubic area as instructed. Following this you should shower to cleanse the area and wash away loose hairs. A light breakfast is advisable.

You must bring an ice bag filled with ice as well as a scrotal support (athletic support) with you to the office. It is best if someone else drives you.

At surgery, the genitals will be painted with an antiseptic solution and sterile drapes will be placed around the area. You must keep your hands away from the sterile field at all times.

A slender needle will be used to inject a local anesthetic. The operation will be done through a tiny puncture in the center of the scrotum. Each vas deferens will be divided and a small portion of each will be removed. The ends will then be cauterized and returned into the scrotum. At the end of the surgery, a drop of antibiotic ointment, dry gauze, and the scrotal support will be applied.

On the day of surgery, after the procedure has been performed, you must apply ice continuously to the area using a watertight bag placed over the support. You should rest quietly and walk as little as possible. Tylenol should be sufficient to control the usually minimal amount of pain. Aspirin should be avoided as it may promote bleeding.

The day after surgery is best spent at home but walking is permitted. The scrotal support should be worn but the ice pack is no longer necessary.

Two days after surgery you may increase your activity, but exercise or walking may cause some discomfort. The support can be left off if desired and you may shower. You may do light work if you feel up to it. Some discomfort usually lasts for one to two weeks and physical activity can be gradually increased accordingly.

Before you leave the office, after surgery, you will make an appointment to return approximately one week later to have the wound checked. You must return again in six weeks and then in three months for semen evaluations. You will have to ejaculate into a clean container within two hours before each of those scheduled visits. Notify the nurse when you arrive at the office so that the specimen can be examined promptly under the microscope. Only after both specimens are found to be completely free of sperm can unprotected intercourse begin. Until then you must use an alternative form of birth control.

Mild swelling of the scrotum and testicles and slight bruising or "black and blue" areas are likely following surgery. However, if rapid and severe swelling and pain occur, contact the doctor immediately.

Slight oozing or drainage from the wound is common and normal following vasectomy. If fever over one hundred degrees occurs you must contact the doctor promptly. Please call the office anytime with any questions or concerns you may have.

Complications of vasectomy are uncommon. However, you should be informed.
Rarely, because of the body's amazing capacity to heal, the cut ends of the vas deferens grow back together and pregnancy may result. This process is called recanalization. Fortunately, this occurs in only about one case per thousand.

Occasionally, bleeding can occur after surgery. This may be severe and could require emergency drainage. Fortunately, serious bleeding is rare.

Another possible consequence of vasectomy is pain in the testicles which may last for weeks, or months, or longer. This usually responds to rest and antibiotics but occasionally surgery is required.

Leaking of sperm from the vas ends may result in a small painful swelling called a granuloma. This can if necessary be treated by surgical removal, which is a relatively minor procedure.

Infection may follow vasectomy. Such infection is usually minor but occasionally antibiotics or other measures become necessary.

Although vasectomy is generally very safe and effective, you must be aware of these potential complications prior to making a decision for surgery.