Background Information:

What are the other Names for the Procedure?

• Deferentectomy
• Vas Ligation
• Vas Occlusion

What is Vasectomy surgical procedure?

• Vasectomy is a male sterilization process. The sperms are carried from the testicles via the epididymis, and then through the vas deferens before being released into the urinary system
• Vasectomy is a surgical procedure which involves cutting and tying of the vas deferens, thereby stopping the flow of sperms

What part of the Body does the Procedure involve?

A Vasectomy procedure involves the scrotum and the vas deferens.

Why is the Vasectomy surgical procedure Performed?

• A Vasectomy surgical procedure is routinely used as a male contraceptive measure and is considered a permanent birth control method
• It is also used in cases of recurrent epididymitis (inflammation of the epididymis; the tube that connects the testes and the vas deferens)

What are some Alternative Choices for the Procedure?

• Vasectomy is a birth control method used for men. Permanent birth control methods available for women include tubal ligation and essure
• There are various other temporary birth control methods that include the use of condoms, withdrawal method, birth control pills, cervical cup, diaphragm, female condoms, abstinence, and rhythm method

What are the Recent Advances in the Procedure?

Various methods, which involve less pain, are less risky, and have a faster recovery, are being developed.

What is the Cost of performing the Vasectomy surgical procedure?

The cost of Vasectomy procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

• It is normal for a patient to feel uncomfortable and confused by the information regarding Vasectomy surgical procedure and on what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
• They can also choose to approach another physician independently. Besides, if the procedure has many alternatives, the patient may take a second opinion to understand and choose the best one

What are some Helpful Resources?

http://www.vasectomyinfo.com/vasectomy_overview.html

Prior to Vasectomy surgical procedure:

How is the Vasectomy surgical procedure Performed?

The Vasectomy surgical procedure is performed as:

• The testicles and scrotum are cleaned with antiseptic and shaved. The area is then either injected or sprayed with a local anesthesia
• With the help of a scalpel, one or two incisions are made on the scrotum to expose the vas deferens from both the testicles
• The vasa deferentia (plural of vas deferens) are then cut, tied, the ends are cauterized (burned) and returned to the scrotum. The incisions are then closed with stitches or sutures that fall off within 7 days
• The No-Scalpel Vasectomy is a minimally invasive technique, where a puncture is made instead. Through the opening, the vas deferens are gently lifted and cut, tied, and put back into position. This method is less painful, less risky, and has a faster recovery period.
• Instead of cutting the vas deferens, a clip (VasClip or Pro-vas) is used to shut the vas deferens and stop the sperm from flowing. However, this method has a lower success rate, with respect to sterilization. Though, such cases are more likely to be successful, when vasectomy reversal is required.

Where is the Procedure Performed?

A Vasectomy procedure is usually performed in an out-patient surgery facility or at a physician’s office. The treated individual can go home the same day.

Who Performs the Procedure?

The surgery is performed by a general surgeon, an urologist, or a family physician.

How long will the Procedure take?

The procedure takes about 20-30 minutes.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.

• Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
• If you are allergic to any specific medication or food items
• If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
• If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
• If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
• If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
• If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
• A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
• Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
• Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
• Local anesthesia may be used; hence, do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
• Avoid application of any deodorant or topical medicines on the area, prior to the procedure
• It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
• Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
• The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
• For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for Vasectomy procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Vasectomy surgical procedure?

Routine blood and urine tests are required, prior to the procedure.

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

• What is a Vasectomy procedure?
• Why is this procedure necessary? How will it help?
• What does the procedure involve?
• Will I need adjunct treatments after the surgery?
• How soon should I get it done? Is there an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place during recovery?
• When can I resume normal work?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• How many such procedures have you (the physician) performed?
• What are the costs involved?

During the Vasectomy surgical procedure:

What kind of Anesthesia is given, during the Procedure?

During the procedure the individual is administered local anesthesia, either with or without sedation.

How much Blood will you lose, during the Procedure?

There is no significant blood loss during the procedure.

What are the possible Risks and Complications during the Vasectomy surgical procedure?

There is only a small risk of infection. Apart from that there are no risks or complications involved with this process.

What Post-Operative Care is needed at the Healthcare Facility after the Vasectomy surgical procedure?

Once the surgery is performed, the patient can go home the same day. At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise.

After the Vasectomy surgical procedure:

What are the possible Risks and Complications after the Vasectomy surgical procedure?

There is a very small margin of risks and complications involved with this procedure. Post Vasectomy, the following complications may arise:

• Infection
• Bleeding and swelling
• Sperm granuloma (benign lump at the surgical site)
• Pregnancy may still occur in 1% of the cases

What is the Prognosis after the Surgery?

• After the procedure, the male does not become sterile immediately; he will still have active sperm in his system
• The semen is tested for the presence of active sperms over the next few weeks and then the Vasectomy procedure is considered complete and successful, once there are no measurable levels of sperm in the semen

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

• Swelling, redness or bleeding at the site of the surgery
• Unbearable pain or discomfort
• Signs of infection

What Post-Operative Care is needed at Home after the Vasectomy surgical procedure?

At home, the following post-operative care is recommended after a Vasectomy procedure:

• Avoid bathing, 24-48 hours after the procedure
• Ice bags should be applied for 20 minutes, every hour, for the next 6-8 hours. After 24 hours, hot bags or heating pads may be used to relieve the incisional pain
• Avoid strenuous work for the next 2-3 days

How long does it normally take to fully recover, from the Procedure?

It usually takes about 2-3 days to completely recover from the surgery.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The procedure does not involve the surgical removal of any tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Vasectomy surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility charges and the physician charges. Alternatively, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The outpatient facility
• General surgeon or urologist
• An anesthesiologist (if anesthesia was administered)

The patient is advised to inquire and confirm the type of billing, before the Vasectomy procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA