Vasectomy Consultation in

Vasectomy (or male sterilization) is a method of male birth control and family planning that involves a minor contraceptive surgery. In a vasectomy, the vas deferens, the small tube that carries sperm from the scrotum, is cut or blocked off. This way, sperm cannot leave the body through semen.

There are two methods of vasectomy: the incision method and the no-cut (no-scalpel) method. Vasectomies are permanent, and usually cannot be reversed. Vasectomies are method of birth control, but will not protect against sexually transmitted infections/ diseases (STDs).

Vasectomies are one of the most effective methods of birth control available. A vasectomy has nearly a 100% success rate in preventing pregnancy. The surgery is minor, and carries a low risk of complications or side effects. A vasectomy usually costs less than the female sterilization (tubal ligation) procedure for women, and carries less risk of complications. Most vasectomies are one-time costs, and as safe a form of birth control as there is. Concerns over sex-drive loss, permanent damage, and cancers are largely unfounded.

Vasectomies are permanent, though. Before getting one, you should be 100% sure that you do not wish to father any children in the future.

Vasectomies can be done one of two ways: the incision method or the no-scalpel method. These surgeries are usually performed in your urologist’s office and usually take about 30 minutes. Both procedures result in the cutting of the vas deferens, or the tubes that carry sperm from the scrotum to the semen.

Conventional Vasectomy

This method uses small cuts in the vas deferens to stop sperm from moving from the testicles to the urethra. Your urologist will first numb the scrotum with a local anesthetic. Then, 1 or 2 small cuts are made in the skin of the scrotum to reach the vas deferens. There are usually vas deferens tubes, one for each testicle. The doctor performing the vasectomy will cut the vas deferens tubes, leaving a small gap in the tube. This may be done with one cut or two. Next, the vas deferens is sealed with stitches or searing, to help the cut heal. In some cases, the cuts may be allowed to close on their own. Once the vas deferens have been cut, sperm can no longer reach semen, and is unable to be ejaculated from the body. Instead, the body absorbs the sperm, which is harmless.

No-Scalpel Vasectomy

A no-scalpel vasectomy requires more training and skill than the conventional method, but has been known to reduce risk of hematomas, bleeding, bruising, and pain. Again, a local anesthesia is used to reduce sensation and pain. The doctor performing the no-scalpel vasectomy feels for the vas tubes under the skin of the scrotum. A clamp is used to hold the vas in place. A small hole is made in the skin of the scrotum, and then is stretched out. The vas deferens are then gently lifted out of the scrotum, cut, tied, and placed back in the scrotum.

The conventional vasectomy uses small cuts in the scrotum to reach the vas, where the no-scalpel method uses a sharp, forceps-like tool to make a small puncture in the scrotum. Both ways are very minor, low-risk surgeries. The no-scalpel method leads to 5x fewer infections, and hematomas (blood clots that cause swelling). It is also the quicker, and less painful.

Risks and side-effects should always be discussed directly with your doctor. However, generally speaking, the biggest concern patients express about vasectomies has to do with their permanence. While almost all vasectomies can be reversed, there is always a risk that men who reverse vasectomies may still be unable to have children. Men should consider whether they may want to have children in the future before getting a vasectomy.

Vasectomies are considered very safe. Some discomfort and pain can be expected after the procedure, along with mild swelling and possible bleeding. If pain does not stop after 1-2 days, or if the scrotum has swollen dramatically, call your urologist right away. These may be signs of infection or damage. One 1-2 men in 100 experience pain after a vasectomy. This is usually treated with pain and anti-swelling medication (such as ibuprofen or Tylenol).

A small lump, or sperm granuloma may occur in the days after surgery. This is caused by sperm leaking from the cut end of the vas. These usually go away on their own, and only cause mild discomfort. Taking an anti-inflammatory drug can help with swelling and discomfort. Book a visit with your doctor to follow up if you're experiencing a granuloma.

It’s recommended that you abstain from sexual intercourse for several days after the procedure. This can cause pain and bleeding in some cases.

You may still be fertile for several weeks after receiving a vasectomy. Sperm can live in semen for up to six months, and so other forms of birth-control should be used until a sperm sample has been examined by your doctor. It can take anywhere from a few weeks to a few months for your semen to be cleared of sperm. The American Urological Association recommends that you ejaculate 15-20 times before having unprotected sex, to be sure that semen is cleared of sperm. Usually, after surgery, you’ll be asked to submit a semen sample to test the sperm count in your semen. Because a vasectomy blocks the release of sperm into semen, the body will instead absorb the sperm produced by the testes, which is harmless. Do not assume that your semen is free of sperm until verified by an examination. This can help protect against unplanned pregnancy.

There are a number of claims/ concerns about the risks of vasectomies that are unfounded or untrue. Among these are:

"Vasectomies affect sex-drive"

Vasectomies do not generally cause erectile disfunction, loss of sex drive, or affect the ability to ejaculate. The ejaculate produced from sexual intercourse or sexual activity is made up of semen without sperm. Because the vas deferens have been cut, sperm is unable to travel from the testes to semen, and is absorbed into the body, which is harmless.

"Vasectomies lead to certain cancers"

Per the Mayo Clinic, there’s no proven link between vasectomy and risk of prostate cancer or testicular cancer.

"Vasectomy is painful."

While there may be discomfort, bleeding, and mild pain after a vasectomy, there should be no severe or lingering pain from the surgery. Talk to your doctor if you have lasting pain from a vasectomy, as this may be a sign of infection. If you have a fever, it is also recommended that you call your doctor’s office, as this may also be a sign of infection.

After your operation, you may experience some discomfort, soreness, and slight swelling. These effects usually disappear in a few days. If pain, bleeding, or oozing from the wound continues after a few days, call your doctor. These may be signs of an infection or more serious complications.

Most vasectomy surgeries take about 30 minutes, with the patient able to leave the clinic after the operation. The Mayo Clinic recommends a few items for recovery:

• Bring a jockstrap to the clinic to use for support after surgery.
• Apply ice packs to the scrotum for a few days after surgery.
• Take anti-inflammatory painkillers such as ibuprofen, if recommended by your doctor.
• Avoid activity for at least 24 hours after surgery. Avoid heavy lifting or sports for a week or so.
• Avoid sexual activity for several days after surgery.

Vasectomy consultations are visits between you and the doctor to discuss your options and determine if getting a vasectomy is right for you. During your consult, you'll be asked a few basic questions about your medical history. Some providers may provide an informational booklet to help you understand the procedure and the impact of the surgery.

During your visit, you and your doctor can decide together whether a vasectomy is right for your needs.

Most doctors suggest that you think carefully about whether you want to have a vasectomy. Vasectomies can be reversed, in most cases, but reversal surgeries require further recovery and may not necessarily guarantee your ability to have children again.

Usually, yes. Most providers will require you to have a consultation before your surgery. This helps the doctor get a clear picture of your medical history, as well as helping to prep you for the surgery. The American Urological Association recommends that men receive a consult before the procedure, and most offices will require you to have one. Maybe most importantly, these consultations help you (the patient) determine whether or not you want to go through with the surgery.

Vasectomies are life-changing procedures that will prevent you from being able to father a child afterwards. This is a big decision, and consultations are provided so that you can ask any questions you may have, as well as talk with your doctor/surgeon about whether or not the procedure is right for you. Vasectomies can be reversed, but there is no guarantee that a reversal surgery will work 100% of the time.

Consultations are pre-op meetings between you and the doctor performing the surgery to talk about the procedure, and the effects of the procedure. Feel free to ask questions and voice any concerns you may have, as this helps both your and your doctor determine whether or not a vasectomy surgery is right for you.

A vasectomy reversal is a minimally invasive microsurgical procedure that undos the effects of a vasectomy and helps restore the presence of sperm in your semen.

Vasectomy reversals restore continuity between the vas deferens and the epididymis (the tubing that carries sperm from the testis to semen), allowing sperm to once again reach your semen for ejaculation.

These are complicated microsurgeries that require powerful surgical microscopes. A general anesthesia will be used to make the patient unconscious during the surgery.

Vasectomy reversals are generally performed one of two ways:

Vasovasostomy: The surgeon undoes a blockage made by sutures or searing and sews back together the severed vas deferens tubes that carry sperm from the testis. A small incision is made in the scrotum so that the surgeon can view the vas deferens with an operating microscope. This is the most common vasectomy reversal surgery, and the easier procedure to perform. Vasovasostomy surgeries are performed as outpatient procedures, meaning that the patient can leave the clinic the same day as long as no severe side effects are seen.

Vasoepididymostomy: This is a more complicated procedure. If there is more blockage, or if a vasovasostomy is unlikely to succeed, the vas deferens may need to be connected directly to the epididymis (the organ on the back of each testicle that holds sperm). Just like the vasovasostomy, a small cut is made in the scrotum, but the vas deferens tubules are connected directly to the epididymis, instead of sewn back together. This type of surgery can increase the success rate of the vasectomy reversal in men who received the original vasectomy several years ago.

Vasectomy reversals are usually performed as outpatient procedures. The procedures usually take around 3-4 hours, depending on the procedure needed to repair and reattach the ends of the vas deferens. If local anesthesia is used, the patient may not need much time to recover at the clinic. If a general anesthesia is used to make the patient unconscious, more time may be needed after the surgery to check for side effects.

Vasectomy reversals are generally successful. If a vasectomy reversal is performed within 10 years of the original vasectomy, success rates range between 50-90%. According to the Cleveland Clinic, successful reversals performed within that 10 year window result in over 50% pregnancy rates in female partners. These rates drop, however, if the vasectomy reversal is performed after that 10 year mark of the original vasectomy. Pregnancy rates drop to the 30% range when the vasectomy reversal procedure is done later than 10 years after the first procedure.

Vasectomy reversals can be an effective way of restoring patency in the vas deferens and regaining sperm motility. However, if there is blockage or scarring from the original vasectomy procedure, or if sperm buildup has caused a rupture in the vas, a vasectomy reversal may not work. Additionally, if there is an underlying issue with a testicle, a vasectomy reversal may not be successful.

A follow up semen analysis is usually scheduled 6 weeks after the vasectomy reversal procedure so that the doctor can see that there are sperm present in the semen, and perform a sperm count.

If you are unable to father a child after a vasectomy reversal, you may consider in vitro fertilization (ivf) or sperm retrieval procedures. These procedures are usually not as effective as a vasectomy reversal, but have resulted in successful pregnancies.

Vasectomy reversal surgery (vasoepididymostomy or epididymovasostomy) is an outpatient procedure that reconnects the vas deferens (the tubes that carries sperm from the testicle to semen). Vasectomies (vasovasostomy) are often meant as a birth control procedures that basically create male infertility. Original vasectomy procedures consist of snipping the vas deferens to stop sperm from reaching semen in ejaculate. The success rate of vasectomy reversal procedures is high, with pregnancy rates in female partners after the surgery ranging from about 30-90%, according to the Mayo Clinic.

Success rates may vary based upon the time between the original vasectomy procedure, and the vasectomy reversal procedure. According to the Cleveland Clinic: "Success rates can be as high as 95 percent if the vasectomy was done within the last 10 years. They start to decline when a man has had his vasectomy 15 years ago." The age of a female partner and sperm health can also contribute to variance in the success rates of vasectomy reversal procedures.

Not really! There are few, if any, negative side effects after the procedure is performed.

It is normal to experience mild pain and swelling after the procedure, and doctors recommended that you apply ice packs to the the bandaged area for a day or two after the procedure to reduce any discomfort. You also may want to take over-the-counter pain medication to help with swelling and soreness following the procedure. It is recommended that you abstain from vigorous activity, such as exercise or heavy lifting for several days after the procedure. Ejaculation and sexual intercourse are strongly discouraged until cleared by your doctor.

In some cases, a vasectomy reversal may cause a hematoma (accumulation of blood in the scrotum). This can cause pain and swelling. In most cases, the pain and swelling will go down after a week or so. If you continue to experience pain and swelling related to a scrotal hematoma, contact your doctor right away.

Vasectomy reversals are most commonly done as outpatient procedures at an urology clinic or hospital. You may want to speak to your doctor or primary care physician to get a referral for a surgeon who can perform a vasectomy reversal.

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