What is a vasectomy (male sterilisation)?

A vasectomy (male sterilization) is a form of contraception that involves surgically cutting or blocking the tubes that transport sperm from the testicles to the penis.

When men undergo a vasectomy their sperm can no longer reach the semen, as a result any semen that is ejaculated during sex does not contain sperm - which is needed to fertilize a woman's egg.
A vasectomy is a very effective and permanent means of preventing pregnancy. It is estimated that only one out of every 2,000 men who receive a vasectomy will impregnate a woman during their lives.

Most vasectomies are only take up to 30 minutes to perform. Because the procedure is minimally invasive most men do not experience significant pain.

Before a vasectomy it is important to consider the consequences and fully understand that after the procedure it is nearly impossible to father any children. According to the National Institutes of Health¹ "Vasectomy can sometimes be reversed, but not always".

You can have a vasectomy at any age. Young adults should consider carefully whether they may want to have children when they are older.

Types of vasectomy

In this diagram the letter F shows where
the van deferens is located.

 

There are two different ways that a vasectomy can be carried out: a conventional vasectomy and a no-scalpel vasectomy. It is best to talk with your doctor and determine which type of vasectomy is best for you.

Firstly, a local anesthetic is applied to numb the scrotum and testicles so that no pain is felt during the procedure. In most cases, the patient is awake during the operation. Only some cases involve using a general anesthetic.

• Conventional vasectomy - this method involves making two small cuts on both sides of the scrotum. These cuts allow the surgeon to go in and break off a section of the tubes that transport sperm, called the vas deferens. The vas deferens are then sealed or tied and the cuts are stitched up.

No-scalpel vasectomy - a small clamp holds the vas deferens in place and then a small hole is pierced into the skin of the scrotum and the hole is opened up to allow the surgeon to similarly cut a piece out of the vas deferens and then seal it up. This procedure is becoming increasingly more common, because of fewer complications compared to the conventional technique.

According to an article in the Indian Journal of Surgery², no scalpel vasectomy is "easily performed as camp procedure in a simple medical setup. Doctors can be effectively trained hands on during the camp procedure."

Outlook

Swelling and mild discomfort will only last for a couple days after the procedure.
It is fairly common for there to be blood in the semen for the first few ejaculations after the surgery. About a week after the surgery patients can begin to have sexual intercourse again - although the sperm count will initially be above zero.

Bearing that in mind, it is highly recommended that men use an additional method of birth control during the first few months after a vasectomy to prevent pregnancy.

After two clear semen tests, it is generally safe to have intercourse without having to use secondary contraception.

However, a vasectomy does not protect against sexually transmitted infections (STIs), so men are encouraged to use condoms with new sexual partners to avoid contracting anything.

Pros and cons of a vasectomy

Pros:

• No effect on sex drive
• No interference with sex
• Rare long term health effects
• Very low failure rate

Cons:

• No protection against STIs
• Reversal difficulties
• Complications and risks

Vasectomy reversal

A vasectomy reversal is call a vasovasostomy.
However, the success rate of a vasectomy reversal is only around 55% if performed within 10 years and 25% if carried out after 10 years.
A pioneering robotic assisted vasectomy reversal using the da Vinci surgical robot is considered to be better than traditional surgery³ in that it may yield more successful outcomes and reduce couples' wait times for conceiving naturally, according to doctors at Northwestern Memorial Hospital.

William Lin, MD, a Northwestern urological surgeon specializing in microsurgery, said:
"Many people think getting a vasectomy reversed is just like turning on a faucet that was off. But it's not that simple. Reversal is a very delicate procedure that requires ultra precision for it to be successful."

Risks associated with a vasectomy

Swelling and bruising around the scrotum is very common after the operation and the soreness will linger for days after the operation.
Other risks include:

• Sperm granulomas - this occurs when sperm starts to leak out of the vas deferens and accumulates in the surrounding tissue, developing into lumps. These lumps are usually relatively small, but they can cause severe irritation and may require surgery.
• Infection - there is a risk of contracting an infection following a vasectomy when bacteria enter the incisions on the scrotum. It is imperative to keep that area of the body as clean as possible until it begins to heal fully.
• Testicular pain - it is common for men to experience testicular pain after the surgery. The pain can occur straight after surgery or a few weeks later, and can last for a while. If the pain persists, it may be due to a pinched nerve which will require further surgery.
• Fertility - although extremely rare, the van deferens can reconnect again, meaning that sperm can travel to the semen again.

In addition, researchers at Northwestern University found that men with a rare form of dementia have a higher rate of vasectomy than men of the same age who are cognitively normal, suggesting that vasectomy might put men at risk for a certain type of dementia.

However, the lead author of the study said: "I don't want to scare anyone away from getting a vasectomy. It's obviously a major birth control alternative. This is just a correlational observation.We need to do more research to find out."http://www.youtube.com