If you are considering having a vasectomy, you are not alone. Vasectomy is one of the safest and most effective methods of permanent birth control, chosen by up to 500,000 men in North America each year. It is much safer and less expensive than the other most common contraceptive surgery, tubal ligation. A conventional vasectomy transects, or blocks, the vas deferens, which is the main conduit for sperm to travel from the testicle. With this technique, sperm cannot be added to the semen when a man ejaculates.
No-Scalpel No-Needle Vasectomy
Dr. Kaufman now offers the much desired no-scalpel, no-needle vasectomy for all patients undergoing a vasectomy in his office. The no-needle method of anesthesia eliminates the need for an invasive injection. The anesthetic is delivered directly through the skin via a powerful spray which results in quicker, more effective anesthesia with less trauma and discomfort.
A safer, less invasive procedure, the no-scalpel vasectomy (NSV) reduces vasectomy's already low complication rate. Developed in China in 1974, it differs from conventional vasectomy in how anesthesia is given and in how the two vas deferens (vasa) are reached. Worldwide, more than 15 million men have had the procedure. Benefits of NSV:
No-scalpel vasectomy uses an advanced technique to anesthetize the scrotum more effectively. It requires no scalpel. Instead, the physician avoids complex surgery by carefully isolating the vas deferens using the fingers of one hand. The vasa are then fixed just below the scrotal skin with an instrument designed to hold firmly without pinching. A single small opening in the skin is made with pointed forceps. The vasa are then delivered through the skin, cut, and sealed in a conventional way. When the operation is complete, no sutures are needed to close the tiny opening.
WHAT TO EXPECT
After the procedure, it is normal to be sore for a period of 24-48 hours. Refrain from any strenuous or sexual activity for a period of 5 days. At that point, you should be fine to resume normal activity, however if you find that you are still uncomfortable, simply limit your activity. A mild amount of bruising or swelling may occur. After the vasectomy, there are still sperm present within the ejaculate. A minimum of 12-15 ejaculates are required over a six-week period, at which point we will ask you to bring in a semen sample to evaluate for any residual sperm. Once you have two documented semen samples without any sperm present, you are free to discontinue birth control, but not before that. It can take, on rare occasions, up to four to six months for all sperm to clear from the ejaculate.
Common Questions About Vasectomy
Q: What should I expect after my vasectomy?
Answer: It is common to have some level of discomfort for 1-2 days after the procedure. Most men return to work by the third day following their vasectomy. Outside of the supplied anti-inflammatories, the majority of Dr. Kaufman’s patients do not require additional pain pills. A small amount of light bleeding is common and generally subsides with 2-3 days. On very rare occasions (< 1%), additional bleeding occurs which can develop into a blood clot or hematoma within the scrotum, which ultimately is reabsorbed over time. Very rarely an additional procedure may be required to drain the hematoma.
Patients should refrain from any physical activity or strenuous exercise for a period of 5 days, and sexual intercourse should be avoided for 7 days.
Q: Can I discontinue other birth control methods right away?
Answer: No! Sperm can remain in the vas deferens above the operative site for weeks or even months after vasectomy. You will not be considered sterile until two post-surgical semen tests have shown that no sperm remain. Until then, you must continue to use other birth control to prevent pregnancy. Dr. Kaufman requires that the two samples are examined no sooner than 8-10 weeks following the procedure, and recommends a minimum of 10-12 ejaculates in that time period.
Q: How will vasectomy affect me?
Answer: Vasectomy only interrupts the tubes that carry sperm from the testes to where they are added to your semen. Your penis and testes are not altered. All hormonal and sexual functions are completely unaffected, so your voice, body hair, and interest in sex remain the same. Your body still produces semen, and erections and ejaculations occur normally. The only difference is that your semen will no longer contain sperm. As before, the body naturally absorbs unused sperm.
Q: Can the vasectomy fail?
Answer: Vasectomy is not guaranteed to be 100% effective in preventing pregnancy. On rare occasions, it is possible for sperm to find its way across the void between the two blocked ends of the vas deferens, even when the procedure is performed correctly. The published rate of “recanalization” is about 1 in every 600 vasectomies, though in practice it probably occurs even less than this. This generally occurs within the first few months of the procedure and is even more reason why it is important to have your semen checked after your vasectomy.
Q: Is vasectomy painful?
Answer: No. You may feel mild discomfort when the local anesthetic is given. After it takes effect, you should feel no pain, though some men feel a slight "tugging" sensation as the vasa are manipulated. After surgery you may be a little sore for a few days. Generally, two to three day's rest is recovery enough before men return to work and most normal, nonstrenous physical activity. Sex can usually be resumed 7 days after the procedure.
Q: Does vasectomy pose long-term health risks?
Answer: Many studies have looked at the long-term effects of vasectomy, and the conclusions are clear. A vasectomy does not have any long-term health risks, and men who undergo a vasectomy are not at any higher risk of prostate cancer, heart disease or other health problems.
In 1993, a panel assembled by the National Institutes of Health, the Association for Voluntary Surgical Contraception, and the National Cancer Institute reaffirmed the conclusion of most medical experts that vasectomy is a safe and effective means of permanent birth control.
Q: Can vasectomy be reversed?
Answer: In many cases, the cut ends of the vas deferens can be surgically reattached. However, this operation, a vasovasostomy, is expensive and, for a variety of reasons, does not guarantee a return to fertility. Vasectomy should therefore be considered a permanent procedure. Before you choose to have a vasectomy, make quite sure that you and your partner do not want any more children. If you're thinking about a reversal now, perhaps you should take more time to decide whether vasectomy is right for you.
Consultation Please contact Dr. Kaufman to schedule a personalized consultation, at which time he will go over this information in more detail, and provide a personalized consultation for you. At that time, you can go ahead and schedule the procedure, and you will be asked to sign a consent form ensuring you understand the risks, benefits and alternatives of a vasectomy.
Prior to signing this form, be sure that you are informed and comfortable with your decision. It is important that you fully discuss and resolve any lingering questions or concerns you may have.
Preparing For Your Vasectomy