Vasectomy and Vasectomy Reversal

Vasectomy is a minor surgical procedure that cuts and closes off the vas deferens, the tubes that deliver sperm from the testes. The procedure is usually performed as a means of contraception and is less invasive than a tubal ligation, which prevents a woman's eggs from reaching the uterus. Vasectomy has few complication, causes no change in sexual function, and is fairly easily reversed, making it the birth control method of choice for many couples, with about 500,000 U.S. men electing to have the operation very year.

How does the male reproductive system work?
The testicles, or testes, are the sperm — and testosterone — producing organs located in a sac, or scrotum, at the base of the penis. Each testicle is connected to the epididymis, the small, coiled tube where sperm are stored. The epididymes are connected to the prostate gland by the vas deferens, which are part of a bundle of tissue, blood vessels, nerves, and lymphatic channels called the spermatic cord. During ejaculation, seminal fluid produced by the prostate gland mixes with sperm from the testes to form semen, which is ejaculated from the penis.

What can I expect?
Vasectomies take about 30 minutes and are usually performed on an outpatient basis, most frequently right in the urologist's office. The doctor numbs the scrotum with one or more injections of local anesthetic, and then makes a small incision and pulls the vas deferens, the tube that delivers sperm from the testes, through the incision, cuts it in two places, and removes a one-centimeter segment. He/she then surgically ties off or clips the ends, places the tube back in the scrotum and sutures the incision, repeating the procedure on the other side of the scrotum. Once the incisions are dressed, the patient can go home.

Are there any alternatives to vasectomy?
No-scalpel or minimally-invasive vasectomies - A no-scalpel vasectomy is just what the name suggests: a puncture (instead of a cut) is made with special forceps, which are then opened to stretch the skin, making a small hole through which the vas deferens is lifted out, cut, sutured or cauterized, and put back in place. The puncture does not require suturing, making the procedure faster and minimizing postoperative discomfort as well as the risk of bleeding or infection.

How should I prepare?
Here's what you should do the day of your vasectomy:
  • Shave and wash your scrotum to prevent infection and allow for easier access.
  • Wear tight-fitting underwear or an athletic supporter to support the scrotum and minimize swelling.
  •  Arrange for a ride home — driving and movement in general can cause pain and swelling.
  • Avoid taking any anti-inflammatory drugs, such as ibuprofen and aspirin, before surgery as they thin the blood and can cause excessive bleeding.
  • Plan to rest and limit movement for one to three days after your vasectomy to help reduce swelling and to allow the vas deferens to heal.
Vasectomy Reversal
A Vasectomy reversal is a microsurgical procedure in which the inside and outside of the vas deferens are reattached with ultra-fine sutures. Most reversals are done on an outpatient basis.

Since vasectomy does not significantly alter a man's ability to produce sperm, an alternative to reversal is sperm aspiration, during which sperm is collected through a needle inserted into the testicle for use in alternative insemination methods.