Vasectomy Procedure

Vasectomy is a safe and effective procedure performed to prevent pregnancy, but it does not provide protection against sexually transmitted diseases.

Types:
A vasectomy procedure can be of two types, based on the method used to perform it:

1. Conventional method: This method involves making two small cuts or incisions in the scrotum to get access to the vas deferens. A small portion of the vas deferens is then removed by cutting it down. The ends are then sealed by cauterization (use of heat) or the end is tied using stitches. Skin glue or a few stitches are then given in the scrotal area to close the incisions.
2. No-scalpel method: This method involves making a small puncture hole on one side of the scrotum to find the vas deferens and pull it out of the hole. After pulling it out, a small part of the vas deferens is cut and removed. The end is then pulled back into its original place by cauterization or tying it off.

Contra-indications:
A man cannot undergo vasectomy in the following situations:

• Skin infection in the scrotum
• Hernia in the groin region (vasectomy can be performed only after treating the hernia)
• Undescended testes on each side
• Inflammation or swelling of the tip of the penis at the time of the surgery 

Advantages:

A vasectomy procedure has the following advantages:

• More than 99% efficacy in the prevention of pregnancy
• Is permanent 
• Is an outpatient procedure (the patient is discharged on the same day of the procedure)
• No long-term effects on health
• Does not affect the sex drive, or levels of hormones, or cause interference with sex
• Safer and simpler alternative to sterilization of the female
• Less expensive than the cost of female sterilization, known as tubal ligation, or the long-term cost of using birth control medicines for women 
• No need to take birth control steps before having sex, such as putting on a condom

Symptoms

A man can undergo vasectomy in the following situations:

• If a man does not wish to have children in future
• If a man is in a physical relationship with a woman having health problems, making pregnancy unsafe for the woman
• If the man and woman both have genetic disorders which they do not want to pass on to their children
• If the couple is not interested in using other measures of birth control 

Diagnosis

1. Physical examination: The doctor will examine the physical health status of the patient. The patient’s medical and sexual history are noted. The patient will be explained about the procedure in detail and only after the patient is sure about not having children in the future, the procedure is planned.
2. Semen analysis: The doctor will check the sperm count of the patient before and after the procedure.
3. Blood tests: These are routine tests performed before any surgery to check for the various blood parameters and diagnose any underlying medical condition that may be present.
4. Chest x-ray: This is also a routine test performed before surgery to check the condition of the heart and lungs.

Treatment

• The procedure is done under local anesthesia, that is, the surgical area is numbed by injecting anesthesia into the skin of the scrotum using a thin needle.
• The doctor either makes a small incision in the upper part of the scrotum (conventional method) or makes a small puncture in the scrotum (no-scalpel method).
• The vas deferens are then located.
• A part of the vas deferens is withdrawn.
• A part of the vas deferens where it has been pulled out of the scrotum is cut by the surgeon.
• The vas deferens is sealed by tying it, using heat (cauterization), surgical clips, or a combination of these methods.
• The ends of the vas deferens are then returned to the scrotum.
• The incision is closed using stitches or surgical glue. Sometimes, the wound may be left to close on its own over some time.

Risks

A vasectomy procedure may be associated with the following side effects:

1. Blood clot formation or bleeding inside the scrotum
2. Blood in semen
3. Bruising of the scrotum
4. Infection
5. Swelling
6. Mild pain or discomfort

The delayed complications of vasectomy include:

• Chronic (long-term) pain
• Buildup of fluid in the testicle, leading to a dull ache that becomes worse with ejaculation
• Inflammation due to leaking sperm (granuloma)
• Spermatocele (abnormal cyst) formation in the epididymis (small, coiled tube present on the upper testicle that helps in the collection and transportation of the sperms)
• Hydrocele (fluid-filled sac) formation surrounding a testicle, leading to swelling in the scrotum
• Failure of the procedure causing a pregnancy (rare)

After Procedure

• You will usually be discharged on the same day of the surgery.
• It takes one to two days to return to your daily routine.
• It is normal to have some pain and swelling for a few days after the surgery.
• You will ejaculate semen after vasectomy, but the semen will no longer contain any sperm.
• You need to wait for many months or longer to clear any sperm that may still be remaining in your semen.
• A follow-up semen analysis is recommended six to twelve weeks after the surgery to confirm that there are no sperms present in the semen.

Home remedies:

• Ice packs can be applied to the scrotum area to relieve discomfort.
• Change your dressing if it is soiled or stained.
• Avoid sexual activity for one week after the surgery.
• Avoid heavy lifting for at least a week after the surgery.
• You may take a bath from the day of the surgery itself.
• Lie on your back for the whole day after the surgery.
• A jockstrap or tight-fitting underwear worn for a minimum of 48 hours helps in providing protection and support to the scrotal area and also helps you in feeling comfortable.

Cost of Vasectomy in India-

The cost of a vasectomy in Mumbai is between INR 90,000 to INR 1,25,000.
The cost of a vasectomy in Delhi is between INR 85,000 to INR 1,15,000.
The cost of a vasectomy in Bangalore is between INR 85,000 to INR 1,15,000.
The cost of a vasectomy in Chennai is between INR 80,000 to INR 1,05,000.