What is Vasectomy?

December 10, 2020 Mens Health 1173 Views

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What is the meaning of Vasectomy?

Vasectomy is a permanent type of male birth control in which the vas deferens or tubes that carry a man’s sperm are cut or sealed. After a vasectomy, there are no sperms in the semen, and hence the man is unable to make his partner pregnant. Therefore, the man opting for a vasectomy should be certain that he does not want any more children in the future. Although reversal of vasectomy is possible, the success rate of the procedure is quite low. Therefore, vasectomy should be considered as a permanent option. 

A vasectomy is a simple surgical procedure done under anesthesia, with very few risks, and is almost 99% effective. After a vasectomy, the patient is discharged from the hospital usually on the same day and is advised to rest for about two weeks. The patient is asked to come back to the clinic after 12 weeks for analysis of sperms in the semen.

Let us give you information about it in today’s article. 

  • Why is a Vasectomy done?  
  • Advantages and Disadvantages of Vasectomy
  • What preparations are needed before a Vasectomy?
  • How is a Vasectomy done? 
  • How to take care after a Vasectomy?
  • What are the causes of failure of Vasectomy?
  • What are the complications of Vasectomy?
  • What is the cost of Vasectomy in India? 

Why is a Vasectomy done?  

Vasectomy is a safe and effective procedure done for reasons such as:

  • It helps prevent pregnancy in those who do not wish to have a child or any more children in the future.
  • Either you or your partner suffers from a genetic disease that you do not want to transfer to your child.
  • Pregnancy would be harmful to your partner due to her existing health conditions. 
  • ( Know more about- What is High-Risk Pregnancy? )
  • You and your partner do not wish to use other temporary birth control methods every time before sex. ( Know more about- What is Condom? )
  • Vasectomy is a safe procedure with a low risk of complications and is cheaper than female sterilization procedures (Tubectomy).

A doctor may not recommend a vasectomy if-

Advantages and disadvantages of Vasectomy 

Advantages

  • It is a one-time method; hence there is no need for other methods of contraception.
  • Most effective protection against pregnancy (99% effective)
  • The risk of complications is small if the procedure is performed according to accepted medical standards.
  • More simple and cheaper procedure as compared to female sterilization.
  • Vasectomy does not affect your sexual drive.

Disadvantages

  • Although vasectomy can be reversed, the outcome is usually poor, and hence vasectomy should be considered as a permanent birth control option.
  • A contraceptive must be used for some time after surgery till azoospermia, i.e., the absence of sperms in the semen is achieved.
  • Few complications such as pain, infection, reconnections of the tubes (though very rare), etc., can be seen.

What preparations are needed before a Vasectomy?

  • Before vasectomy, your doctor will discuss the whole procedure, recovery, risk, and complications of the surgery and answer all your questions related to the procedure. The doctor will also explain that this is a permanent method of birth control, and it is not the correct option if one wants to have children in the future.

Though legally not required, it is best to talk to your partner about your choice of opting for vasectomy as this decision affects your ability to have children.

  • You will be asked to sign a consent form allowing the surgeon to perform the surgery.
  • If you are a smoker, your doctor will advise you to quit smoking before the surgery, as smoking can affect the recovery process.
  • Informing your doctor about all the medications you are on and if you have any allergies to latex, anesthesia, or other medications is extremely important. Certain medications, such as aspirin, ibuprofen, warfarin, etc., might need to be discontinued before the surgery.
  • Hair from the scrotum needs to be shaved off either in the morning or the night before the surgery. It is best to wash the scrotum and its surrounding area one day before as well as on the day of the surgery to prevent the risk of infections.
  • On the day of the surgery, your doctor will advise you to – 
    1. Wear loose and comfortable clothes
    2. Bring some assistance to drive you home after the surgery.
    3. Bring scrotal support or jockstrap to wear after the surgery so that the scrotum is protected.

How is a Vasectomy done?

The surgery takes about 30 minutes and is usually performed by a urologist (a doctor that specializes in diseases of the urinary tract and male reproductive system). To perform a vasectomy, your doctor is likely to take the following steps-

  • You will be asked to remove all jewelry or any other object on the body that can interfere with the surgery. You will also be asked to change into the hospital gown.
  • You will be asked to urinate before the surgery begins so that the bladder is empty.
  • During the surgery, you will be lying down on your back. If your scrotum has not been shaved, it will be shaved before the surgery and cleaned with an antiseptic.
  • The doctor will administer a local anesthetic to numb the scrotal area. ( Know more about- What is Circumcision surgery ? )

Vasectomy can be performed in two ways-

  1. A) Conventional Vasectomy/ Incision Vasectomy – 
    1. In this process, an incision is made by the surgeon on the upper part of the scrotum.
    2. The surgeon will locate vas deferens or tubes and cut a short section from the tube.
    3. Cut ends of the tube will be clipped, tied off, or closed with a tool that seals the cut (electrocautery).
    4. The incision will be closed using dissolvable stitches that disappear within a week.
  2. B) No-Scalpel Vasectomy-
    1. In this procedure, no incision is required. Instead, the surgeon will make a small puncture in the scrotum using a needle-like instrument.
    2. The surgeon will then locate the vas deferens or tubes and follow the same procedure of cutting and sealing as done in conventional vasectomy.
    3. No stitches are needed in this type of vasectomy. The hole made by the puncture needle will heal on its own. 
    4. This method is associated with less pain and fewer complications as compared to conventional vasectomy.

How to take care after a Vasectomy?

The patient can go home on the same day after the surgery. To ensure proper healing of the wound and success of the surgery, the doctor may give the following advice –

  • The patient should be informed that he is not sterile immediately after the operation, and at least 30 ejaculations may be necessary before the semen contains no sperms. Hence, a contraceptive must be used during this period until no sperms are present in the semen.
  • The patient must avoid taking a bath for at least 24 hours post-surgery.
  • The patient must wear T-bandage or scrotal support or tightly fitted underwear for 15 days after the surgery.
  • He must avoid strenuous physical activity such as cycling or lifting heavy weights for 15 days; there is, however, no need for complete bed rest, and he can resume normal work within 2-3 days.
  • It is common to experience some pain, swelling, and bruising over the scrotum after the surgery. Ice packs can help reduce swelling, and painkillers can reduce pain. It is also normal to have some blood in the semen during the initial few ejaculations post-surgery. 
  • Contact your doctor immediately in case of symptoms such as fever, chills, bleeding, lump in the scrotum, difficulty in micturition, pain that does not reduce even after taking medicines, and swelling that progressively increases.
  • Your doctor will call you 12 weeks after the surgery for a semen analysis to make sure no sperms are present in the semen. A vasectomy is 99% effective. 

What are the causes of the failure of Vasectomy?

The failure rate of vasectomy is generally very low. However, in the following conditions that might fail- 

  • The most common cause is due to mistaken identification of the vas deferens or tubes. In such a situation, instead of the vas deferens, some other structure such as a thrombosed vein or thickened lymphatic is cut. To avoid such a mistake, a histological confirmation has been recommended in all cases of vasectomy. 
  • In some cases, the failure might be due to recanalization or reconnection of the vas deferens. 
  • Rarely, there can be more than one vas deferens on each side that gets missed during surgery and hence does not get cut and sealed.
  • Pregnancy could also result from sexual intercourse immediately after the surgery before the absence of sperms in the semen.   

What are the complications after Vasectomy?

The very few complications that may arise include:

  1. Pain, scrotal hematoma that is the accumulation of blood inside the scrotum, and local infection. The administration of antibiotics can reduce the risk of these complications.
  2. Sperm granules, caused by the accumulation of sperms, are a common and troublesome local complication of vasectomy. They appear 10-14 days after the surgery, and the most common symptoms include pain and swelling. The sperm granules eventually subside after some time. It has been seen that using metal clips to close the vas deferens can help reduce this problem.
  3. Spontaneous recanalization or reconnection of the vas deferens. The incidence of this complication is about 0-6%, and its occurrence is serious. Therefore, the surgeon must explain the possibility of this complication to every patient before the surgery. The surgeon should take written consent from the patient acknowledging this fact. 
  4. Autoimmune response, i.e., development of antibodies against the person’s own sperms. Normally, 2% of fertile men have circulating antibodies against their own sperms, but this percentage is raised to almost 54% after vasectomy. However, there is no reason to believe that these antibodies are harmful to the physical health of the patient. 
  5. Psychological- Some men may complain of decreased sexual desire, impotence, fatigue, etc. Such psychological effects are seen in those men who have undergone vasectomy under pressure. That is why it is important to explain the basis of the surgery to every patient and give him enough time to make up his mind voluntarily.

What is the cost of Vasectomy in India?

The total cost of vasectomy surgery in India is around INR 40,000 to INR 50,000. Although, the cost may vary across different hospitals and different locations.

If you are coming from abroad apart from the cost of vasectomy, there will be an added cost of hotel stay, local travel and food expenses,etc. Also, the patient is asked to stay in the hospital for 1-2 days and in a hotel for a few days for better recovery. So, the total cost of vasectomy in India comes to be around INR 70,000 to INR 90,000. 

We hope we were able to answer your questions on Vasectomy through this article.

If you want more information and treatment of Vasectomy, contact a General Surgeon. 

We only aim to give you information through this article and do not recommend any treatment or medication. Only a doctor can give you the best advice and treatment plan. 


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