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Vasectomy

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Vasectomy

Definition
Vasectomy is an operation designed to tie off both of the tubes, known as vas deferens, that carry sperm. It causes permanent infertility, or inability to father children, in males.

Who is a candidate for the procedure?
Vasectomy is an effective form of sterilisation for males. It can be offered to any man who wishes to be sterilised, with the understanding that it is intended to be complete and irreversible. The procedure can be reversed, but reversal does not always work, and it is an expensive and difficult operation.

How is the procedure performed?
Vasectomy is performed with local anaesthesia in the doctor's office. A urologist or general surgeon or experienced procedurist general practitioner does the procedure in most cases. A urologist is a doctor that specialises in treating conditions of the male reproductive and urinary systems. Numbing medication is injected under the skin of the scrotum just above the testicle on both sides. The procedure is usually done through a small incision in the scrotum. A "no-scalpel" vasectomy uses just a small puncture in the scrotum. The male tubes that carry sperm are identified. The tubes are then cut or interrupted by various methods. This may or may not involve removing a section of the tubes.

What happens right after the procedure?
The man will wait in the doctor's office for a short time to make sure there are no immediate negative effects. Men can then go home. Mild pain and swelling in the scrotum are common, but usually quite mild. Over-the-counter pain relievers and ice packs can help with discomfort if present.

What happens later at home?
The wounds need little extra care, and can be kept clean with soap and water. Activity should be limited for a week or two to reduce the chance of bleeding. Within a few weeks, men can generally return to all normal activities. Because there are still sperm in the vas deferens, it is important to continue to use birth control measures, such as condoms. Semen samples will be obtained at follow up visits until the sperm count is noted to be zero by the laboratory. The sperm still in the tubes can be ejected during sexual intercourse. This may result in pregnancy for several weeks, or even months, after the operation. Once the sperm count in the semen is zero, sterilisation is complete and birth control measures are no longer needed.

This procedure can often be reversed, but reversal is not always successful. Men need to keep this in mind before choosing this form of birth control.

What are the potential complications after the procedure?
In rare cases, there can be infection or a haematoma, which is a collection of blood, in the area near where the surgery was performed. Sometimes a lump (sperm granuloma) may develop where the vas deferens is divided and tied.

Author: Stuart Wolf, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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