Sterilization surgery - male

Alternative names
Vasectomy

Definition
A vasectomy is a surgery to “tie the tubes” (vas deferens) of a man, which causes permanent sterility by preventing transport of sperm out of the testes.

Description

Vasectomy is usually done in the surgeon’s office while the patient is awake, but pain-free under local anesthesia. A small incision is made in the upper part of the scrotum. The tubes (vas deferens) are tied off and cut apart. The skin incision is stitched closed. The patient is able to return home as soon as the procedure is completed. The patient may return to work the next day if the job is not physically strenuous. Full physical activity may be resumed in 3-7 days.

This surgery does not affect the man’s ability to achieve orgasm, ejaculate, or achieve erections (potency). There will still be a fluid ejaculate, but there will be no sperm in this fluid, so the man cannot impregnate his partner.

Indications
Vasectomy may be recommended for adult men who are certain that they wish to prevent future pregnancies (permanent sterilization). Vasectomy is not recommended as a temporary or reversible procedure.

RISKS

Some swelling and bruising of the scrotum is common. There is no serious risk to vasectomy. The post-operative semen specimen examination ensures that all sperm have disappeared from the semen and that both tubes (vasa) were divided.

For those who change their mind, vasectomy reversal is available. However, this is a much more involved operation, requiring microsurgical techniques. The results vary, depending on the location of the vasectomy site along the vas deferens and the experience of the surgeon.

Expectations after surgery
Most men recover quickly with no problems.

The sperm count gradually decreases after vasectomy. At 4 to 6 weeks, sperm are no longer present in the semen. A semen specimen must be examined and found to be totally free of sperm a month or more after vasectomy before the patient can rely on the vasectomy for birth control.

Continued use of contraception is recommended until 2 to 3 sperm count tests are negative, indicating that the patient is sterile.

Convalescence
Wearing a scrotal supporter is recommended for 3 to 4 days after the procedure. An ice pack may be used to prevent or reduce swelling. Oral pain medications can usually easily manage the minor pain. Most men return to work within 2 to 3 days. Sexual intercourse can be resumed as soon as the patient feels ready (about a week after the surgery).

Johns Hopkins patient information

Last revised: December 2, 2012
by Arthur A. Poghosian, M.D.

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