Vasectomy

What is a vasectomy?

A vasectomy usually lasts less than 25 minutes and is performed in the Men’s Clinic procedure room. The procedure cuts and closes off the tubes (vas deferens) that deliver sperm from the testes and serves as a permanent form of birth control.  It does not change a man’s orgasm or how much fluid comes out when he ejaculates.

The testes produce sperm which mature in the epididymis, a small coiled tube connected to each testicle. The epididymes are connected to the prostate gland by the vas deferens. The semen produced during ejaculation is created from the seminal fluid in the prostate gland mixing with sperm from the testes.

How is a vasectomy performed?

Vasectomies can be performed two different ways. Traditionally, men remain clothed from the waist up and lie on their back as the scrotum is numbed with one or more injections of local anesthetic. Then, the vas deferens is gathered under one side of the skin of the scrotum as a urologist makes a small incision to pull the tubes through the incision, cut them in two places and remove a small segment. Each end of the vas deferens is then surgically tied off or clipped and placed back in the scrotum before the incision is sutured and the procedure is repeated on the other vas deferens.

In a no-scalpel vasectomy, a puncture incision is made in the vas deferens with special forceps instead of an incision. These forceps stretch the skin to make a small hole through which the vas deferens is removed, cut, sutured or cauterized and then put back into place. The advantages of this procedure include quicker operating time, minimal postoperative pain and potentially decreased risk of bleeding and infection.

Prior to a vasectomy, patients may be asked to make the following preparations:

• Wash the scrotum to prevent infection.
• Bring a pair of tight fitting underwear or athletic support to the procedure to support the scrotum and minimize swelling.
• Arrange for transportation home to prevent extraneous movement.
• Avoid anti-inflammatory drugs such as aspirin and ibuprofen that thin the blood and can cause excessive bleeding a week prior to the procedure.

Following a vasectomy, patients will have limited mobility and be advised to rest for 1 to 3 days to reduce swelling and allow the vas deferens to heal. Patients may experience discomfort for a week after the procedure and may be prescribed anti-inflammatory drugs or painkillers for pain.

Semen samples are usually checked at six and 12 weeks. If no sperm are observed on two consecutive samples, unprotected intercourse is okay. Until then, contraception should be used. Vasectomies are almost 100 percent effective. The procedure is also associated with fewer complications than female tubal ligation (tubes tied). Complications from a vasectomy procedure are rare but may include discomfort that persists longer than expected, pain, bleeding or inflammation. In rare cases, sperm may be present in semen for a year following surgery, indicating that the ends of the vas deferens have reattached or that sperm had difficulty migrating out of the vas deferens following surgery. Patients who experience this may be advised to have a repeat vasectomy. Sperm granuloma is also a potential complication of vasectomy procedures. This condition occurs when residual sperm move out of the tied ends of the vas deferens, causing irritation and the growth of a small nodule.  Usually, these complications do not require additional treatment.

Board-certified urologists staff The Men’s Clinic at UCLA and you can be assured you are getting an experienced physician performing your procedure in a relaxed and comfortable environment. For more information and to schedule an appointment, please call the UCLA Urology Appointment line at 310-794-7700.