Male fertility comes from sperm, a very small component of the semen ejaculated during intercourse. Sperm are made in the testicles. Sperm travel through tubes called vas deferens and eventually are combined with the fluid made by the prostate gland and seminal vesicles. It takes many weeks for sperm to mature, and then they are either ejaculated or die and are quickly reabsorbed by the body.
A vasectomy, in essence, creates a roadblock for sperm in the vas deferens. Sperm are still made but live their short lives in the vas deferens, where they die and are reabsorbed. Because they make up such a small amount of what is in semen, men shouldn’t notice any difference with ejaculation. Two semen tests completely absent of sperm typically indicate that the vasectomy is successful.
A preoperative consultation is the first step. During this visit, a health history is taken, family planning counseling is done, a quick exam is done, and if appropriate, pre- and postoperative instructions are reviewed in preparation for the procedure. Because this procedure doesn’t utilize general anesthetics (which makes it safer), we do provide a mild sedative, if needed, to decrease any anxiety before the procedure. Because of sedation from this medication, another driver is needed the day of the procedure. A local anesthetic is used to prevent any discomfort.
The entire appointment takes about 60 minutes, and most of that time is prepping for the procedure. The actual surgery typically takes about 30 minutes, and you can go home immediately after the procedure. Just like other procedures, there have been advances in vasectomies. Almost all vasectomies with us can utilize a minimally-invasive approach with a single point of entry into the skin and no stitches in the skin.
Anesthetic can last for a few hours after the procedure. Pain or discomfort that may appear after the anesthetic wears off is usually mild and is manageable with over the counter anti-inflammatories or a mild pain medication, if needed. Ice packs and resting for the next couple of days is recommended. While heavy lifting should be avoided for a week, those whose work is not strenuous can return after one or two days.
A patient may resume intercourse after one week, but other methods of birth control are necessary until his sperm count is verified as zero. Semen samples are collected at home and brought in for evaluation roughly 10-12 weeks out from the procedure.