Vasectomy Handout What is a vasectomy? A vasectomy is an operation that is designed to render a man permanently sterile. This means he is unable to impregnate a woman. It involves cutting the vas deferens on each side so that sperm can no longer get into the semen. Sperm are made in the testicles. The sperm from each testicle normally travel through a tube called the vas deferens, and mix with seminal fluid (which is made by the seminal vesicles) and prostate fluid (which is made by the prostate gland). Seminal fluid makes up 99% of the semen, which is the fluid seen during ejaculation. Eliminating sperm from the seminal fluid does not change the appearance of the ejaculate. How is a vasectomy done? A vasectomy is usually done in the doctor's office. The operation takes about 20 minutes. You will be awake during the procedure. Your doctor will give you a prescription for a mild sedative prior to the procedure as well as a local anesthetic at the time of the procedure to numb your scrotum (the sac of skin that holds your testicles) and the area around the vas deferens. After you are numb, your doctor will make a small opening in the middle of your scrotum and pull out a loop of one of the vas deferens. You may feel some tugging and pulling. A very small section of the vas deferens is tied off and removed. The end of the vas deferens, where the section has been removed, will then be sealed shut by searing it with heat. The procedure is then repeated on the other side. The opening is small and generally closes well by itself. Stitches are usually not necessary. You may experience a small amount of drainage. How effective is vasectomy in preventing pregnancy? Vasectomy may be the safest, most effective kind of birth control. Only about 15 out of 10,000 couples get pregnant the first year after a vasectomy. This is a better result than any cther type of birth control besides not having sex. Are there any reasons why I shouldn't have a vasectomy? Don't have a vasectomy unless you are sure you don't want to have children in the future. Your doctor will probably talk to you to make sure you understand this. Other reasons you may need to wait to have a vasectomy or may not be able to have one include having an infection on or around your genitals or having a bleeding disorder. Some vasectomies can be reversed, but the surgery is expensive and must be performed in hospital with microsurgery. Even though many men can ejaculate sperm after the reversal surgery, the sperm are often not able to fertilize an egg. The likelihood of pregnancy after reversal is low, and declines the longer you wait to have the vasectomy reversed. How can I prepare for the operation? Clip the hair in front of the scrotum with a scissors. Shower before coming into the clinic. Wash well with soap and water. Bring an athletic supporter (jock strap) to the clinic with you. Take your sedative one hour prior to the procedure. Have someone drive you to and from the office. What can I expect after the operation? Right after the operation, your doctor will have you relax for the day with an ice pack placed on your scrotum several times throughout the day. You may have some bruising in the area of the surgery. The bruises should slowly lighten and be gone in about two weeks. You should feel back to normal within a couple of weeks. To speed healing, follow the tips provided under, "When can I go back to work?". Is it okay to take medicine? Try acetaminophen (Datril, Panadol, Tylenol) first to relieve pain. Aspirin, ibuprofen (Advil, Medipren, Motrin, Nuprin) or naproxen (Aleve) can thin your blood and cause bleeding.. These medications should be used with caution. Call your doctor if your pain cannot be controlled with the above medications. When can I go back to work? If you have a desk job, expect to return to work after a couple of days. If you do physical labor, or walk or drive a lot, talk with your doctor about when you can go back to work. Will the vasectomy work right away? No. You will need to ejaculate as many as 15 to 20 times before the sperm will be cleared from both the vas deferens. For that reason, keep using some form of birth control. Your doctor will ask you to bring in samples of your semen after at least 15 ejaculations. Only after you have sperm free samples will you be considered sterile. This may take some time. What are the risks of a vasectomy? Bleeding, including a blood clot (hematoma) -9/10,000 Infection -9/1,000 Sperm granulomata (a mild, painless, permanent inflammatory type of reaction to sperm) -1% Psychogenic erectile dysfunction - 1% Failure rate 15/10,000 Call your doctor if: You have a fever. You have swelling that won't go down or keeps getting worse. You have trouble urinating. You can feel a large lump forming in your scrotum. You have bleeding from an incision that does not stop; even after you have pinched the site between two gauze pads for 10 minutes. .