What Is A Vasectomy?
This is a minor operation performed on males as a method of contraception1. The surgical procedure consists of cutting the vas deferens. (This is the tube that carries sperm from the testicle to the seminal vesicle). The seminal vesicle stores semen and is connected to the ejaculatory duct which carries it to the penis.
A vasectomy is 100% percent effective providing it is carried out properly. After the operation the male continues to ejaculate normally, however the semen does not carry any sperm. This in effect makes the male sterile.
How Often Is It Done
Studies done in the United States of America show that almost 500,000 males underwent voluntary vasectomies as a means of birth control. Of these, 75% of the operations were done by specialist in that field (Urologists). A third of the physicians who performed the operation preferred a technique known as Non-Scalpel Vasectomy2.
Vastectomies are often irreversible so it should be considered carefully before the man decides to go ahead with the operation.
A vasectomy is a minor operation and usually takes about 15-20 minutes.) A local anaesthetic is given (to numb the site of the operation). A small incision is made on the scrotum on both sides, near the base of the penis. The vas deferens is located and isolated form the spermatic chord. Care must be taken to avoid blood vessels. The isolated vas deferens is carefully brought out through the incision . The Vas Deferens is cut at the middle. Some surgeons prefer to remove about 15mm of the Vas Deferens 3. The two ends are bent back and tied together. The removal of a short amount of the Vas Deferens and the tying of a ligature is a precaution to prevent the two ends from joining together once again.
The use of surgical clips to seal the ends of the Deferens is of importance as it prevents the tube from decaying and getting infected4. In some instances, the ends of the Vas Deferens may be cauterised (sealed using heat). This is also an effective method of preventing rejoining and is a matter of personal preference5.The two ends are then pushed back into the spermatic chord, and the incision on the scrotum in closed with sutures.
In the last ten years, a new method known as the no scalpel technique has been used. This method has been claimed to have fewer haemotoma’s (internal bleeding) and reduced risk of pain. Some studies however do not support this theory.6 In a separate study, the no scalpel technique was found to take less operating time and it was found that the patients recovered much more quickly. The success rate of both techniques however were thought to be identical7.
A mild, dull, ache may be present for a few days after the local anaesthetic wears off. The pain may be relieved by paracetamol. Occasionally slight bruising or bleeding from the wound may occur for a few days. This is considered an outcome from the operation and bleeding may be controlled by mild external pressure with a gauze pad.
There have been incidences where the performance of a vasectomy has been thought to lead to an increased risk in prostate cancer. However a study done in Boston U.S.A showed that there was no particular significance in people over 55<