Vasectomy

A vasectomy is a surgical procedure in which the vas deferens—the tube that carries sperm from the testicles to the urethra—is cut to interrupt the seminal pathway and prevent fertilization. Ejaculation will still occur, but it will not contain sperm.

 Vasectomy techniques

There are two vasectomy techniques currently performed in our country:

• The standard vasectomyIt is a simple and minimally invasive procedure performed on an outpatient basis under local anesthesia. The procedure involves making an incision on each side of the scrotum, allowing access to the vas deferens, externalizing the spermatic cord, and severing the duct.
• In recent years, a no-scalpel vasectomy technique This procedure involves no incision, but rather a small tear in the skin to sever both vas deferens. It is much less invasive, and recovery is more comfortable, as it doesn't even require stitches to close the small tear. Therefore, the return to daily activities is much faster and less painful. This procedure is considered the gold standard for vasectomy by the prestigious American Urological Association.

Post-operative period following vasectomy

A vasectomy is a short procedure, lasting approximately 30 minutes. After the surgery, a scrotal support is placed to minimize the possibility of bleeding and scrotal pain. It is recommended to keep the support in place for as long as any discomfort persists.

After surgery, the patient is taken to the recovery room, where they will stay for a varying amount of time depending on whether the procedure was performed with or without sedation. Once their readjustment to normal activity is confirmed, an overnight stay in the hospital is not necessary. It is generally recommended that, in cases of sedation, the patient be accompanied.

Some time after a vasectomy (usually around 3 months later), the treatment outcome should be checked with a semen analysis, as there are cases of vas deferens recanalization—in addition to potential technical issues. During the period between the vasectomy and a negative semen analysis, contraception should continue to be used, since the risk of pregnancy is low, but not zero.

Chronic testicular pain occurs in 1% of men who undergo vasectomy.

Risks of vasectomy

One potential concern with a vasectomy is that you might later change your mind about wanting to have a child. While it is possible to reverse a vasectomy, there is no guarantee that it will be successful. Reversal surgery is more complicated than a vasectomy and, in some cases, is not effective.

If you have chronic testicular pain or testicular disease, you are not a good candidate for a vasectomy. In most men, a vasectomy does not cause any noticeable side effects, and serious complications are rare.

How to reverse a vasectomy

Vasectomy reconstruction is possible. Several complex surgical options exist to restore the vas deferens and regain fertility, although the chances of success are much lower. In recent years, a growing number of men have requested vasectomy reversal. The time between the first and second vasectomy procedures is an important prognostic factor for this treatment, with the likelihood of successful reversal decreasing as time passes.

Vasovasostomy , as the reversal surgery is called, is complex. It involves identifying both severed ends of the vas deferens and restoring their patency through microsurgery. Additionally, in many cases, a biopsy is performed to preserve testicular pulp for gamete retrieval if the vasovasostomy is unsuccessful.