Vasectomy

What does vasectomy consist of?

Vasectomy is a surgical procedure in which the vas deferens - the tube that carries sperm from the testicles to the urethra - is severed to interrupt the seminal duct and prevent the possibility of fertilization. Ejaculation will continue to occur in the same way, but without containing spermatozoa.

 Vasectomy techniques

There are two vasectomy techniques currently performed in our country:

• The standard vasectomy. It is a simple and non-aggressive procedure that is performed on an outpatient basis under local anesthesia. For the intervention, an incision is made on each side of the scrotum allowing access to the vas deferens, externalization of the cord and sectioning of the duct.
• In recent years, a no-scalpel vasectomy technique has been developed in which no incision is made, but rather a small tear in the skin to section both vas deferens. This procedure is much less aggressive and the recovery is more comfortable, since it does not even require any stitches in the skin to close the small tear. Therefore, the return to daily activity is much faster and less painful. This procedure is considered as the best (Gold Standard) for the practice of vasectomy by the prestigious American Urological Association.

Vasectomy postoperative period

Vasectomy is a short procedure, lasting approximately 30 minutes. At the end of the surgery, a scrotal jockstrap is placed to minimize the possibility of bleeding and scrotal pain. It is recommended that the jockstrap be maintained for as long as the discomfort lasts.

After surgery, the patient is transferred to the recovery room, where he/she will stay more or less time depending on whether the procedure has been performed with or without sedation. Once the patient's readaptation to the environment has been checked, it is not necessary to stay overnight in the hospital. In the case of sedation, it is usually recommended that the patient be accompanied.

Some time after the vasectomy has been performed (usually about 3 months later), the result of the treatment should be checked by means of a semen analysis, since there are cases of repermeabilization of the vas deferens - in addition to potential technical problems. During the period from vasectomy to obtaining a 0 semenogram, contraceptive or contraceptive measures should continue to be used, since the risk of pregnancy is low, but not 0.

Chronic testicular pain occurs in 1% of men undergoing vasectomy.

Vasectomy risks

One possible concern with vasectomy is that you may 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 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, vasectomy causes no noticeable side effects and serious complications are rare.

How to reverse a vasectomy

Reconstruction of the vas deferens after vasectomy is possible. There are several complex surgical options to repermeabilize the seminal duct and return to fertility, although with much lower possibilities. Over the past few years, an increasing number of men have requested vasectomy reversal. The time from the first procedure to the second is an important prognostic marker for this treatment, with the likelihood of repermeabilization worsening as time passes.

Vasovasostomy, as the reversal surgery is called, is complex. It consists of the identification of both severed ends of the vas deferens and their repermeabilization by microsurgery. Additionally, on many occasions a biopsy and preservation of the testicular pulp is performed to obtain gametes in case the vasovasostomy is not successful.