Tying up Loose Ends: Understanding Vasectomies

Contraceptive surgeries according to the top urologist in Lahore, Karachi or Islamabad aren’t just for women; men can have them too, with the most common male sterilization surgery being a ‘Vasectomy’.  A permanent, potentially irreversible procedure, it involves blocking the sperm ducts, or ‘Vasa deferentia’ to avoid causing a pregnancy.

How It Works:

Sperms (cells responsible for fertilization) are manufactured in the testicles, transported to the penis, and mixed into sebum (sperm-carrying fluid ejaculated during intercourse) via two small tubes called the vasa deferentia. Surgically cutting and tying these tubes permanently blocks the sperms’ sebum-entry route. Following a vasectomy, the produced sperms stay in the testicles, where they continue to get absorbed by the body as they die.

Types:

Being a minor outpatient procedure that does not require a hospital stay, a vasectomy generally takes between 20-30 minutes, and may be performed in one of the following two ways:

1. The Incision Method: Involves removing a small section of each vas deferens after making two small cuts on either side of the scrotum (the testicle-containing pouch). After tying or blocking the tubes using surgical clips or passing an electrical current (cauterization), the incisions are sealed with dissolvable stitches, glue, or in some cases, left to self-seal over time.
2. The No-Scalpel Method: After feeling for, and holding the vasa deferentia with clips, a tiny puncture is then made on either side to reach, cut, and tie or cauterize the tubes. This method does not require stitches, reduces healing time, and minimises the risk of bleeding, infection, and other complications.

Pre-Surgery Preparations:

• Stop taking blood-thinners like warfarin and aspirin (if prescribed), and OTC painkillers like ibuprofen at least a week before surgery to avoid excess bleeding.
• Shower and thoroughly wash and shave your entire genital area to the top of the penis and over the scrotum with a manual razor on the day of the surgery.
• Take supportive underwear or jockey shorts with you to wear after surgery.

Post-Surgery Care:

• Arrange for someone to drive you home after surgery.
• Wear supportive, tight-fitting underwear and intermittently ice the scrotum for 20 minutes at a time for the first 24 hours to relieve pain and swelling.
• Take OTC painkillers like acetaminophen instead of blood-thinners like aspirin and naproxen for pain relief.
• Although most can resume work after a day’s rest, those with physically taxing jobs may require up to a week’s leave.
• Refrain from hard physical activity, heavy lifting, and exercise for a week after surgery to avoid scrotal pain and bleeding.
• If the cut skin separates due to fluid or blood leaks, pinch the edges together using your fingers and sterile gauze to seal the skin and allow it to heal.

Benefits:

• With a 99% success rate, vasectomies are the second-best form of birth control after abstinence.
• They cost much less than female sterilization and long-term birth control expenses.
• They take the burden of preventing pregnancy off from one’s partner.
• Due to sperm-absence, no other form of birth control is required for intercourse, as opposed to some female sterility procedures.

Complications:

As with any surgical procedure, vasectomy also carries some risks, although most are either self-resolving, easily treatable via OTC medication and icing, or occur infrequently:

• Pregnancy
• Chronic pain
• Bleeding at the incision site
• Temporary pain and/or discomfort
• Congestion, or pressure, caused sperm pressing against the testes
• Bleeding under the skin causing swelling and bruising (hematoma)
• Fluid buildup in the testicles resulting in dull aches that worsen with ejaculation
• Scrotal swelling caused by the development of a fluid-filled sac surrounding a testicle
• Spermatic Granuloma (swelling) caused by sperm leakage from the vas deferens resulting in inflammation and the formation of a hard, pea-sized lump sometimes requiring surgical drainage
• Abnormal cyst formation in the epididymis (sperm transporting tube) located in the upper testicle.

Note: Call your doctor if you experience a persistent fever of over 100° F, pain and swelling in the scrotum and/or testicles, and blood or pus from the incision site.

Should You Get One?

A vasectomy can be reversed, although you may or may not regain fertility. Therefore, only opt for the procedure if you want to eliminate the need for using contraception, mutually agree with your partner to not have any more children or none at all, or in certain cases, certain genetic disorders that you and/or your partner do not want to pass on.

So, if you are considering the procedure, discuss why you want a vasectomy with your doctor and partner, and alternate, less permanent contraceptive options (if needed). You can also book an appointment with a top Urologist in Lahore, Karachi and Islamabad through oladoc or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your testicular concerns