Procedure Vasectomy

1 procedure

1.1 other techniques

1.1.1 vas occlusion techniques


1.2 recovery

procedure

the traditional incision approach of vasectomy involves numbing of scrotum local anesthetic (although men s physiology may make access vas deferens more difficult in case general anesthesia may recommended) after scalpel used make 2 small incisions, 1 on each side of scrotum @ location allows surgeon bring each vas deferens surface excision. vasa deferentia cut (sometimes section may removed altogether), separated, , @ least 1 side sealed ligating (suturing), cauterizing (electrocauterization), or clamping. there several variations method improve healing, effectiveness, , mitigate long-term pain such post-vasectomy pain syndrome (pvps) or epididymitis.

fascial interposition: recanalization of vas deferens known cause of vasectomy failure(s). fascial interposition ( fi ), in tissue barrier placed between cut ends of vas suturing, may prevent type of failure, increasing overall success rate of vasectomy while leaving testicular end within confines of fascia. fascia fibrous protective sheath surrounds vas deferens other body muscle tissue. method, when combined intraluminal cautery (where 1 or both sides of vas deferens electrically burned closed prevent recanalization), has been shown increase success rate of vasectomy procedures.
no-needle anesthesia: fear of needles injection of local anesthesia known. in 2005, method of local anesthesia introduced vasectomy allows surgeon apply painlessly special jet-injection tool, opposed traditional needle application. numbing agent forced/pushed onto , deep enough scrotal tissue allow virtually pain-free surgery. initial surveys show high satisfaction rate amongst vasectomy patients. once effects of no-needle anesthesia set in, vasectomy procedure performed in routine manner.
no-scalpel vasectomy (nsv): known key-hole vasectomy, vasectomy in sharp hemostat (as opposed scalpel) used puncture scrotum. method has come widespread use resulting smaller incision or puncture wound typically limits bleeding , hematomas. smaller wound has less chance of infection, resulting in faster healing times compared larger/longer incisions made scalpel. surgical wound created no-scalpel method not require stitches. nsv commonly performed type of minimally invasive vasectomy, , both describe method of vasectomy leads access of vas deferens.
open-ended vasectomy: in procedure testicular end of vas deferens not sealed, allows continued streaming of sperm scrotum. method may avoid testicular pain resulting increased back-pressure in epididymis. studies suggest method may reduce long-term complications such post-vasectomy pain syndrome.
vas irrigation: injections of sterile water or euflavine (which kills sperm) put distal portion of vas @ time of surgery brings near-immediate sterile ( azoospermatic ) condition. use of euflavine however, tend decrease time (or, number of) ejaculations azoospermia vs. water irrigation itself. additional step in vasectomy procedure, (and similarly, fascial interposition), has shown positive results not prominently in use, , few surgeons offer part of vasectomy procedure.

other techniques

the following vasectomy methods have purportedly had better chance of later reversal have seen less use virtue of known higher failure rates (i.e., recanalization).an earlier clip device, vasclip, no longer on market, due unacceptably high failure rates.

the vasclip method, though considered reversible, has had higher cost , resulted in lower success rates. also, because vasa deferentia not cut or tied method, technically classified other vasectomy. vasectomy reversal (and success thereof) conjectured higher required removing vas-clip device. method achieved limited use, , scant reversal data available.

vas occlusion techniques

injected plugs: there 2 types of injected plugs can used block vasa deferentia. medical-grade polyurethane (m.p.u.) or medical-grade silicone rubber (m.s.r.) starts liquid polymer injected vas deferens after liquid clamped in place until solidifies (usually in few minutes).
intra-vas device: vasa deferentia can occluded intra-vas device or i.v.d. . small cut made in lower abdomen after soft silicone or urethane plug inserted each vas tube thereby blocking (occluding) sperm. method allows vas remain intact. i.v.d. technique done in out-patient setting local anesthetic, similar traditional vasectomy. i.v.d. reversal can performed under same conditions making less costly vasovasostomy can require general anesthesia , longer surgery time.

both vas occlusion techniques require same basic patient setup: local anesthesia, puncturing of scrotal sac access of vas, , plug or injected plug occlusion. success of aforementioned vas occlusion techniques not clear , data still limited. studies have shown, however, time achieve sterility longer more prominent techniques mentioned in beginning of article. satisfaction rate of patients undergoing i.v.d. techniques has high rate of satisfaction regard surgery experience itself.

recovery

a post-vasectomy scrotum, showing typical post-operative bruising, incision stitches , shaved scrotum.

sexual intercourse can resumed in week (depending on recovery); however, pregnancy still possible long sperm count above zero. method of contraception must relied upon until sperm count performed either 2 months after vasectomy or after ten twenty ejaculations have occurred.

after vasectomy, contraceptive precautions must continued until azoospermia confirmed. 2 semen analyses @ 3 , 4 months necessary confirm azoospermia. british andrological society has recommended single semen analysis confirming azoospermia after sixteen weeks sufficient.