The male reproductive cells called sperms are produced in the testes, which are situated inside the scrotum. These sperms are carried for ejaculation through tiny tubes called vas deferens. These tubes join the ducts of the seminal vesicles to form the ejaculatory ducts. These ejaculatory ducts carry the seminal fluid, which contains sperms to the urethra, through which the semen (seminal fluid) is ejaculated.
Vasectomy is a surgical procedure, where the vas deferens tubes are severed and tied or sealed to prevent entry of sperms into the seminal fluid. The sealing process may involve any of the following methods, i.e. tying, burning or stitching. Normally, vasectomy is a minor operation performed under local anesthesia.
Different Types of Vasectomy
Conventional Vasectomy: The preparation for this surgery includes cleaning and shaving the scrotum, which is then injected with a local anesthetic. If the surgeon allows, an anesthetic cream can be applied over the area to reduce the pain inflicted by the injection. An incision is made on one side of the scrotum, and the vas deferens (on that side) is taken out through the incision. It is fitted with two clamps at a distance of around 20 mm. The segment that lies between the two clamps is removed, and the two ends of the tube are sutured or cauterized (burned) with an electric needle. The open ends of the tube can also be sealed or clipped. The removed segment should have a length of more than 15 mm. After the sealing procedure, the vas deferens is placed back into the scrotum, and the procedure is repeated with the second vas deferens.
Fascial Interposition Vasectomy: To improve the efficacy of contraception, a technique called fascial interposition is employed, in addition to the conventional procedure. This method makes use of the fibrous membrane called fascia, to cover the open ends of the vas deferens. After the tube is cut, this fibrous layer is pulled over the cut end and sewed. This provides additional safety against entry of sperms into the ejaculate. In some cases, the cut ends are sutured and cauterized, and are left with the fibrous layer positioned as a barrier between them.
Open and Closed-ended Vasectomy: Vasectomy can be open-ended when one of the cut ends of the vas deferens are tied or sutured and the other is left open. In an open-ended procedure, the tube end which is connected to the testis is left open and the other which is leading to the prostate is sutured or tied. This is one of the popular types of vasectomy, because of the low risk of complications. This method causes least amount of pain and discomfort to the patient. Closed-ended method denotes the closing or sealing of both the open ends of the vas deferens which have been cut.
No-Scalpel Vasectomy (NSV): In this method the doctor feels the tube under the skin and holds it in place with a small ring-like clamp. A very small puncture is made on the scrotum, near the tube. The puncture is then stretched enough to pull out the tubes through it. The procedure of taking out the vas deferens tubes in a non-scalpel vasectomy is called supination maneuver, where the surgeon has to rotate his wrist, while doing the task. Then the tubes are cut and the ends are sealed by tying, suturing or cauterizing. In this method, there is no need to close the opening made on the scrotum, as it is very small and heals naturally. One more advantage of this method is that it leaves no scar, and bleeding is meager, as compared to other methods. NSV is emerging as one of the popular forms of vasectomy and is considered the safest among all. It causes less pain and takes very little time to perform (usually 10 to 15 minutes). This procedure should be performed by an expert surgeon.
Vasclip Implantation: In this type of vasectomy, a rice-sized plastic clip called vasclip is used to lock the vas deferens, so as to block the sperm flow to the ejaculation duct. There is no severing and sealing of the tubes. Even though there is no risk of complications, like bleeding, infection and pain; it has been reported that this method is not as effective as other types of vasectomy.
To summarize, vasectomy is a minor surgery with a very low risk of complications. The patient should not take blood-thinning medication, like aspirin; or NSAIDS (Non Steroidal Anti-Inflammatory Drugs) like avil and motrin, to prevent excessive bleeding and problems in urination. The patient can be discharged within a few hours of rest, and it takes only a few days for recovery. In short, it is a perfect choice for permanent contraception in males.
Disclaimer: This article is for informational purposes only, and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.