What is a Vasectomy?
What is a vasectomy? As you probably know already, a vasectomy is a surgical procedure that renders a man sterile. What you may not know are the specifics of the procedure and the period that follows. The following is designed to give you a better understanding of both � before the surgery takes place. To begin with, you should have some basic knowledge of the anatomy and physiology of the male reproductive system. During intercourse, sperm cells travel from the testicles through the vasa deferentia, become part of the seminal fluid (which is produced by the seminal vesicles and the prostate gland), and are ejaculated through the penis. When the surgeon performs a vasectomy, he cuts though the vas deferens (plural is vas deferentia) extending from each testicle. He then removes a small segment of the vas deferens and ties off the two remaining ends. The object of the procedure is to make it impossible for the sperm to become part of the seminal fluid. Since conception cannot take place in the absence of sperm, a vasectomy results in permanent sterilization. Will I be sterile as soon as the operation is over? NO. Contrary to popular belief, most people may not be sterile immediately after the operation. This is because some sperm still remain above the area where the vas deferens is cut during the procedure. Until all of these sperm cells have been ejaculated, you will still be fertile. In general it takes between 12-20 ejaculations following vasectomy for sperm to disappear. Most physicians who perform the vasectomies require that their patients bring a sample of seminal fluid to the office or lab after about 30 ejaculations have taken place. The seminal fluid will be examined under a microscope to be sure that no sperm are present. Only when this has been confirmed can you be sure that the surgery has been a success. Are the effects of the surgery permanent? YES. For all intents and purposes, once the surgery has been declared successful, you will be permanently sterile. The chances of the two cut ends of the vas deferens being spontaneously rejoined are extremely rare, approximately 3 in 1000. For this reason, it is most important that you are completely sure that you want no more children before you consent to the surgery. Suppose I change my mind later on, can the operation be reversed? Your physician can reconnect the two ends of the vas deferens, and once this is done you may possibly be fertile again. However, after the procedure, called a vas reanastomosis, fertility is restored in fewer than 50% of the patients upon whom it is performed. Therefore, you should consider the vasectomy to be an irreversible procedure. How will the procedure affect my sex life? Although the vasectomy will make you sterile, it will have no effect whatever on your potency � that is your ability to have sexual intercourse. In fact, many couples find that their sex life improves after the vasectomy because they no longer have to worry about the surprise of an unwanted pregnancy. Will I still ejaculate in the normal manner? Yes. Most of the seminal fluid that the male ejaculates during intercourse is produced by seminal vesicles and the prostate gland. Only a small amount of the seminal fluid consists of sperm. Therefore, after vasectomy, ejaculation will take place in the same way as it did before. The only difference is that there will be less fluid ejaculated, and this difference is barely noticeable. Can a vasectomy be performed in the physician's office? This is a matter to be discussed with your physician, and you should follow his recommendation. Although the procedure is relatively uncomplicated and can be performed with minimal difficulty in the physician's office, many find it more convenient to perform the vasectomy in a hospital setting. Is a vasectomy painful? As any operation, no matter how minor, there will be some discomfort associated with it. However, with proper anesthesia, this discomfort will be kept to a minimum. Your physician will discuss the type of anesthesia to be used. As a rule, a local anesthesia is all that is required. In some cases, general anesthesia may be needed, but this is a matter to be left to the discretion of your physician. Are there any complications associated with a vasectomy? The problems that occur after the operation are usually quite minor. There will be some pain and tenderness in the area where the surgery is performed. There may also be some swelling and discoloration (black and blue marks). Your physician will probably prescribe some medication to keep the post-procedure discomfort to a minimum. As with any surgery, the possibility of an infection is always present. However this is usually quite rare following a vasectomy. In a very small percentage of patients, a blood vessel inside the scrotum continues to bleed after the operation. If this happens, the scrotum will swell and become very tender. Should you experience this problem, contact your physician. He may have to re-open the scrotum to tie off the "bleeder." This could require a return to the hospital and the administration of general anesthesia. Are there any long-term complications? As far as medical science can determine at this time, there are few long-term complications associated with vasectomy. Recent reports in the lay press have focused attention on scientific studies that show a group of monkeys who had vasectomies developed premature hardening of the arteries when compared with a group of monkeys who did not have the operation. To date, comparable results have not been found in man. The results of a recent study suggest that there is no apparent association of coronary disease with prior vasectomy. One (1) person in 1000 will develop chronic pain called post-vasectomy syndrome. This is rare, but can be a difficult condition to treat. Aside from this, the only other known long-term side effect of the operation is that there may be a slight scar on each side of the scrotum where the incision is made. How soon after the operation can I have sexual intercourse? You may resume your normal sexual activity as soon as you feel well enough to do so. This will probably be within a few days of the surgery. Remember, however, that you may not be sterile until some time after the operation, and therefore you should continue to use some form of birth control until you doctor confirms that all sperm have disappeared from your semen. Is there anything I should do before the surgery? Once you have decided to have the surgery, you should discuss it with your physician. He may ask you to purchase an athletic supporter before the operation takes place. Although it is not essential, he may suggest that you have someone accompany you to his office or to the hospital on the day of surgery so that you can be driven home after surgery.
You will be given antibiotics and pain medication. Please take them as directed. What must I do after the operation? Once again, this is up to your physician. Many physicians will suggest the following: Wear the athletic supporter for the first 24 hours after the operation. After that you need only wear it if it makes you more comfortable. Do not engage in any strenuous physical activity for the first day, and work you way back to your normal routine over a period of about one week. You may shower on the day after surgery. Just be sure you wash the scrotal area gently, and rinse with warm water. When you dry the scrotum, do so by blotting the water with a soft towel. If your physician uses stitches to close the incisions, they will dissolve themselves and you will not have to return to have them removed. However, because the incisions are so small, many physicians do not use stitches. In such cases, there may be slight discharge from either or both of the incision sites. This need not concern you. Simply place a small sponge or gauze pad over the incision, replacing it on an as-needed basis, until the wound is completely healed. Even with such a discharge, you may still shower each day. COMMENTS:
If you have not previously discussed the physician's fee, Dr. deSouza, Dr. Horgan, Dr. Lundak, Dr. Trainer, Dr. Bolte, and Dr. Galejs' current fees are as follows:
Surgery: $820.00 - this includes post vas sperm count Supplies: $ 84.00 Pathology: $180.00 Tissue identification is done through a lab and is charged separately. The vasectomy is an elective surgery; therefore all co-pays and deductibles are due at the time of surgery. If your insurance company does not cover this surgery, payment is expected at the time of surgery. |