Vasectomy is a contraceptive procedure in men that is done by cutting off sperm distribution to semen. Thus, the semen will not contain sperm, so pregnancy can be prevented.
The vasectomy procedure is performed through a minor surgical operation by administering local anesthetic to the testicles and scrotum area. In this procedure, the tubes through which sperm pass from the testes are cut and tied to prevent sperm from reaching the semen that is released during ejaculation during sexual intercourse.
Vasectomy can also be referred to as sterilization or permanent contraception in men. This procedure has a relatively less risk of complications, does not take much time to recover, and is very effective at preventing pregnancy.
Vasectomy Indications
Vasectomy can be performed on patients who do not wish to have more children. This method of contraception requires relatively shorter hospital stays.
However, the decision to have a vasectomy should be a mutual agreement with the partner. This is because surgery to reopen the sperm duct is not always successful.
Vasectomy Warning
Vasectomy can be performed on men of any age. However, doctors usually don't recommend this method for men who are under 30 years old and haven't had children. Special consideration also needs to be given to men with certain medical conditions, such as:
- Are taking anticoagulant and antiplatelet drugs, such as warfarin or aspirin
- Suffering from an acute skin infection as a result of an accident or having a scar on the scrotum
- Have anatomical abnormalities in the reproductive organs, such as large varicoceles or hydroceles
- Suffering from blood disorders or excessive bleeding
- Have allergies or are sensitive to local anesthetics or antibiotics
- Have you ever had surgery on your genitals?
- Have recurrent urinary tract infections or genital infections
Keep in mind that a vasectomy cannot prevent sexually transmitted infections. Therefore, continue to have sexual intercourse in a safe way, namely by using condoms or not changing partners.
Before Vasectomy
Before performing a vasectomy, the doctor will usually do a thorough examination of the patient. The doctor will ask why the patient wants to have a vasectomy and the patient's readiness for the procedure, in order to prevent regrets in the future.
In addition, the doctor will also explain about the vasectomy procedure, from preparation to complications that may occur.
The doctor will ask the patient to do the following:
- Not taking blood-thinning medications, such as aspirin or warfarin, for 7 days before the vasectomy
- Clean the genitals and shave the genitals all over the scrotum 1 day before the vasectomy
- Avoid heavy meals and replace them with light snacks before the vasectomy
- Bring tight underwear to wear after the vasectomy, to support the scrotum and reduce swelling
- Invite someone to accompany and take you home after the vasectomy
Vasectomy Procedure
Vasectomy can be done in a hospital or clinic. This procedure can be performed by a general surgeon or a urologist. The time for the vasectomy procedure ranges from 10–30 minutes.
To perform a vasectomy, there are two surgical techniques that can be done, namely conventional techniques and techniques without a scalpel.
Conventional technique
The following are the stages of the vasectomy procedure using conventional techniques:
- The patient will be anesthetized first with local anesthetic in the testicular and scrotal area.
- The doctor will make 1–2 small incisions on the side of the scrotum, so that the doctor can reach the sperm ducts (vas deferens).
- After that, both sperm ducts are cut and the ends of each duct are sutured or closed using diathermy (adhesive device with high temperature heating).
- Then, each incision is sutured with skin-absorbable thread.
Technique without Sperm duct cutting
In a vasectomy with a technique without cutting the sperm ducts, the steps of the procedure are as follows:
- The patient will be anesthetized first with local anesthetic in the testicular and scrotal area.
- The doctor will clamp the sperm duct (vas deferens) under the skin of the scrotum from the outside with clamps (tweezers).
- After that, the doctor will make a small hole in the skin above the sperm duct.
- The doctor will open the hole by using a pair of special clamps to reach the sperm duct.
- The sperm duct is slightly perforated to insert the cautery needle.
- The cautery needle is inserted into the sperm duct, then it is electrified while slowly being pulled out. The goal is that the inner surface of the sperm duct burns which will then block the sperm duct.
Bleeding and pain in a vasectomy without cutting the sperm ducts is lighter than conventional vasectomy techniques.
In addition to cautery, blockage of the sperm duct without having to cut it can also be done with installation vaseclip. However, this method is less effective when compared to vasectomy using cautery or conventional vasectomy.
Sehas Vasectomy
For 1–2 hours after the vasectomy, the patient can still feel the effects of the anesthetic on the scrotum. After the anesthetic wears off, the patient may experience some pain and swelling which will usually go away within a few days.
To relieve pain and swelling, patients are advised to compress the scrotum with an ice pack for at least 36 hours, rest for 24 hours, and use a bandage or tight underwear to support the scrotum for at least 48 hours after the vasectomy. If needed, pain relievers, such as paracetamol, can also be taken.
Some other things that also need to be considered and done after a vasectomy are:
- Maintain personal hygiene by showering after surgery and gently drying the surgical area
- Start normal activities gradually after 2-3 days after the vasectomy procedure
- Avoiding strenuous activities, such as exercising or lifting weights, for 3 days after the vasectomy, as they can cause pain or bleeding in the scrotum
- Using other contraceptives to prevent pregnancy, because usually the sperm is still left in the canal vas deferens up to 15-20 ejaculations
- Don't have sex for a few days after the vasectomy, until the pain goes away
- Have a test at least 12 weeks after the vasectomy to make sure the semen is free of sperm
- Use a condom when having sex, because a vasectomy cannot prevent sexually transmitted infections
Vasectomy Complications
Although rare, a vasectomy can cause several complications, such as:
- Infection in the incision wound
- Collection of blood (hematoma) in the scrotum
- Sperm granuloma
- Testicles feel full
- Pain in the testicles