A vasectomy is a small, minimally invasive procedure that involves the removal of a piece of vas deferens with the goal of sterilization. It is one of the most successful and least invasive ways to achieve permanent birth control. This can be an office based or operating room procedure and the anesthesia given for the procedure also widely varies. This article will explore all of the different options and what we offer here at Purely Vasectomies.
What is a Vasectomy?
Men have a structure called the vas deferens that carries the sperm from where they are stored to where they will be released at time of ejaculation. A vasectomy involves the removal of a piece of this tube. This prevents sperm from being able to reach the ejaculate, thus preventing pregnancy. We consider this a permanent form of sterilization.
A vasectomy is such a great option because it is a small and minimally invasive procedure with a short recovery period. It can involve the use of sedation or general anesthesia but it is not a requirement.
Types of Anesthesia Used in Vasectomies
Local: This is used whether or not you have any other kind of sedation or general anesthesia. This is an injection of numbing medicine in the area to numb the nerves running alongside the vas deferens. This is what makes the procedure comfortable while you are awake and also helps with pain control for a few hours after the procedure as well.
Sedation: This is nitrous oxide which makes you feel relaxed and calm. It takes the edge off during the procedure and makes the whole experience less anxiety-ridden. It is a gas that you breathe. It takes effect and wears off quickly so that you would be able to drive home after your procedure.
Heavy or Deep Sedation: This typically requires medicine given through your IV to make you sleepy and completely unaware of what is going on during the procedure. This is similar to a sedation you might receive for a colonoscopy. These medications are administered by an anesthesia provider and requires the procedure to be done in an operating room setting. Someone would need to drive you home after receiving this type of sedation.
General Anesthesia: This requires a combination of gas and IV medication that puts you completely to sleep. This requires the insertion of an airway, also known as a tube in your throat. All of this is done by an anesthesia provider and requires the procedure to be done in an operating room setting. Someone would need to drive you home after this type of sedation.
Do You Need to be Put to Sleep for a Vasectomy?
The short answer is: it depends.
The procedure itself does not require the use of general anesthesia. Most men are able to tolerate this procedure in the office with just local anesthesia or light sedation with nitrous oxide. With this regiment most men describe it like getting a dental filling.
There are a number of reasons patients may elect to undergo a vasectomy in the operating room under heavy sedation or general anesthesia.
These include:
- Patient tolerability: some patients are queasy or may pass out with the thought of needle pokes or with the sight of blood. These patients may not be the best candidates for an in-office procedure.
- Patient preference: even if patients would tolerate needles or the site of blood, they may just not want to be awake/aware of the procedure and that’s just as valid!
- Patient anatomy: the vasectomy lies within the spermatic cord and all are of different lengths. Some patients have a shorter spermatic cord, meaning the testicles are closer to the body. This may leave the provider less room to work and the patient may not be as comfortable during the procedure
- Prior scrotal procedures: any prior surgeries on the scrotum such as torsion, orchiopexy, prior vasectomy, etc. may cause some scar tissue in the area. This can make a vasectomy more complex or prolonged. This does not mean you cannot have a vasectomy in the office, but it may make it more uncomfortable for the patient to have an office procedure
In all, anesthesia is certainly not required, but may be preferred in certain situations.
Procedure Overview: What to Expect
Overall, the procedure typically involves a spermatic cord block, or injection of numbing medication in the cord to numb the nerves that run alongside the vas deferens. Some numbing medicine is also injected at the site of the incision. Some time is taken for that to go into effect and then the provider makes an incision, isolates the vas deferens, and removes a small segment. There are also a variety of other methods to obstruct each end of the remaining vas deferens to ensure that there is no chance of re-connection. Both sides are either done through the same incision in the middle of the scrotum. Most of the time, a stitch is placed on the incision that will dissolve on its own over time. Patients are typically given an undergarment such as a jock strap after to help with support of the scrotum. The procedure typically takes less than 30 minutes total.
Pros and Cons of Different Anesthesia Choices
General Anesthesia/Heavy Sedation: The benefits of using an anesthesia provider for heavy sedation/general anesthesia is that you won’t be aware of the procedure occurring. You wouldn’t have any discomfort during the procedure but would have the same recovery afterwards. The downside is that this would require being in an operating room rather than in an office setting. This would be much more costly as the operating room time, equipment, and anesthesia provider factoring into your bill. If you receive heavy sedation or anesthesia, you would have to have someone drive you home after the procedure and it is typically not recommended for you to drive for about 24 hours after receiving general anesthesia.
Light Sedation: Light sedation is administered in the form of nitrous oxide, the same stuff that dentists use. It is a gas that you breathe through a mask. It is rapidly acting and rapidly wears off. It makes you feel lighter, calmer, and some even say euphoric. You would be able to drive yourself to and from your appointment. There are minimal side effects.
At Purely Vasectomies, we use nitrous oxide as part of their vasectomy.
A vasectomy is a minimally invasive procedure that is typically performed in the office with the option of light sedation in the form of nitrous oxide. This is part of the Purely Vasectomies process. Under certain patient circumstances such as patient anxiety or prior scrotal surgery, patients may choose to have their vasectomy in the operating room with an anesthesia provider to administer heavy sedation or general anesthesia.
