A vasectomy is a procedure that involves removing a piece of the vas deferens. The vas deferens is a structure that carries sperm to where they will be released into the ejaculate. By removing this piece, sperm would not be able to reach the ejaculate and find the egg, which prevents pregnancy. We consider a vasectomy a permanent form of sterilization because while it can be reversed, reversal can be expensive and is not guaranteed to be successful.
You may be wondering, “why is a vasectomy such a great form of birth control?” It’s because it is a single procedure that produces permanent results. It does not involve taking hormones or implantation of a foreign body to prevent pregnancy. It does not involve having to remember to buy condoms or other barrier devices. It ends up being very cost-effective over time. It has even been found that vasectomy can improve sexual function due to the psychological effect of no longer having the fear of unwanted pregnancy. Both male and female partners have reported increased sexual arousal, satisfaction, orgasm, and confidence!!
It should be reassuring that this is a highly effective form of sterilization. The rates for vasectomy failure marked by reappearance of sperm after documented absence of sperm is around 1/2000.
As surgeons, we have a saying that a minor procedure is any procedure performed on someone else. So, even though it may be relatively quick and straightforward, it can still cause a great deal of anxiety. We want to reassure you that there are very low risks for complications. These may include bleeding/hematoma (4-20%), infection (0.2-1.5%), or risk of chronic testicular pain (1-15%).
Before the Procedure
There will be instructions provided with preparation work required prior to showing up on the day of the procedure, including shaving. Alcohol usage should be avoided the day before and the day of the procedure as well. Be sure to read through these thoroughly to make sure you and your partner are fully prepared.
Leading up to the procedure, it is a good idea to have an open conversation regarding the decision to have a vasectomy and any fears or concerns your partner may have leading up to the procedure. Reassure your partner that you will be there to support them emotionally and take care of them following the procedure.
Day of the Procedure
You should ensure your partner has a good meal prior to the procedure so they don’t feel lightheaded or feel like passing out during the procedure. It would also be a good idea for them to have a ride home, mostly for moral support!
The actual procedure varies depending on the provider because there are many ways the procedure can be performed, all with the same results/efficacy. A vasectomy typically involves one or two small incisions in the scrotum to remove the vas deferens. Several additional methods may be used by the provider to ensure efficacy of the vasectomy including burning each end, tying each end, or separating the ends in different layers of tissue. The incisions are typically closed with a stitch that will dissolve on its own, but again this depends on the provider.
Recovery
Wound Care:
It is important to keep the incision sites clean and dry for the first 24 hours. After that, daily showers are recommended. The incisions do not need to be scrubbed, but soap and water can just run over the incisions.
Pain Management:
Unfortunately, no invasive procedure is pain-free. However, at Purely Vasectomies, we make this procedure as comfortable as possible. There are options for sedation during the procedure. After the procedure, Tylenol should be the first line medication for pain. Most of the time, that is enough to keep patients comfortable for normal activities. Tylenol and Ibuprofen can be used together if needed for additional pain control.
Activity Restrictions:
After the procedure, it is recommended that your partner takes it easy over the next 2-3 days. Minimizing physical activity can help reduce the risk of post-procedure swelling and hematoma (bleeding). More normal/regular daily activities can typically be resumed by day 3 and aggressive activities (slowly and as tolerated) can be resumed around day 10. After about 10 days or when your partner is pain free, you can start easing back into sexual activity!
Scrotal support, which includes wearing tight underwear, a jock strap, or both can reduce the risk of swelling and/or bleeding. This should be used for at least 3 days. It may also be comfortable to continue scrotal support as activity increases up to a week after the procedure.
Your partner will still be considered fertile for at least 3 months and 20+ ejaculations after the procedure. The reason for this is that there may still be sperm present at any point along the tubing that will need to be cleared out. There will be a post-vasectomy semen analysis that will confirm absence of sperm. Some men may take a little longer to clear those tubes and may require another sample. It is important to continue some other form of birth control until there is a semen analysis that shows absence of sperm.
By being understanding of your partner’s physical limitations during the recovery period, you can help minimize the risk of complications and foster a good environment of recovery!
Open Communication and Emotional Support
Keep open lines of communication with your partner throughout the entire process—making the decision to move forward with a vasectomy, preparing for the procedure, and dealing with the care after the procedure.
One of the best ways to help reduce anxiety/emotions surrounding the procedure is to make sure this is the right decision for you and your partner! Remember that a vasectomy is an efficient way that helps avoid hormones, implants, barrier devices, etc., it is a procedure and the decision to proceed should not be taken lightly. It is imperative to have a frank discussion with your partner about the risks and benefits of all forms of contraception to avoid any sort of pressure or reluctance to move forward with a vasectomy.
As mentioned above, any minor procedure is one that is performed on someone else. It is not helpful to minimize any anxiety or fear your partner has leading up to the procedure, even if it may seem relatively small or straight forward. Provide them with the space to express their concerns. Sometimes, just talking about things can help alleviate any stress/anxiety.
Lastly, the physical limitations during recovery can have an emotional impact not only on the patient, but the partner as well. Try to get ahead of the same and make a plan before the procedure on how things will be managed and taken care of during the recovery period. This way, when the time comes, everything will be a bit more seamless!
A vasectomy is a very safe procedure with low rates of complications and high rates of efficacy. Purely Vasectomies will ensure you are comfortable and well taken care of throughout the entire process.
