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Medical Video: 5 Myths About Vasectomies - Jesse Mills, MD | The Men's Clinic, UCLA Health
If you are already good at not wanting to have more children, a vasectomy is the most reliable method of contraception - safer and more affordable than tubal ligation, a permanent contraception procedure for women.
Here are some of the most frequently asked questions about vasectomy.
What happens during a vasectomy?
To understand how a vasectomy works, you need to understand a little more about the anatomy of your body. Sperm is produced in the testes and stored in a sac called the epididymis. From this bag, sperm will flow through a thin tube the size of a 40-centimeter shoelace, called the vas deterens. The vase deterent is connected to the prostate gland producing semen and seminal vesicles near your bladder.
Once the sperm comes out of the end of the vase, male intervention in the reproductive process begins. If the sperm does not come out of the vase, there will still be semen coming out - but it does not have sperm content to fertilize the egg in a woman's womb.
To do a vasectomy, the surgeon will massage your scrotum until he can feel the vase. The process of finding a vase is the same as when you try to find a rope in a rubber waist jogging pants after the rope is pulled in. Once found, the doctor will stab the second layer of the scrotum to make a micro hole using a needle and use a small clamp to slightly pull the vase out. Then, he will sew the tip of the tube, with a process called intraluminal cauterization with fascial interposition. With this technique, the doctor will slice the end of the vase tube into two branches, making a wound on one of the inner walls with a hot needle. After that, the doctor will sew a protective vase tissue (fascia) to close the tube opening.
Tailoring the tube prevents recanalization, which may occur when microscopic channels grow between the ends of the vase tube. When that happens, sperm can flow through this new pathway to then mix with semen.
Will this procedure hurt?
Vasectomy usually takes about 30 minutes, and can be done under the influence of local or general anesthesia. Pain reported when undergoing a vasectomy includes mild to moderate around the testicles, only a few seconds, depending on the pain tolerance threshold of each patient. You must rest 24 hours after that and avoid heavy physical work, such as cycling, lifting weights, playing golf, jumping, swimming, jogging and soaking, for a week.
A few days after a vasectomy, the testicles may feel sore or sore like they have been kicked. While most men only feel uncomfortable for a few weeks after the procedure, there is still a risk of a longer recovery time for some patients. Very rarely, infection or bleeding may arise, and swelling will redden in the first year. If this happens, chronic pain relief medications will be prescribed to relieve your complaints.
Will a vasectomy affect sex life?
Vasectomy will not reduce testosterone levels, interfere with your sex drive, ability to erect, orgasm, or ejaculate.
There will be no major changes in ejaculation, both from color and texture, smell, to taste. The testicles will still produce sperm, but will be absorbed again by the body. This also occurs in sperm that is not included in the ejaculatory fluid when you climax, after a while, regardless of whether you have a vasectomy or not. Because the tube is blocked before the seminal vesicles and prostate, you still ejaculate in the same fluid volume.
You can continue to have sex as soon as you feel comfortable, usually around a week. Note that you may have occasional mild pain in your testicles during sexual arousal for several months after surgery.
Is a vasectomy 100 percent effective in preventing pregnancy?
More than 99 percent of vasectomy cases are guaranteed effective for preventing pregnancy.
What needs to be understood, you can still get your partner pregnant unless your sperm count is really zero. Until then, you should still use another contraceptive method for up to three months after a vasectomy, because there are still remnants of sperm floating around the end of the vase opening.
When will I be really sterile?
You have to ejaculate at least 20-30 times after the procedure to cleanse existing sperm reserves. After that, it is strongly recommended that you immediately undergo a sperm count test 12 weeks postoperatively to make sure your sperm count is zero.
After being proven zero, you can have sex without the help of other contraceptives. But remember, a vasectomy is not a method to stop the spread of venereal disease and HIV. You can still infect or get venereal disease when you have unprotected sex, because the castration process will have no effect on your sexual health.
Vasectomy can be canceled. Is it true?
Vasectomy is permanent contraception, but it is still possible to cancel this procedure if you already have it and want to return to fertility. This operation is called a vasovastotomy - more complicated and takes twice as long as a vasectomy.
The surgeon must find the two ends of the vase that are cut and untied and cut off any scar tissue. Then the two ends must be very carefully sewn together in a skilled operation.
The farther the distance between a vasectomy and a vasovastotomy, the lower your chances of success are to turn things around. Even if the reversing procedure is successful, you will not automatically be able to have a child again, because pregnancy also depends on your partner's fertility.
Is there a risk of prostate cancer and dementia?
At present there is no medical evidence and consistent clinical trials that can show the link between prostate cancer and vasectomy. In addition, the risk of dementia is still a mere hypothesis, which requires deeper medical studies.
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