Description of the Vasectomy Procedure
At the urological clinic of Dr. Carlos Marois, the vasectomy procedure is preceded by an initial consultation and evaluation. This involves a short questionnaire, a physical exam, and an explanation of the procedure.
After this, we schedule a second appointment for the vasectomy. However, for patients who have definitely made up their mind, it is possible to do both the initial evaluation and the vasectomy in a single visit. This is conditional upon a normal exam and that the patient has not been on anti-coagulant medication. Also the patient must not have any coagulation disorders.
We recommend that the patient be accompanied. As needed an Antivan may be offered, but only to anxious patients who are accompanied by someone. It is also recommended to avoid drinking coffee or other stimulants the morning of the vasectomy.
The scrotum must be shaved.Dry shaving is generally done with a shaver, such as a pick, while applying traction on the skin. Thus, there is less damage to the scrotum than by shaving with water or with an electric razor. Also, refrain from applying a hair removal cream such as Neet!
Vasectomy is a permanent male contraceptive method.
In principle, the technique is irreversible. If the patient ever desires to have children after the intervention, we can attempt a vasovasostomy, with no guarantee of success.
Complications are rare, but bleeding, infection, swelling, or pain in the scrotum can occur.
Very rarely, the vas deferens canal will reform on its own before the spermogram (early recanalisation, i.e. when two ends of the tubes reattach and allow for the passage of sperm, and therefore fertility). Exceptionally, spontaneous late recanalisation after vasectomy can occur, even with sectioning, ligation and cauterisation of the vas deferens.
Medical counter indications for vasectomy are relative and rare. Uncertainty about whether or not you may want children, blood coagulation disorders, scrotal hernia, and non-descended testicles are examples. In certain patients, vasectomy is sometimes unilateral and thus only performed on one side.
Vasectomy has no impact on sexuality, which remains unchanged. Erections and ejaculations are unchanged, but the liquid from ejaculation will no longer contain sperm.
You will not be able to see any difference in the ejaculate since sperm only represents a small part of this liquid. The ejaculate mainly comes from the seminal vesicles (2 small sacs located at the base of the prostate where the vas deferens tubes originate). You will also experience no change as regards sensation.
We recommend that the patient be accompanied; it is also recommended that the patient avoid coffee or other stimulants on the morning of the vasectomy. The scrotum must be shaved before arrival.
Anesthesia for a Vasectomy
This procedure is usually performed under local anesthesia. It is performed through a small subcutaneous injection in the scrotal site. The anesthesia is however limited to the area surrounding the injection. For a more effective anesthesia and a more comfortable vasectomy, a right and left sperm block are created under the guidance of an ultrasound scan. This infiltration of the spermatic cord suppresses pain within the scrotum.
In addition, the sometimes unpleasant abdominal traction of the vas deferens is slightly felt. Patients are required to wait 5 to 10 minutes before starting the procedure. There is a low risk of hematoma as the needle is directed at the side of the visualized veins.
This infiltration technique requires specialized ultrasound equipment. It is only used by some urologists who have developed the experience to perform scrotal surgery under local anesthesia with regional blocks.
An Ativan is also provided before vasectomy for anxious patients who are accompanied.
The Chinese Method (No Scalpel)
Vasectomy is minor surgery that involves sectioning and blocking the vas deferens tubes, which contain spermatozoa.
One or two small cuts are made in the scrotum (that is the envelope containing the testicles) under the penis.
In the case of an operation with one single cut, it is easily made in the center of the scrotum in tall and thin patients whose vas deferens tubes are usually longer and more mobile. In the case of two cuts, they are made on either side of the scrotum in men who have relatively short vas deferens tubes or who have relatively thick scrotal skin. Moving the vas deferens tubes is therefore easier as they are more accessible.
Recovery is essentially the same in both cases. The most important thing about Chinese method vasectomy is how easy it is to perform, whether with one cut or two, in order to minimise discomfort and risk of bleeding.
The skin is pierced with a very fine instrument that punctures the skin only a few millimetres. The vas deferens is then pulled out of the scrotum using a special curved instrument designed for Chinese vasectomy. The vas deferens is cut (1 to 2 cm), ligated, and each extremity is cauterised with an electrocauterising instrument, which prevents the passage of sperm.
Vasectomy takes about 10 minutes.
The skin is generally closed with one absorbable suture, especially if there is bleeding. The suture will disappear in less than 2 weeks.
Of course, this suture is not required with Chinese vasectomy. However, from experience, the risk of echymosis (bluish skin) is generally lesser when there is a cutaneous suture in place.
Contact us for more information about vasectomy or about the other procedures we offer.
Fill out the following form to register for a vasectomy. A member Dr Marois's team will get back to you to set up an appointment and answer your questions.