Vasectomy is a contraceptive procedure in men by cutting the sperm distribution in semen. Thus, pregnancy can be prevented because sperm cannot fertilize a woman's egg.
In this procedure, the channel that carries sperm from the testes is cut and bound to prevent sperm from reaching semen released during ejaculation during sexual intercourse. Vasectomy can also be referred to as sterilization or permanent contraception in men. Surgery to reopen the sperm duct is possible, but it is not always successful.
Vasectomy procedures are carried out through minor surgical operations with the provision of local anesthesia, so that the patient is kept awake. The anesthesia is only done in the scrotal and testicular area. The time for vasectomy alone only takes 10 to 30 minutes. In addition, the risk of vasectomy is also very small and the patient can go home after the vasectomy procedure is performed.
Vasectomy Indications
Vasectomy can be done after the patient is fully aware that he does not want to have more children and choose contraception by vasectomy. This method of contraception is attractive to men who want a contraceptive procedure quickly and do not need treatment in a hospital. Nevertheless, the decision to do a vasectomy should be a joint agreement with a partner.
Vasectomy Warning
Vasectomy can be done at any age. However, doctors usually do not recommend this method for men under the age of 30 years and do not have children. Special considerations also need to be given to men with certain medical conditions, such as:
- Currently taking anticoagulant and antiplatelet drugs.
- Has acute post-traumatic skin infection or has a scrotum scar.
- Having anatomic abnormalities, such as a large varicocele or hydrocele.
- Have a history of blood disorders or excessive bleeding.
- Have allergies or are sensitive to local anesthetics or antibiotics.
- Have a history of surgery on the genitals before.
- Having a urinary tract infection or recurrent genital infection.
Before vasectomy
Before performing a vasectomy, your doctor will ask you to stop taking aspirin or other blood-thinning drugs for 7 days. These drugs can increase the risk of bleeding during vasectomy surgery. Meanwhile, to prevent infection, you will be asked to clean the genitals and shave the genitals throughout the scrotum using a razor the day before the vasectomy is done.
On the day of vasectomy, bring tight underwear to wear after surgery to support the scrotum and reduce swelling. Also, invite someone who can take you home after the vasectomy.
A few hours before the vasectomy, the consumption of pre-operative medicines recommended by the doctor. Furthermore, avoid consuming heavy food and replace it with light snacks.
Vasectomy Procedure
Vasectomy procedures can be performed by general surgeons or urologists in hospitals or clinics. Some preparations made before vasectomy include:
- Clean the testes and scrotum with antiseptic fluid.
- If needed, the doctor can give sedatives orally or intravenously. Giving this drug will make the patient sleepy.
- Local anesthetic injection of scrotal skin. The anesthetic that can be given is 1 percent lidocaine with or without epinephrine.
To run a vasectomy, there are two surgical techniques that can be done, namely the conventional technique and the technique without a scalpel. In conventional techniques, the doctor makes a 1-inch incision on each side of the scrotum so that the doctor can reach the sperm channel (vas deferens). After that, both sperm ducts are cut off and the ends of each duct are sewn or closed using a diathermy. Each incision is then sutured with a thread that can be absorbed by the skin so there is no need to remove the post-operative thread.
Whereas in a vasectomy without a scalpel, the doctor clamps the sperm ducts under the scrotum skin with clamps. After that, a small hole is made in the skin above the sperm duct. The hole is opened using a pair of forceps, so the doctor can reach the sperm duct, to then cut and bind. In this procedure, blood does not come out much and feels less pain than conventional techniques.
Another way that can be done is to install a vasclip to close or clamp the sperm duct, so that no cutting and binding are made. But this method is less effective compared to other methods.
After vasectomy
For one to two hours after vasectomy, patients can still feel the effects of anesthesia on the scrotum. After that, the patient starts to feel a little pain and swelling which will generally disappear within a few days. To reduce this, compress the scrotum with an ice bag for at least 36 hours, rest for 24 hours, and use tight bandages or underwear to support the scrotum for at least 48 hours after vasectomy. If needed, pain medications such as paracetamol can also be taken.
In addition, several things that need to be considered after a vasectomy include:
- Maintain personal hygiene by bathing after surgery and gently drying the area of the former operation.
- Avoid strenuous activities for 3 days after vasectomy, such as exercising or lifting weights because it can cause pain or bleeding in the scrotum. Generally, patients can resume normal activities after 8 to 9 days after the vasectomy procedure.
- Sex can be re-done several days after the vasectomy or after the patient feels comfortable doing it. However, sperm are usually still left in the vas deferens channel up to 20 or 30 ejaculations. During this time, patients are asked to use other constructs to prevent pregnancy. Tests to ensure clean semen from sperm can be done at least 8 weeks after vasectomy.
- Vasectomy does not make a person free from transmission of sexually transmitted infections, such as HIV. The most effective way to protect against this disease is to use a condom.
Complications of vasectomy
Although rare, vasectomy can cause some serious problems such as the following:
- Infection. This is caused by bacteria that enter the cut wound in the scrotum.
- Hematoma. This condition occurs when there is bleeding and blood seepage into the scrotum, causing the scrotum to feel painful and swollen.
- Sperm granuloma. In this case, there is a hard lump containing sperm in the tissue around the testes. This lump usually feels very painful.
- Testicle feels full. This usually occurs due to epididymis in the scrotum filled with the remaining sperm, this condition can subside within a few weeks.
- Pain in the testicles. This pain can appear some time or several years after a vasectomy is performed. The cause is a wound or a pinched nerve during surgery. Vasectomy patients who experience pain like this are recommended to undergo surgery, in order to improve the condition and minimize pain.
