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Vasectomy Introduction

Vasectomy is a procedure in which the two tubes that carry sperm from the two testicles to the urinary tract are surgically altered so sperm cannot pass through and be released to fertilize a woman's egg during sexual intercourse. For couples who have made the decision not to have any more children, vasectomy is the safest and easiest form of surgical sterilization. While reversible in many cases, vasectomy should be considered a permanent form of birth control.

Vasectomy has grown in popularity throughout the world since its inception in the 19th century. Many men each year choose to undergo a vasectomy in the United States alone. Many vasectomies are performed by urologists (specialists in men's health), and 15% are performed by family practitioners. The cost ranges from $800 to $1,500 and is frequently covered by insurance plans. Some doctors that do the procedure also offer to store frozen sperm in case the person's situation changes and desires children sometime after the vasectomy and either does not want to undergo a vasectomy reversal operation or the reversal operation is unsuccessful.

Anatomy and technique

  • A vasectomy involves the surgical interruption of both vas deferens, which are the tubes that carry the sperm from the testicles to the urinary tract. The surgeon reaches the vas deferens through a very small opening made in the front surface of the scrotum, after a local anesthetic makes the area numb. The vas deferens is then brought to skin level, where it is cut or cauterized (burned), then clipped off or tied before being dropped back into the scrotum. A section of the vas deferens may or may not be removed. The man must continue to use contraception (such as a condom) until an examination of his semen reveals that no sperm are present. The disappearance of sperm from the semen is not detectable by the patient. Only a specific laboratory and microscopic analysis of the semen can verify the total lack of sperm, which is the goal of the vasectomy surgery.
  • The no-scalpel vasectomy -- a slightly less invasive procedure - was developed in China in the 1970s and was brought to the United States in the late 1980s. This modification uses special instruments, allowing vasectomies to be done faster and through an even smaller opening. Some studies have shown less pain and bleeding with this newer technique.

Terms to know

  • Bladder: A muscular, elastic pouch that serves to store and expel urine
  • Epididymis: Tightly coiled, very small tubes covering the back and sides of the testis, where sperm are stored and mature after leaving the testis before they are transported to the vas deferens
  • Prostate gland: Located below the bladder, gland that contributes significantly to seminal secretions and is where the ejaculatory ducts, the vas deferens, and the urethra join
  • Scrotum: The sac that contains the testicles, epididymis, and vas deferens
  • Semen: The combination of sperm and glandular fluid released by the urethra when a man ejaculates; normally a mixture of less than 1% sperm and 99% seminal fluid
  • Seminal vesicle: A sac at the end of the vas deferens that produces a component of seminal secretions, the fluid that is ejaculated by a man at sexual climax and that transports and nourishes the sperm
  • Testes/testicles: Located in the scrotum, the male reproductive glands that produce sperm and male hormone (testosterone)
  • Urethra: The passageway running from the bladder to the tip of the penis, which carries urine and semen outside the body
  • Vas deferens: The two muscular tubes that carry sperm from the testicle and epididymis to the urinary tract and out the urethra; each referred to as a vas and together as vasa
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Vasectomy Reversal

While the best thing about a vasectomy is that it is permanent in almost every individual that gets the procedure, couples sometimes choose to reverse a vasectomy. In the United States, approximately 600,000 men per year have a vasectomy. Up to 5% later choose to reverse it. This reversal procedure is not guaranteed to restore fertilityand is usually not covered by insurance.

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