Vasectomy
(DR.SAJEEV VASUDEVAN)
Vasectomy is male sterilization by the surgical interruption of the vas deferens, the two sperm-transporting tubes that lead from the male testes to the ejaculatory duct. This procedure prevents sperm cells from reaching the semen storage structures, called seminal vesicles, where glandular secretions form semen. As a result, the semen becomes sterile. Because vasectomy does not affect hormone or semen production, sexual activity of the male is not hampered.
Almost 500,000 vasectomies are performed annually in the United States. It is usually performed under local anesthesia in a physician's office. In the past a small incision requiring sutures was necessary, but a new "no-scalpel" vasectomy is becoming the standard procedure. In this technique each vas deferens is secured just beneath the skin. A sharp-tipped instrument pierces the skin and stretches it to a small opening from which the vas deferens is then lifted out and cut. The ends of the vas deferens are blocked either by ligation or cautery. The tiny skin opening does not require a suture and this approach reduces bleeding, bruising, hematoma, and infection. After a vasectomy the male is not sterile until sperm that has already been stored in the seminal vesicles is flushed from the system. This generally takes about 15 ejaculations.
Reversal of vasectomy may be possible by microsurgery, although not all men regain fertility. Changes in the vas deferens system, the length of the vas deferens removed, and the time since vasectomy influence success.
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