Miami urologists David Robbins, MD and Dr. Amery Wirtshafter, MD are proud to offer patients an office based solution to achieve permanent contraception.
- What is a vasectomy?
- Is a vasectomy a good choice for you?
- How is a vasectomy performed?
- Myths about a vasectomy procedure
- What are the real risks associated with a vasectomy?
- How to prepare for your vasectomy
- What to expect after your vasectomy
- Follow up instructions
What is a vasectomy?
A vasectomy is a minor surgical procedure performed in the office resulting in permanent sterility by preventing sperm from exiting the penis during ejaculation. A vasectomy procedure is minimally invasive and highly effective with success rates greater than 99%. A vasectomy procedure is simple to perform and low risk as compared to a tubal ligation in females and for that reason it is the most popular means of birth control when the goal is to achieve permanent sterility.
Is a vasectomy a good choice for you?
A vasectomy procedure is an ideal way to achieve permanent sterility. However, the decision to undergo a vasectomy procedure should be taken seriously. A vasectomy procedure is performed for men that have made the decision that they no longer want to father children. Although a vasectomy reversal procedure is possible, this is a complex surgical procedure performed in the operating room performed under general anesthesia. It has a low success rate and is typically not covered by insurance.
How is a vasectomy performed?
Vasectomy works by preventing sperm from reaching your penis.
Sperm is made inside of your testicles. After leaving the testicles, the sperm travels through an organ called the epididymis where it can mature. At the time of ejaculation, sperm exits the epididymis though a long tube called the vas deferens into the urethra where it is then mixed with fluid from the prostate and semenal vesicles to create semen. The semen is then forced out of the urethra via rhythmic contractions of the muscles around the penis and perineum during orgasm.
During a vasectomy procedure, the vas deferens are transected thereby preventing sperm from reaching the penis during ejaculation, thus achieving sterility. Typically we send a small portion of the vas deferens from each side to the laboratory as confirmation that the vasectomy was performed properly. Additionally, each side is cauterized and tied with a tiny suture to ensure the intended result is achieved. There are gimmicky devices on the market which clamp the vas without dividing it which claim to be less invasive, however they do not change the time it takes to perform a vasectomy and certainly do not decrease the risk of complications. These devices introduce a foreign body into the scrotum which can be uncomfortable and potentially cause infection.
Myths about a vasectomy procedure
Many men are concerned about a vasectomy procedure because they have read on the internet or heard from a friend that it may cause erectile dysfunction or they will not ejaculate after the procedure. A vasectomy procedure certainly does not cause damage to the nerves that cause erections or cause injury to the erectile bodies. Erectile dysfunction is simply not a known complication of a vasectomy procedure. Also, a vasectomy procedure does not lead to decreased ejaculatory volume. Only a minute portion of the volume of semen in the ejaculate is contributed to by sperm from the testicles. Greater that 99% of the semen volume is from the semenal vesicles and prostate and the path for these fluids is not changed by a vasectomy. The volume, color and consistency of semen is not altered by a vasectomy procedure.
Additionally, some patients report that they have heard that a vasectomy procedure may increase their risk for developing prostate cancer. There is no literature making this connection with statistically significant data and recent studies looking at this concern have shown no connection with vasectomy procedure and prostate cancer.
Finally, It is a common misconception that a vasectomy procedure can affect a man’s libido or ability to achieve orgasm and ejaculate normally. These functions are definitely not altered by a vasectomy procedure.
What are the real risks associated with a vasectomy?
A vasectomy procedure is considered a safe procedure with few risks especially when performed by a urologist with expertise and experience with the procedure such as Dr. Robbins and Dr. Wirtshafter.
Occasionally minor complications may occur and may include:
Very infrequently a post vasectomy syndrome may occur which is associated with prolonged scrotal discomfort. Typically this can be alleviated with anti inflammatory medications such as ibuprofen and the symptoms should resolve with time.
How to prepare for your vasectomy
A vasectomy procedure is typically performed in our North Miami Beach or Miami Beach office under local anesthesia. The vasectomy procedure takes about 15 minutes to perform and is tolerated very well by our patients. To add to patient comfort during a vasectomy procedure, we prescribe Valium to be taken 1 hour prior to the procedure. Additionally, we recommend to patients that they bring an ipod or personal music player with earphones to make their vasectomy experience more relaxing. With the combination of a Valium and music, it is common for patients to fall asleep during the vasectomy procedure.
Before your vasectomy:
- Clean and shave your scrotal area.
- Avoid taking anti-inflammatory medicines like ibuprofen or Aspirin.
- Wear tight-fitting underwear to your vasectomy appointment.
- Bring someone to drive you home after surgery.
What to expect after your vasectomy
After a vasectomy, it is important to avoid strenuous activities such as exercise heavy lifting or sexual activity for 3-5 days. It is typical to have mild discomfort that can be relieve with Tylenol or ibuprofen.
Ice should be applied to the area indirectly for 20 minutes every few hours while awake for the first day to reduce swelling and discomfort.
A topical antibacterial such as Neosporin or Bacitracinshould be applied to the wounds 2-3 times per day for several days.
It is important to avoid submerging the wound in water such a in a bath or swimming pool. These activities can allow bacteria to enter the wound and lead to infection. It is OK to take a shower even the day of the procedure, but the area should not be washed vigorously or scrubbed with a brush.
Since you will be taking Valium, it is important that someone is there during the procedure and available to drive you home.
Immediately following vasectomy, there is a slight risk of bleeding into your scrotum. Contact your doctor if you experience:
- Significant swelling in your scrotum.
- Intense pain.
- Redness in the scrotum.
A vasectomy procedure is not immediately effective. There are still sperm that are left in the vas deferens beyond the point where the tube is divided. These sperm are viable and capable of causing an unplanned pregnancy. Effective birth control should be resumed after the vasectomy procedure until a negative semen analysis is documented and confirmed by Miami urologist Dr. David Robbins or Dr. Amery Wirtshafter.
A semen analysis should be performed 2 months after the procedure and it is important to have at least 12 ejaculations prior to the analysis to clear the tubes of any remaining sperm.
For the first day or two after vasectomy you may experience mild discomfort in your scrotum or abdomen. Over-the-counter medications such as Tylenol should help. The doctor may also send you home with narcotic pain medication.
Urological Consultants of Florida vasectomy forms
Miami urologists Dr. David Robbins and Dr. Amery Wirtshafter have provided a pdf copy for download of the vasectomy consent form that you signed at the Miami Beach office or the North Miami Beach office. You can additionally download the post vasectomy instruction form below.
Please click on the link below to contact Miami urologists Dr. Amery Wirtshafter and Dr. David Robbins for further information or to schedule an appointment.
DISCHARGE INSTRUCTIONS FOLLOWING VASECTOMY
LEAVING THE MIAMI BEACH OR NORTH MIAMI BEACH OFFICE:
1. You will need to have someone take you home following the surgery
WHEN YOU GET HOME:
1. Stay off your feet as much as possible for the next 12 hours. This will reduce the chance
of scrotal swelling.
2. Wear cotton, JOCKEY undershorts for increase support and comfort.
3. Avoid heavy lifting or vigorous exercise for seven (7) days after surgery.
4. You can shower the day after surgery. Avoid rubbing the scrotum when drying.
5. Sexual activity can begin one week after your vasectomy when scrotal swelling and
6. CONTRACEPTIVE PRECAUTIONS ARE ABSOLUTELY NECESSARY UNTIL THE SEMEN
ANALYSIS PRODUCES NEGATIVE RESULTS.
7. Eight to Twelve (8‐12) weeks after your vasectomy, you need to do a Semen Analysis.
8. Please call our office immediately if you have any post op complications including:
c. Increasing pain
e. Temperature of 101
9. If you have any questions, please call the office at (305) 944‐0025.