Northwest Urology Center is considered

Northwest Urology Center is considered

We've been hearing about vasectomies for years, and may think we know all about this procedure for male sterilization.
But, did you know that now there is a method that doesn't involve using a scalpel to make incisions, but rather an instrument that makes just one small puncture? Since there is no incision, no stitches are required. The procedure is faster, and permits a quicker recovery.
And were you aware that vasectomy reversal is becoming more common? Specialists in microsurgery have developed techniques that are increasingly successful in reversing a vasectomy, even if it was performed many years earlier. This is a truly exciting development for men whose life situation has changed and who now want to be able to father children.
Dr. Robert Finnerty of Northwest Urology Center is considered to be an expert in the United States on surgical vasectomy reversals. He has performed nearly 2,000 such procedures, and is often called upon as a consultant in difficult cases. He is pleased to share his knowledge and experience in this section.

In this Center, we'll describe what a vasectomy is, and the factors you should consider before having this procedure done. You'll also learn about the common techniques used in a vasectomy, and about post-vasectomy recovery and resuming sexual activity.
In addition, information about vasectomy reversal is included.

A brief lesson in male anatomy helps in understanding what a vasectomy is. Sperm are continually produced by the testicles, and are stored in the epididymis, a gland located directly above the testicles. Sperm travel from the epididymis through two tubes, each of which is called the vas deferens, to reach the prostate gland. Prior to ejaculation, sperm are mixed with fluids from the seminal vesicles and the prostate to form semen.
A vasectomy stops the flow of sperm through the vas deferens, so it can't join the other fluids expelled during ejaculation.
Vasectomy doesn't affect production or release of testosterone, the male hormone responsible for a man's sex drive, beard, deep voice, and other masculine traits. The procedure also has no effect on sexuality-erections and climaxes remain the same.
Sometimes a man may experience sexual difficulties after vasectomy, but these almost always have an emotional basis that can be alleviated with counseling. More often, men who have undergone the procedure, and their partners, find that sex is more spontaneous and enjoyable once they are relieved of concerns about contraception and accidental pregnancy.

What should I think about before having a vasectomy? Be certain that you don't want to father a child under any circumstances. Remember, it may be permanent. And talk with your partner; it's important that you make the decision together.
Some of the "go ahead" signs that you are ready for a vasectomy include:
•Your marriage is stable and long-term, and you both agree that you never want more children
•You can't, or don't want to, use temporary methods of birth control
•You or your partner has a disorder that you don't want to risk passing on to a child
•Pregnancy poses a serious health risk to your partner
And the signals that vasectomy may not be a good choice include:
•You're young
•You have few or no children
•Your relationship with your partner is not solid
•You worry about how the result will affect your sexuality
•You're thinking about "banking" sperm, just in case.
•You think there's a chance you might want more children if your situation changes, such as a new spouse, death of a child, or better financial status
•Your situation calls for being protected against sexually transmitted diseases (Vasectomy offers no protection for STD's)
•You think that a vasectomy reversal is a good option if your situation changes
•Most important, you're not a good candidate if either you or your partner is not absolutely certain about this choice.

How is a vasectomy done?
Vasectomy is a minor surgical procedure done in the doctor's office and is usually completed within 15 to 30 minutes.
In the conventional approach, the physician makes one or two small incisions in the skin of the scrotum, which has been numbed with a local anesthetic. Each vas deferens is cut and a small section is removed. The cut ends are tied, and the incisions are closed with stitches.
In the late 1980's, a new procedure developed in China was introduced in the United States. The "no-scalpel" vasectomy can be completed in 10 to 15 minutes, and involves no incisions. The doctor feels for the vas deferens under the skin of the scrotum and holds it in place with a small clamp. A special instrument is used to make a tiny puncture in the skin and stretch the opening so that the vas deferens can be cut and tied. This approach produces very little bleeding, and no stitches are needed to close the punctures, which heal quickly by themselves. This method also produces less pain and fewer complications than conventional vasectomy.
Complications, if any, are usually minor. As with any surgical procedure, there is always a small risk of infection, bleeding, or testicular pain.
 
How long is the recovery after a vasectomy?
You will probably feel sore for a few days, and should rest for a least 2 or 3 days. You may want to take a mild painkiller if you've had a conventional vasectomy. Heavy lifting should be avoided for at least a week. Many men have their vasectomy done on Friday so they can relax over the weekend and return to work on Monday.
When can I begin sexual activity again?
You can resume sexual activity within a few days after the vasectomy, or as soon as you feel comfortable.
But, you must take precautions against pregnancy until a test shows that your semen is free of sperm. Usually, this test is done after you've had 10 to 20 post-vasectomy ejaculations over a period of 6 to 8 weeks. If sperm are still present in the semen, you'll be asked to return later for a repeat test.

How is a vasectomy reversed?
There are two ways in which a vasectomy is reversed.
A vasovasostomy is the most frequently performed operation. It involves stitching the cut ends of the vas deferens together.
If a blockage has occurred in the epididymis, merely reconnecting the two cut ends of the vas deferens will not solve the problem. To bypass this blockage, a vasoepididymostomy must be performed. This is done by connecting the vas deferens directly to the epididymis.
What's the success rate of reversals?
Recent studies indicate that following a vasovasostomy, sperm appears in the semen in about 85% to 97% of men. In a vasoepididymostomy, about 65% of men have sperm in their semen.
The largest research study on vasectomy reversal indicates that the shorter the time between the vasectomy and the reversal, the better the chances of pregnancy occurring. For example, where the time period is less than 3 years, sperm returns in 97% of cases. Between 9 and 14 years, sperm returns about 79% of the time. And after more than 15 years, 71% of the cases showed the presence of sperm.
The data show that despite long periods between vasectomy and the reversal, successful pregnancies can result.

1. Will a vasectomy change me sexually?
The only thing that will change is that you won't be able to make your partner pregnant. Testosterone, the hormone responsible for your sex drive, deep voice, and other masculine traits, will still be produced. And erections, climaxes, and the amount of ejaculate remain virtually the same.
2. How effective is a vasectomy?
The overall failure rate is .15%. Most failures occur within the first few months after a vasectomy, when sperm may still be present in the semen. You must continue to use other methods of birth control, for perhaps as long as 6 months, until tests indicate that no sperm are present. About one of every 4,000 vasectomies fails because a vas deferens manages to reconnect.
3. Are there disadvantages to a vasectomy?
The main advantage of vasectomy -- its permanence -- is also its chief disadvantage. The procedure itself is simple, but reversing it is difficult, expensive, and not always successful.
4. Does a vasectomy lead to any medical problems?
Most medical experts, including panels organized by the World Health Organization and the National Institutes of Health, have determined that vasectomy is a safe procedure. Research studies suggest that vasectomized men aren't more prone than other men to develop cancer, heart disease, or other health problems.
5. Will a vasectomy protect me from getting or passing on a sexually transmitted disease or AIDS?
Vasectomy offers no protection against AIDS or other sexually transmitted diseases. It is important that vasectomized men continue to use latex condoms in any sexual encounter that carries the risk of contracting or transmitting infection.