How Is A Vasectomy Operation Done?
Now, what actually
happens to you during the operation? Well, when you first come to the surgery
at the prearranged time early in the morning (usually 8:30am on a Friday morning)
you can relax in the knowledge that there will not be any other patients there
who might possibly overhear what is about to happen to you! We value your
privacy. Please have your usual breakfast before coming in and bring along
something to read during the usual one hour's observation time after it’s
all over. You can even bring along your favourite CD if it will help you to
relax during the operation. Otherwise you may have to put up with the doctor's
choice of music!
Once you are called into the treatment room, you’ll be asked to remove
your shoes, pants and jocks and lie on the operating couch. Our surgery
nurse, usually Joan, will explain things. Occasionally a trainee doctor
may be present to observe the operation but only with your consent! The
first step is to thoroughly wash the skin of the penis, the scrotum and
the pubic region and all the surrounding skin and remove as many skin germs
as possible (it's impossible to remove them all unfortunately!). Then a
sterile green operation drape is applied over the lower half of the abdomen,
legs and feet. It has a small opening in it which exposes only the scrotum
and therefore keeps you warm and helps prevent infection-causing germs from
getting into the wound during the operation.
Now the vas deferens on one side must be found within the scrotum. Once found it is held firmly so it can't slip out of the doctor's grasp and the local anæsthetic is injected via a tiny needle first under the skin lying immediately over the immobilised vas and then further down to just around the vas itself to make it numb. The injection does sting a bit but only briefly.
Once the skin
is numb - this takes only a few seconds - a tiny (5mm approx.) incision
is made in the skin and the underlying tissues extending right down to
the vas to allow the vas to be grasped with a small instrument. A small
loop of vas can then be gently drawn out of the incision and its outer
layers are peeled off to free approximately 10 mm of vas.
Then a tiny plastic tube or cannula is gently threaded up the end of the vas leading towards the prostate and seminal vesicles (ie. away from the testicle), a syringe is attached to the cannula and about 5ml of sterile saline (salt solution) is gently and slowly syringed down the channel of vas in order to flush out as many sperm as possible from the vas and from the seminal vesicle on that side. This fluid ends up by entering the urethra and so the flushing part of the procedure makes you feel that you’re passing a few drops of urine.
The next step is to cut away about 5mm of vas so it can be sent away to be examined by a pathologist (thus proving that the vas was indeed operated upon!).Then each end of the vas is tied closed (ligated) with a synthetic and slowly dissolving material called Vicryl and then each end is folded back upon itself and retied in order to make it almost impossible for Nature to undo the operation and join the two ends again. (The risk of this happening and fertility returning are of the order of 1 in 1000 to 1 in 10,000.)
