Picture of a man undergoing a vasectomy

Male sterilization is a permanent contraceptive method. The principle of contraception is to cut off the ejaculatory duct that transports sperm from the testicles to the genitals, so that the sperm cannot enter the semen and are discharged from the body. This permanent contraceptive method is only suitable for couples who do not want to get pregnant. After a man undergoes sterilization, it will not immediately produce a permanent contraceptive effect, so other reliable contraceptive methods should be used after the operation until two sperm tests are performed to confirm the existence of complete azoospermia.

In very rare cases, the severed ejaculatory ducts can be reopened, thus restoring fertility. Mild symptoms usually caused by surgical treatment include wound swelling and pain.

FAQ

1. Provide good preoperative consultation and eliminate concerns;

2. If a small dark blue patch appears around the scrotal wound after surgery, you do not need to seek medical attention. However, if the scrotum swells and the skin gradually expands and becomes purple or bleeds, you should seek medical attention immediately.

3. Sexual intercourse is prohibited within two weeks after the operation. Pay attention to rest and avoid heavy physical work and excessive exercise.

4. Contraceptive measures are required again for 3 months after the operation.

Surgical method

1. Sterilize the endoscope three times with warm 0.1% benzalkonium bromide solution (1:1000 new gentamicin solution aqueous solution) and cover the hole with a towel. Use the thumb and middle thumb of the right hand to find the ejaculatory duct in the front of the scrotum, and squeeze it firmly into the subcutaneous tissue, and pinch the firm ejaculatory duct. Apply local anesthesia to the skin where the ejaculatory duct is fixed, and push the medicine while inserting the needle, so that the medicine diffuses from the skin to the periphery of the ejaculatory duct.

2. Use a small sharp knife to make a small incision at the local anesthesia injection site, with the incision length not exceeding 0.4 cm. Separate the ejaculatory duct and fix it with a clamp to go straight through the ejaculatory duct, and slightly separate it along the longitudinal coordinate of the ejaculatory duct. Then insert the ejaculatory duct fixing clamp into the incision, pinch the ejaculatory duct and pull it out of the incision.

3. Use mosquito forceps to separate the tunica vaginalis and blood vessels of the ejaculatory duct. After the ejaculatory duct is stretched out 1-1.5cm, use two mosquito hemostatic forceps to clamp the ejaculatory duct on the left and right sides of the separated section, and then remove the fixed forceps.

4. Cut off and ligate a part of the ejaculatory duct that was separated during the ligation operation. After twisting it with a hemostatic forceps, use No. 1 thread to ligate both sides of the operation, with an interval of 1.5 cm. Lift the ligation thread and cut off about 1 cm of the ejaculatory duct. Check if there is any bleeding, cut off the ligation thread, and protect the separated broken end with the distal side with the external muscle fascia of the spermatic flexor. Then put it into the skin wound and promote blood circulation carefully. The skin wound does not need to be sutured surgically, but the two ends of the skin edge must be aligned.

5. Use the same method to solve the ejaculatory duct on the other side. After the operation, cover the wound with sterile gauze and fix it with tape.