Vasectomy Surgery in Delhi, India

Vasectomy is a safe, predictable, and effective birth control choice for individuals who are sure they do not want babies in the future. It is also recommended for men who desire inexpensive outpatient permanent surgical sterilisation.

Vasectomy is recommended for those individuals who are certain they do not want to get a woman pregnant in the future. This is because a vasectomy makes a person sterile or makes them unable to get a woman pregnant. A vasectomy is not advisable as a short-term type of birth control for men. In addition, the procedure to reverse a vasectomy is complex.

Vasectomy may be a good option for a man who fits the following criteria:

• Both partners are in a relationship and agree they do not want children or additional children. They do not intend to use any other forms of birth control.
• In a relationship where pregnancy could have ill effects on the woman's health.
• One or both partners may have genetic conditions they do not wish to pass on in a relationship.

Vasectomy may not be a good option for someone who:

• Is in a relationship with a woman who hasn't decided whether to have children in the future.
• Is in an unstable or stressful relationship
• Is considering the operation to please their partner.
• Wants to have babies later in their life by storing sperm or by reversing the vasectomy
• Is young and may not want babies at all
• Is single when they decide to have a vasectomy, including men who are divorced, widowed, or separated.
• Has a history of chronic testicular pain or testicular disease.

For getting a vasectomy, one must get the following tests done:

• Complete blood count to check for any infections or underlying medical conditions.
• Semen analysis to ensure that no sperm is present in the semen.

• Food and Medications: Doctors advise stopping aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or other blood-thinning medicines at least three days before the procedure and two days after. This helps avoid any complications associated with bleeding. 
• Clothing and Personal Items: Carrying a pair of tight-fitting underwear or an athletic supporter to wear after the procedure can be useful. It helps support the scrotum and reduce swelling.
• Other precautions: Bathe or take a shower on the day of surgery. Be sure to wash the genital area thoroughly. Trim or completely shave hair if necessary.

After the surgery, arrange a ride home to avoid any movement and pressure on the surgical area caused by driving.

Vasectomy is a quick and painless outpatient surgical procedure. In most cases, patients return home the same day. Vasectomy is of two types:

1. Conventional Scalpel method
2. Non-scalpel method

Conventional Vasectomy Method

The scrotum is anaesthetized with a local anaesthetic. Then two small incisions are made in the skin on each side of the scrotum to access the vas deferens - tubes that carry sperm out of the testicles. Each tube is then ligated, and a small part of it is removed. Next, the tubes are sealed with heat or tied with a suture. Finally, the incisions are stitched using dissolvable sutures.

No-scalpel Vasectomy Method

The scrotum is anaesthetized with a local anaesthetic. Next, a tiny puncture hole is made in the skin of the scrotum to get access to the tubes. Then, the same procedure as a conventional vasectomy is carried out. Finally, the tubes are sealed by tying or heat sealing.

The advantage of no-scalpel vasectomy is there is the lesser bleeding, and no stitches are required. In addition, it is less painful and less likely to cause any complications.

A potential concern with vasectomy is that the patient may change their mind about wanting a baby. Although it might be possible to reverse the vasectomy, there's no guarantee it will work. Reversal surgery is more complicated than vasectomy. It can be expensive and may be ineffective in some cases.

Another technique available to father a child following a vasectomy is in vitro fertilization. However, this technique is expensive and not consistently effective. So, it is crucial to be sure before getting a vasectomy. Side effects immediately post-surgery include:

• Blood in the semen
• Mild pain or discomfort
• Swelling
• Bleeding or blood clot inside the scrotum
• Bruising of the scrotum
• Infection of the surgery site

Delayed complications include:

• Chronic pain in the scrotum
• Fluid buildup in the testicle can cause a dull ache that gets worse with ejaculation
• Inflammation caused by leaking sperm (granuloma)
• If vasectomy fails, pregnancy is rare.
• An abnormal cyst called spermatocele may develop in the coiled tube on the upper testicle that collects and transports the sperm.
• A fluid-filled sac called hydrocele may form surrounding the testicle, causing swelling in the scrotum
• Signs of infection like fever, redness, or pain in the scrotum may become evident
• Regretting the procedure

Following a vasectomy, the patient may experience bruising, pain and swelling which subsides in a few days. One must follow the instructions religiously as given by the doctor, such as:

• In case of any signs of infection, immediately contact the doctor. Some symptoms include blood oozing from the surgery site, a fever, redness, or extreme pain or swelling.
• The scrotum should be supported with a dressing and tight-fitting underwear. This should be done for at least 48 hours post-operatively.
• Ice packs should be applied to the scrotum for the first two days.
• Limit physical activity for some days after the surgery.
• Avoid any sexual activity for a week. One may find it painful to ejaculate or may see blood in the semen.

Ejaculating semen after a vasectomy is common. Still, it will not contain any sperm (after ejaculating about 20 times).

Reviewed by Dr. Atul N.C. Peters, Director - Bariatric, Minimal Access & General Surgery, Laparoscopic / Minimal Access Surgery, Bariatric Surgery / Metabolic, General Surgery, Department of General Surgery and Robotics on 27-Apr-2023.