There are a multitude of techniques for performing vasectomy: all of them aim to interrupt the passage through the vas deferens, some by ligating (knotting) the ends, coagulating them inside, folding them back on themselves, removing a portion of the vas... or combining some of these techniques.
When the end of the vas deferens coming from the testicle is closed, these are called closed end techniques.
Inconveniences of closed vasectomy
Even when the vas deferens is closed, the testicle continues to produce testicular fluid with spermatozoa. This fluid then accumulates in the small inner ducts of the testicle and in the epididymis, and can give rise to:
- chronic testicular discomfort due to hyperpressure
- atrophy of the germinal epithelium , with loss of sperm-forming capacity in case of repentance
- Dilatation of the epididymal tubule, with risk of rupture of the epididymal tubule, thus eliminating the possibility of reversibility for this testicle.
Open techniques: Silber technique
This is the technique we use in the Urology and Andrology Department.The end that comes from the testicle is left open, releasing the testicular fluid into the cellular tissue under the skin. The other end is coagulated (welded) inside. The two ropes are isolated, leaving the one from the testicle outside the fibrous sheath that covers the vas deferens.
This technique aims to leave the testicle in the best possible condition in case reversibility needs to be considered.
- PREOPERATIVE: Blood tests with coagulation tests are requested.
- ANTIBIOTIC PROPHYLAXIS: Cloxacillin 500 mg / 8 hours 4 days
Postoperative period after vasectomy
Rest after the operation until the following morning. Afterwards, you can carry out light activities such as going to the office, work that does not require significant effort or dangerous contact.
Testicular jockstrap. Afterwards, it will be replaced by tight briefs, slip type.
Analgesia on the first day: Oral Nolotil in case of discomfort.
Cure at our centre on the third day if there have been no problems.
After this cure, sexual activity can be resumed, TAKING THE USUAL ANTI-CONCEPTIVE PRECAUTIONS . There are still many millions of sperm in the seminal tract.
Seminal checks after vasectomy
We recommend the first check-up when the patient has had 22 ejaculations. We carry out a seminal study, and when we find a total absence of spermatozoa (azoospermia), the patient is allowed to continue his sexual life without other contraceptive systems.
Complications after vasectomy
Infection: Very rare in our experience: less than 7 per 1000.
Local inflammation: 4%. Rest and suspensory support are very important.
Spermatic granuloma: A type of nodular formation in the area of the interruption of the vas deferens. Can be bothersome if it involves nerve endings.
Spontaneous reversibility: This is described in several publications. It could be accepted as a consequence of a granuloma that retunneled. In our opinion, this retunneling can only occur within the first six months. After that time, the wounds have "cooled down" and we should not expect this complication. For this reason, we carry out a SEMINOGRAM for our patients six months after the operation.
Contact us, we will be happy to answer your questions.