In summary, a vasectomy is a safe, simple, and effective method of male contraception without any known long-term health hazards. Because of its simplicity, it is performed in more than 500,000 patients per year, mainly in a physician's office, making it a very cost-effective contraceptive method. With the introduction of the microscope into the operating suite of the urologist, this procedure that was once considered permanent is amenable to reversal at a later date.
PIP: Vasectomy technique by a single incision as used by a urologist is described. The patient is first examined for varicocele or hydrocele or drug allergy to lidocaine, and informed consent obtained. An incision in the median raphe is made after local anesthetic. The vas is grasped with a towel clip percutaneously, which is never removed without applying a second clip. The suggested technique is to cauterize each vas lumen, place a free-tie suture on the proximal vas and a suture ligature, all 3-0 chromic sutures, between the free-tie and the clamp. The end of the vas is tied back on itself and buried on a different fascial level from the other cut end of the vas. The other vas is ligated in the same way and the skin is closed with a 4-0 suture, after palpating both vasa to be sure both have been ligated. A turban dressing is used on the scrotum for 24 hours, and the patient is discharged with oral pain medication. Most can return to work the same day. It is recommended that be bring a semen sample after 6-10 ejaculations, and that 2 consecutive analyses be made with an informed consent, to ensure sterility. Complications and their management are reviewed, hemorrhage, hematoma, epididymitis, pain, infection, sperm granuloma and failure to confer sterility. There are no know long-term health risks of vasectomy.