Vasectomy Techniques: What to Expect from the Procedure

Vasectomy surgical technique

Hello Doctor: My husband underwent a vasectomy on September 2 at Cathay General Hospital in Hsinchu, performed by the chief of urology.
Before deciding on the procedure, we researched online and found that the incisions for the surgery typically involve two small 0.5 cm openings on either side of the scrotum.
We thought it seemed quite simple and easier than a female sterilization, so we felt reassured and scheduled the surgery.
When we arrived, the doctor did not ask any questions or provide any explanation about the procedure, such as the surgical technique, the size of the incisions, or how much pain to expect.
He simply scheduled the surgery time.
After the procedure, my husband returned home in significant pain, and upon examining the incision, I nearly fainted.
The incision was approximately 4 cm long, made along the midline of the scrotum, which is much larger than we anticipated.
During the follow-up appointment on September 5, I asked the doctor why he made such a large incision when it is generally done with two small openings.
The doctor merely replied, "I make one incision while others make two," and did not provide further explanation.
Is this surgical technique typical for a vasectomy?

Xiao Li, 30~39 year old female. Ask Date: 2016/09/08

Dr. Du Shixi reply Urology

The method of vasectomy depends on the physician's preference, and there is no significant difference in effectiveness.
Most procedures can be performed under local anesthesia.
Some patients may experience more pain when receiving the anesthetic injection.
It is important for your husband to take good care of the surgical site and to avoid getting it wet in the short term.
If there is any redness, swelling, fever, or severe scrotal pain, he should return to the clinic.
Recovery typically takes about 1 to 2 weeks.
As a reminder, he should return for a semen analysis approximately 2 months after the procedure, and during this time, contraception should be used.
Thank you, and I wish you both all the best and safety.

Reply Date: 2016/09/08

More Info

Vasectomy is a surgical procedure designed to provide permanent contraception for men by cutting and sealing the vas deferens, the tubes that carry sperm from the testicles to the urethra. Understanding the techniques and what to expect from the procedure is crucial for patients and their partners.
In your case, it seems that there was a significant discrepancy between your expectations and the reality of the surgical procedure performed on your husband. Typically, a vasectomy can be performed using two common techniques: the conventional method and the no-scalpel technique.
1. Conventional Vasectomy: This method involves making two small incisions on either side of the scrotum to access the vas deferens. After cutting the tubes, the ends are either tied off or sealed using heat or clips. The incisions are then closed with sutures. This method usually results in minimal scarring and discomfort.

2. No-Scalpel Vasectomy: This is a less invasive technique where a small puncture is made in the scrotum to access the vas deferens. This method typically results in less bleeding, reduced risk of infection, and quicker recovery times.
In your husband's case, it appears that the surgeon opted for a more invasive approach, making a larger incision of about 4 centimeters. While this is not the standard practice for a vasectomy, it can be justified in certain situations, such as anatomical variations or complications during the procedure. However, it is essential for patients to be informed about the specific technique that will be used and the reasons behind it.

Post-Operative Expectations
After a vasectomy, some pain and discomfort are normal, but the level of pain should not be severe. Common post-operative symptoms include:
- Swelling and bruising in the scrotal area
- Mild to moderate pain, which can often be managed with over-the-counter pain relievers
- Discomfort during physical activities or sexual intercourse for a short period
If your husband is experiencing significant pain or if the wound appears to be healing poorly, it is crucial to follow up with the surgeon. Complications, although rare, can occur, including infection, hematoma (a collection of blood outside of blood vessels), or chronic pain.

Communication with the Surgeon
It is concerning that your husband did not receive adequate information about the procedure beforehand, and the follow-up response from the surgeon was dismissive. Open communication is vital in medical care, and patients should feel empowered to ask questions and express their concerns. If you feel that your husband's care was inadequate, consider seeking a second opinion from another urologist.

Conclusion
In summary, while vasectomy is generally a straightforward procedure, variations in technique can lead to different experiences and outcomes. It is essential for patients to have clear communication with their healthcare providers regarding the procedure, expected outcomes, and post-operative care. If there are any concerns about the surgical technique or recovery, do not hesitate to seek further medical advice. Your husband's comfort and health should always be the priority.

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