Types of Vasectomy

The male reproductive cells called sperms are produced in the testes, which are situated inside the scrotum. These sperms are carried for ejaculation by tiny tubes called vas deferens, which joins the ducts of the seminal vesicles to form the ejaculatory ducts. These ejaculatory ducts carry the seminal fluid, which contains sperms to the urethra, through which the semen (seminal fluid) is ejaculated. Vasectomy is a surgical procedure, where the vas deferens is severed and tied or sealed to prevent the entry of sperms into the seminal fluid. The sealing process may involve any of the following methods, i.e. tying, burning or stitching. Normally, vasectomy is a minor operation performed under local anesthesia. The patient should not take blood-thinning medications like aspirin or NSAIDS (Non Steroidal Anti-Inflammatory Drugs) like avil, motrin, etc. to prevent the possibilities of excessive bleeding and problems in urination. The following are the different types of vasectomy.

Conventional Vasectomy
The preparation for this surgery includes cleaning and shaving the scrotum, which is then injected with a local anesthetic. If the surgeon allows, the patient can apply some anesthetic cream over the area to reduce the pain inflicted by the injection. An incision is made on one side of the scrotum and one vas deferens is taken out through the incision and is fitted with two clamps at a distance of around 20 mm. This segment, which lies between the two clamps is then removed and the two ends of the tube are sealed with sutures and are cauterized (burned) with an electric needle. The sealing technique can be tying or clipping too and the removed segment should have a length of above 15 mm. After the sealing procedure, the vas deferens is placed back into the scrotum gently and the procedure is repeated on the other vas deferens.

Fascial Interposition Vasectomy
To improve the efficacy of contraception, a technique called fascial interposition is employed in addition to the above procedure. This method makes use of the fibrous layer called fascia, that covers the vas deferens. After the tube is cut, this fibrous layer is pulled over the cut end and sewed. This provides additional safety against the entry of sperms into the ejaculate. In some cases, the cut ends are sutured and cauterized and left with the fibrous layer positioned as a barrier between the cut ends.

Open and Closed-ended Vasectomy
Vasectomy can be open-ended when one of the cut ends of the vas deferens is tied or sutured and the other is left open. In an open-ended vasectomy, the tube end which is connected to the testis is left open and the other which is leading to the prostate is sutured or tied. This method is favored for the fewer complications associated with it. It is also observed that this method inflicts least amount of pain and discomfort to the patient. Closed-ended vasectomy denotes the closing or sealing of both the open ends of the vas deferens which have been cut.

No-Scalpel Vasectomy
No-scalpel vasectomy (NSV) differs from the conventional one in the method of approaching the vas deferens. In this method the doctor feels the tubes under the skin and holds them in place with a small ring-like clamp. A very small puncture is made on the scrotum, near the tube, with a sharp hemostat. The puncture is then stretched enough to pull out the tubes through it. The procedure of taking out the vas deferens tubes in a non-scalpel vasectomy is called supination maneuver, where the surgeon has to rotate his wrist while doing the task. Then the tubes are cut and the ends are sealed by tying or suturing and cauterizing. In this type of vasectomy, there is no need to close the opening made on the scrotum, as it is very small and heals naturally. One more advantage of this method is that it leaves no scar and bleeding will be really meager, as compared to other methods. NSV is emerging as one of the popular forms of vasectomy and is considered as the safest among all. It inflicts less pain and takes very little time to perform (usually 10 to 15 minutes). This type of vasectomy should be performed by an expert surgeon.

Vasclip Implantation
In this type of vasectomy, a rice-sized plastic clip called vasclip is used to lock the vas deferens, to block the sperm flow to the ejaculation duct. There is no severing and sealing of the tubes, but only locking by this clip. Even though there is no risk of complications, like, bleeding, infection and pain, there are reports that this method is not as effective as other types of vasectomy.

To summarize, vasectomy is a minor surgery with a very low chances of complications. The patient can be discharged after a few hours of rest and it takes only a few days for recovery. In short, it is a perfect choice for permanent contraception in males.