Preparations that may be required prior to undergoing vasectomy include the following:
- Avoid anti-inflammatory drugs, such as ibuprofen and aspirin for 2 weeks prior to the procedure. (These medications "thin" the blood and can cause excessive bleeding.)
- Wash the scrotum to help prevent infection. (Most urologists also instruct patients to shave the front of the scrotum; please check with your doctor.)
- Bring a pair of tight-fitting underwear or athletic supporter to support the scrotum and minimize swelling.
- Arrange for a ride home to minimize exertion and movement that can exacerbate swelling.
A urologist performs a vasectomy on an outpatient basis, usually in the office. The procedure takes about 15–30 minutes. The patient typically remains clothed from the waist up and lies on his back. The scrotum is numbed with one or more injections of local anesthetic (lidocaine), the vas deferens is gathered under the skin of the scrotum, and a small incision (usually 1 centimeter or less) is made. The vas deferens is then pulled through the incision, cut in two places, and a 1-centimeter segment is removed. Each end of the vas deferens is surgically tied off or clipped, and placed back in the scrotum. The incision is sutured and the procedure is repeated on the other side of the scrotum. Some urologists cauterize the ends of the vas deferens, but others find that cauterization complicates reversal and is unnecessary. The incisions are dressed and most men go home immediately after the procedure.
In the no-scalpel vasectomy, a surgical clamp is used to hold the vas deferens while a puncture incision (instead of a cut) is made with special forceps. The forceps are opened to stretch the skin, making a small hole through which the vas deferens is lifted out, cut, sutured or cauterized, and put back in place. The puncture incision does not require suturing. Some urologists recommend the no-scalpel method because they find it is quicker and minimizes postoperative discomfort and the risk for bleeding and infection. Recently, as encouraging studies are reported, more vasectomies are being performed using this approach.