What happens during a vasectomy? This is a logical question a man would ask before undergoing the procedure. After all, a vasectomy involves cutting or snipping in a highly sensitive area of the body. Some men are uncertain or squeamish about getting their scrotum cut or poked, so it is important to fully understand what a surgeon will do during a vasectomy. The answer to “what happens during a vasectomy?” depends on which type of vasectomy you and your doctor have chosen, either a scalpel (incision) vasectomy or a no-scalpel (non-incision) vasectomy.
Regardless of which method you choose, once in the operating area you will be asked to undress from the waist down and to lie on a table. A medical assistant will clean your scrotum with iodine and cover you with a drape with your scrotum exposed.
What happens during a vasectomy with a scalpel?
If you have chosen a scalpel vasectomy, your doctor may give you medication 30 to 60 minutes before the procedure to help you relax and make you sleepy or just use local anesthesia. After the medication takes effect, your doctor will inject an anesthetic into your pelvic region. Some doctors use a pressurized jet injection device that delivers the anesthetic (e.g., xylocaine) without a needle. Once you are numb, the doctor will make one or two small incisions in your scrotum. This allows the doctor to expose the vas deferens, which is the tube that transports sperm from the testicles and epididymis (a tightly coiled tube where sperm mature and are stored) to the penis for ejaculation.
The surgeon cuts the vas deferens, often removing a small section, and then ties the ends, seals them with a cauterizing device, or uses occluding clips (hemoclips). The incisions are closed with a few dissolvable stitches, and the vasectomy is complete. A scalpel vasectomy takes 15 to 30 minutes, depending on how your doctor decides to close off the ends of the vas deferens.
What happens during a vasectomy without a scalpel?
If you chose a no-scalpel vasectomy, medication to make you sleepy may not be necessary, but your doctor may offer it. The doctor will then numb the scrotum by injecting a local numbing solution into the scrotal skin or use a pressurized jet spray, which delivers an anesthetic over the vas deferens without the use of a needle. Instead of making an incision to expose the vas deferens, the doctor feels for the tube under the skin of the scrotum.
Once the doctor locates the vas deferens, he secures it with a tiny clamp and uses razor-sharp pointed forceps to perforate the layers of skin until the vas is revealed. The vas deferens is lifted out and cut, and the ends are either tied, cauterized, or occluded using clips (hemoclips). Use of clips can slightly shorten the procedure time, but there are no proven advantages to using clips over tying or cauterizing. Since the punctured opening for the vas deferens is smaller than an incision, it can close on its own, although your surgeon may choose to suture it.
The no-scalpel vasectomy is associated with less bleeding and a reduced risk of infection, bruising, and other complications compared with the scalpel approach. A no-scalpel vasectomy takes about 5 to 15 minutes, depending on how the doctor closes off the ends of the vas deferens.