Male Sterilization (Vasectomy)

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1- Introduction

2- Anatomical Overview

3- Procedure

4- Treatment


The common method of sterilizing males is a deferentectomy, popularly called a vasectomy. During this procedure, part of the ductus deferens is ligated and/or excised through an incision in the superior part of the scrotum. Hence, the subsequent ejaculated fluid from the seminal glands, prostate, and bulbo-urethral glands contains no sperms. The unexpelled sperms degenerate in the epididymis and the proximal part of the ductus deferens.

© image from Moore's Clinically Oriented Anatomy

Anatomy and Physiology

Male Reproductive System

  • Testes: Produce sperm and testosterone.
  • Epididymis: Stores and matures sperm.
  • Vas Deferens: Transports sperm from the epididymis to the urethra.
  • Seminal Vesicles and Prostate Gland: Produce seminal fluid that mixes with sperm to form semen.
  • Urethra: Carries semen out of the body through the penis.



1. Anesthesia

  • Local Anesthesia: Most vasectomies are performed under local anesthesia to numb the scrotum, ensuring the patient remains awake but does not feel pain in the area.

2. Accessing the Vas Deferens

  • Conventional Vasectomy:
    • Incision: Small incisions are made on each side of the scrotum to access the vas deferens.
  • No-Scalpel Vasectomy (NSV):
    • Puncture: A special instrument is used to make a tiny puncture in the scrotum to access the vas deferens without the need for incisions.

3. Isolation of the Vas Deferens

  • The vas deferens is gently pulled through the incision or puncture site using a surgical instrument.

4. Cutting and Sealing the Vas Deferens

  • Cutting: The vas deferens is cut to prevent sperm from traveling from the testes to the urethra.
  • Sealing: The cut ends are sealed by one of the following methods:
    • Tying: The ends are tied with sutures.
    • Cauterizing: The ends are cauterized (burned) to close them.
    • Clipping: Metal or plastic clips are applied to the cut ends.
  • Sometimes, a small segment of the vas deferens is removed to create a gap between the two ends.

5. Repositioning and Closure

  • Repositioning: The sealed ends of the vas deferens are placed back inside the scrotum.
  • Closure: The incisions are closed with sutures or surgical glue if necessary. In the case of NSV, the puncture wound usually does not require sutures.


Personal and Lifestyle Reasons

  1. Family Planning:

    • Completion of Family: Men who believe their family size is complete and do not wish to have more children.
    • Mutual Decision: Couples who mutually decide that they do not want any more children.
  2. Permanent Birth Control:

    • Long-Term Solution: Desire for a permanent, worry-free method of contraception without the need for ongoing measures like condoms or hormonal birth control.
    • Reliability: Vasectomy is more reliable and less prone to failure compared to other contraceptive methods.
  3. Partner Considerations:

    • Partner’s Health: When a partner has health issues that make pregnancy risky or contraindicated.
    • Relief for Partner: To relieve the female partner from the burden of contraceptive side effects or risks associated with female sterilization procedures.

Medical Reasons

  1. Genetic Concerns:

    • Hereditary Conditions: Men with genetic disorders or family histories of genetic diseases may opt for sterilization to prevent passing on conditions to offspring.
  2. Health Risks:

    • Chronic Illnesses: Men with serious or chronic health conditions that could be exacerbated by having children.
    • Mental Health: In some cases, severe mental health issues may lead individuals to choose sterilization as a responsible decision.
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