WHAT IS IT?
Vasectomy is a dependable method of birth control for men who think they will never want any or any more children.
Developed as a means of contraception in the early 20th century, and popular (500,000 procedures per year) since the 1950’s,
It is a simple 20 minute procedure performed in a doctor’s office or clinic with a local anesthetic.
The objective is to prevent sperm from entering the semen, 95% of which is support fluid made by glands called the prostate and seminal vesicles, located in the pelvis behind and beneath the bladder.
Anatomy Before Vasectomy
Anatomy After Vasectomy
HOW DOES THE SPERM MOVE?
Sperm are made in the testes
From each testicle, sperm move through a long curled-up tube behind the testis (the epididymis) wherein they become mature. From there, they swim up a foot-long tube (the vas) which guides them up to the channel (urethra) through which men urinate and ejaculate. Just before entering the urethra, the left and right vas tubes are enlarged, and it is here, behind the bladder, where many sperm are stored between ejaculations.
Male Anatomy – Sperm Production
HOW IS IT DONE?
GETTING TO THE VAS
The easiest place to access the vas tubes is just above the testes where the vas tubes are just beneath the thin scrotal skin, easy to feel and very mobile.
Vas is grasped through the skin and elevated
Skin is entered with sharp instrument (no-scalpel)
During SimpleVas® Vasectomy, Dr. Guarín administers an anesthetic solution with a pressure spray applicator (MadaJet®) to numb the scrotal skin and the vas tubes, without using any needles.
Anesthesia: Needle Vs. No-Needle
Madajet®: No-Needle Device
During SimpleVas® Vasectomy, Dr. Guarín uses special instruments to perform the procedure through a single tiny access-opening on the front side of the scrotum. The 1/4-inch slit usually seals within hours, so no stitches are needed.
Sharp Forceps to enter the skin
Clamp to grasp Vas and Skin
EXPOSING THE VAS
Through the small incision each vas deferens is delivered to the exterior were it can be interrupted.
Piercing the skin and the vas
Taking the Vas out of Scrotum
BLOCKING THE VAS TUBES
Each vas (left and right) is divided about one inch above each testis, where it is just beneath the thin scrotal skin and very easy to reach.
– Some operators remove a piece of vas, others don’t.
– Some tie off one or both vas ends using permanent or absorbable sutures or the small clips used to stop bleeding blood vessels during other types of surgical procedures
– Others cauterize (burn) the ends so that they will seal by scarring
– Still others simply place the divided ends out of alignment, by closing the vas sheath between the 2 ends with a suture or tiny clip so the ends won’t grow back together.
Cauterization of the Vas
Using Silk Sutures
Using Titanium Hemoclip
IS IT EFFECTIVE?
Dr. Guarín follows a very effective technique (with less than 0.5% failure rate) in which the portion of each vas that goes towards the abdomen is cauterized, buried into the surrounding tissue, and secured with a small titanium clip (no side effects); while the portion that goes to the testicles is left open and free flowing (which reduces the risk of congestion post-vasectomy)