regular activities, including sexual activity, within
two weeks. When varicocele is the cause of infer-
tility, FERTILITYusually returns when the surgical
wound heals.
See alsoSPERMATOCELE; SURGERY BENEFIT AND RISK
ASSESSMENT.
vas deferens A narrow tube that carries SPERM
from the epididymis to the ejaculatory duct during
ORGASMandEJACULATION. One vas deferens, also
called a ductus deferens, arises from each testicle.
The smooth-MUSCLEwalls of the vas deferens con-
tract and relax in wavelike movements to propel
sperm from the testicle to mix with seminal fluid,
which then carries the fluid (SEMEN) from the PENIS
during ejaculation.
For further discussion of the vas deferens
within the context of the structures and functions
of reproduction and sexuality, please see the
overview section “The Reproductive System.”
See also FERTILITY; TESTICLES; VASECTOMY.
vasectomy A surgical OPERATIONto sever (cut)
the VAS DEFERENS, the narrow tubes that carry
SPERMfrom a man’s TESTICLESto the ejaculatory
ducts where the sperm mixes with seminal fluid in
preparation for EJACULATION (ejection from the
PENISduring ORGASM). One vas deferens extends
from each testicle, running very close beneath the
surface of the SKINof the SCROTUM.
Surgical ProcedureThere are two methods for performing vasectomy,
both of which are outpatient procedures usually
done in the doctor’s office. Each begins with the
doctor injecting local ANESTHESIAinto the scrotum
to numb the area. For conventional vasectomy the
doctor then makes two small incisions, one on
each side of the scrotum, or a single incision at the
base of the scrotum. Each vas deferens is accessi-
ble through the incision. The doctor cuts each vas
deferens, removes a small segment to separate the
ends, and sutures (stitches) the ends closed. The
doctor then places several small, dissolving sutures
to close the incisions in the scrotum.
For the nonsurgical or no scalpel vasectomy,
the doctor locates and clamps the vas deferens
through the skin of the scrotum using a special
instrument called a ringed extracutaneous vas
clamp. The clamp closes in a small circle; each tip
is sharp. When closed the clamp makes a tiny
puncture in the scrotum and pulls the vas defer-
ens through the surface. The doctor cuts the
exposed vas deferens, ties or cauterizes the ends,
and tucks the sealed ends back inside the scrotum.
The puncture heals without sutures. The doctor
repeats the procedure on the other side.Risks and Complications
Some swelling and discomfort is normal during
the first 24 to 48 hours after the vasectomy. Ice to
the scrotum and one of the NONSTEROIDAL ANTI-
INFLAMMATORY DRUGS (NSAIDS) such as ibuprofen
help relieve INFLAMMATIONand PAIN. Wearing tight-
fitting briefs or an athletic supporter for a few days
gives additional support to the scrotum to mini-
mize discomfort. Excessive bleeding and INFECTION
are uncommon though can occur, as with any sur-
gical operation. Some men experience HEMATOMA
(collection of BLOOD within the scrotum) and
GRANULOMA(SCAR tissue formation) after vasec-
tomy. Most hematomas reabsorb within a week.
Granulomas develop in reaction to sperm that
leak into the tissues within the scrotum from the
cut end of the vas deferens. Though granulomas
are not harmful, they may remain tender or even
painful for several weeks to several months.
Sperm may remain in the seminal ducts and
other structures for quite some time, so a vasec-
tomy is not effective immediately. A man must
have two negative sperm counts one to two
months after the vasectomy (or after 10 to 20
ejaculations) before he can consider himself infer-
tile. It is essential to use an alternative method
of CONTRACEPTIONduring this time. Because reanas-
tomosis (also called recanalization) may occur
years to decades after vasectomy, a man who has
had a vasectomy should have periodic sperm
counts throughout life to confirm that he remains
infertile.Outlook and Lifestyle Modifications
Vasectomy renders a man permanently infertile
(sterile) by blocking the route by which sperm
travel out of the testicles. Spermatogenesis (pro-
duction of new sperm cells) continues; the body354 The Reproductive System