Name of the Procedure:

Vasotomy, Cannulization with or without Incision of Vas, Unilateral or Bilateral

Summary

A vasotomy refers to the surgical procedure where an incision is made into the vas deferens (the duct that conveys sperm from the testicle to the urethra). This procedure may involve the insertion of a cannula (a thin tube) to permit the passage of fluids or to perform certain medical treatments. This can be done on one or both sides of the body.

Purpose

The procedure primarily addresses male infertility issues or problems related to sperm retrieval. It may also be used in the course of vasectomy reversals or to diagnose and treat conditions affecting the vas deferens.

Indications

• Male infertility potentially treatable by sperm retrieval
• Blockages or strictures in the vas deferens
• Cases where sperm is required directly from the vas deferens for assisted reproductive technologies
• Vasectomy reversal procedures

Preparation

• Patients may be advised to fast for a few hours before the procedure.
• A thorough medical history and physical examination are required.
• Blood and urine tests may be performed to ensure the patient is fit for surgery.

Procedure Description

1. The patient is usually administered local or general anesthesia.
2. A small incision is made in the scrotum to access the vas deferens.
3. The vas deferens is isolated and a second small incision is made to expose the duct.
4. A cannula is inserted into the vas deferens.
5. The procedure may include flushing, aspirating, or other treatments as required.
6. Once completed, the incision is closed with sutures.

Tools:

• Scalpel
• Cannula
• Suturing material

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

This procedure is usually performed in an outpatient clinic or a specialized surgical center.

Personnel

• Urologist or specialized surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection at the incision site
• Scarring
• Hematoma (blood clot) formation
• Temporary or permanent changes in sensation
• Pain or discomfort post-procedure

Benefits

• Potential improvement in fertility
• Successful retrieval of sperm for assisted reproductive technology
• Resolution of any blockages or strictures in the vas deferens

Recovery

• Patients may experience some swelling, bruising, and discomfort which can be managed with pain relievers.
• Most can resume normal activities within a few days but are advised to avoid heavy lifting and strenuous activity for a week.
• Follow-up appointments are typically scheduled to monitor healing.

Alternatives

• Vasectomy reversal using other surgical techniques
• Assisted reproductive technologies like intracytoplasmic sperm injection (ICSI) where sperm is directly injected into the egg
• Alternative sperm retrieval techniques like testicular sperm extraction (TESE)

Patient Experience

During the procedure, patients under local anesthesia may feel some pressure but should not experience significant pain. Post-procedure, discomfort is manageable and subsides in a few days. Long-term results vary but many patients experience positive outcomes in improving fertility or treating obstructions.