Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)
CPT4 code
Name of the Procedure:
Vasectomy, unilateral or bilateral. Commonly known as "Vasectomy", this procedure can be performed on one (unilateral) or both (bilateral) vas deferens.
Summary
A vasectomy is a minor surgical procedure for male sterilization or permanent contraception. During the procedure, the vas deferens are cut or sealed to prevent sperm from entering the urethra, thereby preventing fertilization. The procedure may include postoperative semen examinations to confirm the absence of sperm.
Purpose
A vasectomy addresses the need for long-term birth control and is usually chosen by men who:
- Do not want to father any more children.
- Seek a permanent contraception method.
The goal is effective and permanent sterilization without significantly impacting sexual function or hormone levels.
Indications
- Desire for permanent birth control.
- Completion of childbearing plans.
- Medical conditions where pregnancy would pose health risks to the partner.
Patient criteria include men who are certain they do not want more children and have discussed other temporary contraceptive options.
Preparation
- Consult with a healthcare provider to discuss intentions and irreversible nature of the procedure.
- Arrange for a ride home post-surgery due to anesthesia effects.
- Avoid aspirin and other blood-thinning medications for a specified period before surgery.
- Shave the scrotal area, if instructed by the healthcare provider.
Procedure Description
- Anesthesia: Local anesthesia is typically administered to numb the scrotum.
- Accessing Vas Deferens: A small incision or puncture is made in the scrotum to access each vas deferens.
- Cutting and Sealing: Each vas deferens is cut, tied, or sealed using clips, heat (cautery), or other surgical methods.
- Closure: The small incision is closed with stitches or allowed to heal naturally.
Duration
The procedure typically takes about 30 minutes.
Setting
A vasectomy is usually performed in an outpatient clinic or surgical center.
Personnel
- Surgeon (Urologist)
- Nurse or medical assistant
Risks and Complications
- Infection at the incision site.
- Bleeding or hematoma.
- Chronic pain (Post-Vasectomy Pain Syndrome).
- Rarely, spontaneous reconnection of the vas deferens.
Benefits
- Permanent contraception with over 99% effectiveness.
- Minimal impact on sexual function and hormone levels.
- Quick recovery and minimal downtime.
Recovery
- Rest and avoid strenuous activity for a few days.
- Wear supportive underwear to alleviate discomfort.
- Use ice packs to reduce swelling.
- Sperm count tests are conducted a few months post-procedure to confirm sterility.
- Normal activities and sexual intercourse can generally resume within a week.
Alternatives
- Temporary contraceptives: Condoms, hormonal birth control for partners, IUDs.
- Permanent alternatives: Female sterilization (tubal ligation).
- Pros of alternatives: Reversible (in some cases), non-surgical options.
- Cons of alternatives: Potential side effects, lower long-term effectiveness.
Patient Experience
- Mild discomfort or pain during the procedure, typically well-managed with local anesthesia.
- Post-procedure discomfort is generally minimal and treated with over-the-counter pain medications.
- Anxiety about the procedure can be addressed through counseling and thorough discussion with the healthcare provider.