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Ligation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure)
CPT4 code
Name of the Procedure:
Ligation (percutaneous) of vas deferens, unilateral or bilateral
Common Name(s): Vasectomy
Technical/Medical Terms: Percutaneous vas deferens ligation
Summary
A vasectomy is a minor surgical procedure performed to render a man permanently sterile by cutting and sealing the vas deferens, which carry sperm from the testicles. This can be done on one side (unilateral) or both sides (bilateral).
Purpose
The primary purpose of the procedure is male sterilization, preventing the release of sperm during ejaculation. This is a permanent form of birth control designed to prevent pregnancy.
Indications
- Desire for permanent contraception
- Men who have completed their family
- Medical conditions that make other forms of birth control risky or unsuccessful
Preparation
- Preoperative consultation to discuss the procedure, risks, and benefits
- Signing a consent form
- Shaving the scrotal area if instructed
- Fasting may not be required unless sedation or general anesthesia is planned
- Avoid certain medications (aspirin, anticoagulants) as advised by the doctor
Procedure Description
- The patient is positioned comfortably, and local anesthesia is administered to numb the scrotal area.
- A small puncture (percutaneous) or incision is made in the scrotum to access the vas deferens.
- The vas deferens is then cut and a small section is removed.
- The ends of the vas deferens are sealed by tying (ligation), cauterizing, or applying surgical clips.
- The procedure is repeated on the other side if performing a bilateral vasectomy.
- The skin is closed using absorbable sutures or medical glue.
Duration
The procedure typically takes about 15-30 minutes.
Setting
A vasectomy is usually performed in an outpatient setting, such as a doctor's office, outpatient clinic, or surgical center.
Personnel
- Urologist or surgeon
- Nurses or surgical assistants
- Anesthesiologist (if sedation or general anesthesia is used)
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma
- Chronic pain or discomfort
- Granulomas (small lumps caused by sperm leakage)
- Rarely, recanalization (spontaneous reconnection of the vas deferens)
Benefits
- Permanent and highly effective contraception
- Quick recovery period
- No significant long-term effects on sexual performance or hormone levels
Recovery
- Rest and limit physical activity for a couple of days post-procedure
- Wear supportive underwear to minimize discomfort
- Apply ice packs to reduce swelling and pain
- Follow-up appointment after a few weeks to ensure proper healing
- Use alternative contraception until a semen analysis confirms the absence of sperm (usually about 3 months post-procedure)
Alternatives
- Temporary contraception methods (condoms, oral contraceptives)
- Female sterilization (tubal ligation)
- Long-acting reversible contraception (IUDs, implants)
Patient Experience
- Mild discomfort or pressure during the procedure due to local anesthesia
- Post-procedure pain similar to mild bruising for a few days
- Pain management with over-the-counter pain relievers and ice packs