Purpose
The intent of this operation, known as bilateral partial vasectomy, is to render you sterile (i.e., unable to cause a pregnancy in a female partner). You should also understand that there is only a remote possibility of reversing the state of infertility, once achieved.

Nature
The vas deferens are the tubes that conduct sperm from the testicles, and there is ordinarily one tube from each testicle. Bilateral partial vasectomy means dividing and closing each of these tubes and separating the severed ends. A segment may or may not be removed. The skin incisions in your scrotum may be closed with a suture material that will later dissolve as healing occurs.

Anesthesia
The operation will be performed under local anesthesia. The skin of the scrotum and the nerves to the tube to be severed will be numbed by injection of the anesthetic. You will be fully conscious. At least one injection will be given on each side of the scrotum. Sometimes discomfort is experienced in the area of the groin and testicles.

After the operation
You may expect some minor postoperative problems and occasionally some complications. The minor discomforts that frequently occur include:

• Black-and-blue marks on the scrotum
• Swelling beneath the incisions
• Tenderness around the incision sites and testicles
• Discharge from the edges of the skin incisions

Epididymitis
Painful swelling of the tissues alongside the testicles, which might include swelling of the testicles (epididymo-orchitis). The resolution of this inflammatory process may take several weeks or longer.

Sperm granuloma
Persistent tender swelling beneath the skin incision above the testicle. This is commonly due to leakage of sperm from the severed ends of the tubes into the tissues, causing an inflammatory reaction.

Hematoma
Hemorrhage due to undetected bleeding into the scrotal sac. In this instance, the scrotum may become swollen and discolored, and may require a second incision to drain the accumulated blood.

Abscess
Pus may form within the scrotum and require a second incision so it may be drained.

Recanalization
The ends of the vas may rejoin themselves. If sperm are present in the semen later on, the operation would have to be redone.

Failure of bilateral partial vasectomy
You should understand that until you have had two consecutive negative sperm checks, you must continue to use other methods of contraception. The vasectomy will sometimes fail to produce sterility; this occurs up to 4 percent of the time. Therefore, it is your responsibility to have your semen examined periodically, and understand that two negative semen checks are not an absolute guarantee against future pregnancies, due to the remote possibility of recanalization.

Pre-Vasectomy Instructions
All consent forms must be signed by you and your wife and brought to us before the vasectomy can be performed.

• SHAVE ALL HAIR FROM THE UPPER SCROTUM. This means just under the penis onto the scrotal sac. The area shaved should measure about two to three inches around. You should do this on the day of the vasectomy. You may lather the scrotum with soap and water and shave with a safety razor.
• After shaving the area, thoroughly wash the penis and the scrotum; then shower or bathe to remove all loose hairs. If needed, wash the area again just before coming in for your vasectomy.
• Bring a scrotal support (jock strap or suspensory, or tight Jockey shorts).
• Wear comfortable trousers.
• If possible, bring someone who can drive you home.
• Refrain from eating or drinking for three hours before your vasectomy.

Post-Vasectomy Instructions
Today's operation does not immediately protect you from contributing to a pregnancy. Continue to use some other method of birth control until you have had your semen analyzed twice and have been told each time that it contains no sperm.

• It is recommended that you wait at least three days before resuming sexual activities. After three days you may resume sexual activities if you are not having any discomfort, but having ejaculations too soon after a vasectomy may increase the chance of minor problems developing or a rejoining of the tubes.
• Ejaculations help to clear the passage of sperm, but you and your sexual partner must use some other method of birth control until you are told that you may discontinue its use.
• For two days after the operation, do not do any work that requires heavy lifting, pushing, or straining. You may do light work as soon as you wish.
• Keep the incisions dry for two days following the operation. Thereafter, you may resume normal bathing.
• Some black-and-blueness (bruising), draining (oozing) from the incision, swelling, or mild tenderness of the scrotum are not unusual. Also, the edges of the incision may pull apart and heal rather slowly, and sometimes a knot may be present which remains for several months. These are all part of the normal healing process and are nothing to worry about.
• Wear a suspensory or athletic supporter only as long as you need it for comfort.
• If you have pain or discomfort immediately after the vasectomy, taking two Tylenol tablets every four hours should provide relief. After the local anesthetic wears off, an ice pack will provide additional comfort and can also prevent swelling if used for several hours at half-hour intervals (one half-hour on, then one half-hour off).
• If stitches are placed, they do not have to be removed. They are absorbed and drop off by themselves, usually within 10 days, but often taking longer.