Vasectomy Information

A vasectomy is a permanent method for birth control. A vasectomy prevents the release of sperm whenever a man ejaculates. Metropolitan Urological Specialists in St. Louis, Missouri would like to give you the following information so that you can make the right decision for you and your partner.

During a vasectomy, the vas deferens from each testicle is clamped, cut, or otherwise sealed. This prevents sperm from mixing with the semen that is ejaculated from the penis. An egg cannot be fertilized when there aren't any sperm in the semen. The testicles continue to produce sperm, but the sperm are reabsorbed by the body. (This also happens to sperm that are not ejaculated after a while, no matter if you've had a vasectomy.) Because the tubes are obstructed before the seminal vesicles and prostate, you will still ejaculate about the same amount of fluid.

It usually takes several months after a vasectomy for all remaining sperm to be ejaculated or reabsorbed. You have to use another method of birth control until you have a semen sample analyzed and it shows a zero sperm count. Otherwise, it is possible to still get your partner pregnant.

What Happens

In a vasectomy:

•   Your testicles and scrotum are cleaned with an antiseptic and probably shaved.
•   You may be given an oral or intravenous (IV) medication to reduce anxiety and make you sleepy. If you do take this medication, you may not remember much about the procedure.
•   Each vas deferens is located by touch.
•   A local anesthetic is injected into the area.
•   Your doctor makes one or two small openings within your scrotum. Through an opening, both vas deferens tubes are cut. The 2 ends of the vas deferens are tied, stitched, or sealed. Electrocautery can be utilized to seal the ends with heat. Scar tissue from the procedure helps block the tubes.
•   The vas deferens is then replaced inside the scrotum and the skin is closed with stitches that dissolve and don't have to be removed.

The treatment takes about 20 to 30 minutes and can be carried out in an office or clinic such as Metropolitan Urological Services in St. Louis, MO. It may be done by a family medicine doctor, a urologist, or a general surgeon.

No-scalpel vasectomy is a method that utilizes a small clamp with pointed ends. Instead of using a scalpel to cut the skin, the clamp is poked through the skin of the scrotum and subsequently opened. The benefits of this procedure include less bleeding, a smaller sized hole in the skin, and fewer complications. No-scalpel vasectomy is as effective as regular vasectomy.

In the Vasclip implant procedure, the vas deferens is locked shut with a device known as a Vasclip. The vas deferens is not cut, sutured, or cauterized (sealed by burning), which possibly reduces the potential for pain and complications. Some research shows that clipping isn't as effective as other ways of sealing off the vas deferens.

What You Should Expect After Surgery

Your scrotum will be numb for 1 to 2 hours after a vasectomy. Apply cold packs to the area and lie face up as much as possible for the rest of the day. Wearing snug undergarments or a jockstrap will help ease discomfort and protect the area.

You may possibly have some swelling and minor pain in your scrotum for a number of days following the surgery. Unless of course your work is strenuous, you'll be able to return to work in one or two days. Avoid heavy lifting for a week.

You can go back to sexual activity when you are comfortable, normally in about a week. But you can still get your partner pregnant until your sperm count is zero. You should use another method of birth control until you have a follow-up sperm count test 2 months after the vasectomy (or after 10 to 20 ejaculations over a shorter period of time). When your sperm count is zero, no other birth control method is needed.

Most men go back to the physician's office to get their sperm count checked. But there is also a home test available.

A vasectomy will not affect your sex drive, capacity to have erections, feeling of orgasm, or capability to ejaculate. You may have occasional mild aching in your testicles in sexual arousal for just a few months following your surgery. If you think that a vasectomy may be something worth exploring for you or your partner, get a hold of Metropolitan Urological Specialists and set up an appointment. Metropolitan Urological Specialists serves St. Louis, Creve Coeur, Florissant, and Kirkwood, MO with the latest in non-invasive surgical and nonsurgical urological solutions.

Causes Of Male Infertility

Male fertility is a complicated process, which is why the professionals at Metro Urological Specialists in St. Louis, MO have this important information for your use. In order to get your partner pregnant, the following need to occur:

•   You need to make healthy sperm. At first, this requires the growth and formation of the male reproductive organs during puberty. One or both of your testicles need to be working properly, and your body needs to produce testosterone and other hormones to trigger and maintain sperm production.

•   Sperm need to be carried into the semen. When sperm are made in the testicles, delicate tubes transport them until they combine with semen and are ejaculated from the penis.

•   There needs to be enough sperm in the semen. If the number of sperm in your semen (sperm count) is low, it reduces the chances that one of the sperm will fertilize your partner's egg. A low sperm count is under 15 million sperm per milliliter of semen or fewer than thirty-nine million per discharge.

•   Sperm have to be functional and able to move. If the movement (motility) or function of your sperm is unusual, the sperm might not be able to reach or penetrate your partner's egg.

Medical Causes

Problems with male fertility may be the result of a number of health issues and medical treatments. Metro Urological Specialists, serving the folks of St Louis, Creve Coeur, Florissant, and Kirkwood, has the ability and experience to deal with all of these issues, including:

•   Varicocele. A varicocele is a swelling of the veins which drain the testicle. It's the most common correctable cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it might be related to irregular testicular temperature regulation. Varicoceles lead to reduced quality of the sperm. Treating the varicocele can improve sperm numbers and function, and may possibly improve outcomes when using assisted reproductive techniques such as in vitro fertilization.

•   Infection. Some infections can interfere with sperm production or sperm health or can cause scarring that hinders the passing of sperm. These include irritation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transferred infections, including gonorrhea or HIV. Although some infections can bring about lasting testicular damage, usually sperm may still be retrieved.

•   Ejaculation issues. Retrograde ejaculation occurs when semen goes into the bladder during orgasm instead of emerging out the tip of the penis. Various health conditions can lead to retrograde ejaculation, including diabetes, spinal injuries, medications, and surgery of the bladder, prostate, or urethra. Some men with spinal cord injuries or certain diseases can't ejaculate semen, even though they still generate seminal fluid. Often in these instances sperm can still be retrieved for use in assisted reproductive techniques.

•   Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that mistakenly identify sperm as dangerous invaders and attempt to eliminate them.

•   Tumors. Cancers and nonmalignant tumors could affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. In many cases, surgery, radiation, or chemotherapy to handle tumors can affect male fertility.

•   Undescended testicles. In some males, during fetal development one or both testicles fail to come down from the abdomen into the sac that usually contains the testicles (scrotum). Lowered fertility is much more probable in men who've had this problem.

•   Hormone imbalances. Infertility can be a consequence of disorders of the testicles themselves or an irregularity affecting other hormonal systems including the hypothalamus, pituitary, thyroid, and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of potential root causes.

•   Defects of tubules that transport sperm. A variety of tubes carry sperm. They can be obstructed due to various causes, including accidental injury from surgery, previous infections, trauma, or abnormal development, such as with cystic fibrosis or similar inherited conditions. Blockage can occur at any level, including within the testicle, within the tubes that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts, or within the urethra.

•   Chromosome defects. Inherited disorders like Klinefelter's syndrome — in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) — cause unusual development of the male reproductive organs. Other genetic syndromes related to infertility include cystic fibrosis, Kallmann's syndrome, and Kartagener's syndrome.

•   Difficulties with sexual intercourse. These can include difficulty keeping or maintaining an erection adequate for sex (erectile dysfunction), early ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship issues that affect sex.

•   Celiac disease. A digestive disorder triggered by sensitivity to gluten, celiac disease can result in male infertility. Fertility might improve after implementing a gluten-free diet.

•   Certain medications. Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medicines can impair sperm production and decrease male fertility.

•   Previous surgeries. Some surgeries may prevent you from having sperm in your semen, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries done for testicular and rectal cancers, among others. Usually, surgery can be performed to either reverse these obstructions or to retrieve sperm directly from the epididymis and testicles.

Environmental Causes

Overexposure to certain environmental elements like heat, toxins, and chemicals can reduce sperm production or sperm function. Specific causes include:

•   Industrial chemicals. Extensive exposure to benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials, and lead may contribute to low sperm counts.

•   Heavy metal exposure. Exposure to lead or other heavy metals also may result in infertility.

•   Radiation or X-rays. Exposure to radiation can lessen sperm production, although it will often eventually return to normal. With high doses of radiation, sperm production may be permanently decreased.

•   Overheating the testicles. Elevated temperatures hinder sperm production and function. Even though research is limited and inconclusive, recurring utilization of saunas or hot tubs may briefly reduce your sperm count. Sitting for extended periods, wearing tight clothing, or working on a laptop for long periods of time also may increase the temperature in your scrotum and may somewhat lessen sperm production.

Health, Lifestyle, and Other Causes

Some other causes of male infertility include:

•   Illicit drug use. Anabolic steroids taken to provoke muscle strength and growth might cause the testicles to shrink and sperm production to decrease. Use of cocaine or marijuana may temporarily reduce the number and quality of your sperm as well.

•   Alcohol use. Consuming alcohol can lower testosterone levels, trigger erectile dysfunction, and decrease sperm production. Liver disease as a result of excessive drinking may also lead to fertility problems.

•   Smoking cigarettes. Men who smoke may have a lower sperm count than do those that don't smoke. Secondhand smoke also may influence male fertility.

•   Emotional stress. Stress can interfere with certain hormones needed to produce sperm. Severe or prolonged emotional stress, including difficulties with fertility, can impact your sperm count.

•   Weight. Obesity can impair fertility in many ways, including directly impacting sperm themselves and by causing hormone changes that reduce male fertility.

•   Some occupations including welding or those involving extended sitting, such as truck driving, may be associated with a risk of infertility. Nevertheless, the research to support these links is mixed.

As you can see, there are numerous factors that can play a role in infertility. If you feel that you are infertile or you've got any questions relating to infertility, Metro Urological Specialists in Washington, Florissant, and St. Louis, Missouri is the perfect place to go to get the help you need.