What is vasectomy? Male sterilization that does not require contraceptives and is almost 100% pregnancy-free | 男性不妊治療は銀座リプロ外科            
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パイプカットとは 避妊具不要でほぼ100%妊娠しない男性避妊術

At our clinic, we offer both vasectomies and reversal of previous vasectomies. To schedule an initial consultation, please visit our initial consultation page.

Why use a microscope?
The spermatic cord in the upper part of the scrotum contains many cord-like structures (blood vessels, nerves, muscles, connective tissue, and vas deferens). The use of a microscope reduces bleeding and pain in small areas of surgical manipulation. Most importantly, the vas deferens can be reliably located and securely ligated among the many ducts. At our clinic we have experienced cases of reoperation after failed vasectomies from other hospitals, where the vas deferens were not ligated properly, or where the vas deferens were ligated with other tubules similar to the vas deferens.
At our clinic, the primary surgeon is Professor Nagao of Toho University, who has performed many more advanced microscopic vasectomy reconstructions. He is familiar with the characteristics of the vas deferens and is able to examine them under a microscope, so you can undergo the surgery with peace of mind.

The primary surgeon is a super microsurgeon.
Our doctors also perform super microsurgery (anastomosis of lymphatic vessels with the thinnest diameter of 0.3 mm) among microsurgery specialists, which enables us to perform safer and more reliable surgeries.

One day microsurgical artery-sparing vasectomy at our clinic: 7 features

1. Confirm under the microscope that it is definitely a vas deferens
The vas deferens has a thick cross-sectional wall and a narrow lumen. In some cases of vasectomy failure at other hospitals, a similar tube was ligated (tied and secured), or the tube was not properly ligated.

2. Four-ligature ligation (double ligation of one end)
This allows for a vasectomy with less failures.

3. Cover the cut with fascia to prevent re-opening
This procedure is also used to prevent surgery failure.

4. Preserve the vas deferens artery
This is to maintain blood flow to the testicles and prevent testosterone depletion.

Image of the vas deferens after surgery

↑Image of the vas deferens after surgery (will be displayed while clicked)
*Warning: this is an image of the affected area after surgery.

5. Preserve the vas deferens nerve.
This prevents postoperative pain.

6. Prevent damage to the epididymis by cutting at the upper part of the vas deferens
This is important in the case of reanastomosis (returning the vas deferens to its original state) and also prevents postoperative pain.

7. Provide the patient with a microscopic photograph of the vasectomy

Click here to book your first visit for a vasectomy

What is Vasectomy?

A vasectomy is a sterilization procedure performed on men. It is a contraceptive method in which a 1 cm incision is made in the scrotum and the vas deferens is ligated or severed to prevent the passage of sperm.
We perform this procedure under a microscope, using local anesthesia, and it is a painless one-day procedure.

When is this surgery performed?

This surgery is performed when a person wishes to not have more or any children. For patients in a relationship, it is important to have a discussion with your partner before undergoing this procedure.

Advantages of Vasectomy

The major advantages of a vasectomy are as follows

  • No need for contraceptives (e.g. condoms).
  • Both parties can enjoy sexual intercourse without worrying about pregnancy.

No need for contraceptives

Vasectomy allows for sexual intercourse without the use of contraceptives (condoms, etc.).

Sexual intercourse has the potential to cause pregnancy. Even if a condom is used, the chances of pregnancy are not zero. It is said that the pregnancy rate (failure of contraception) with condoms is about 14%.

On the other hand, a vasectomy provides almost 100% contraceptive protection. Once the surgery is performed, the contraceptive effect is semi-permanent. If you do not wish to become pregnant, a vasectomy is recommended.

Some people may also be allergic to rubber and have difficulty wearing condoms.A vasectomy is also recommended for such people.

Both parties can enjoy their sex life.

Vasectomy allows both parties to enjoy sexual intercourse without the need for condoms.

Men do not have to worry about getting someone pregnant and women do not have to worry about getting pregnant. Both parties are freed from the burden of unwanted pregnancies and can focus on their sexual activities. It also eliminates the need to buy and wear condoms.

Disadvantages of Vasectomy

The three main disadvantages of vasectomy are as follows

  • There is no guarantee that the vasectomy can be fully reversed
  • This contraception may not be 100%
  • Does not prevent sexually transmitted diseases

There is no guarantee of reversibility.

Once a vasectomy is performed, it is difficult to restore the vas deferens. Surgery to reconnect the vas deferens (vasectomy reanastomosis) is available, but there is no 100% guarantee that it can be fully reversed. It is also possible that the testes may lose their ability to produce sperm over time.

Therefore, if you decide after the surgery that you still want to have children, there is a possibility that you will not be able to naturally. This is why vasectomies must be done only after discussing the future with your partner and coming to an agreement.

Its contraception may not be 100% assured

As explained in the benefits section, pipe cut is almost 100% effective in preventing pregnancy, but it is not 100% certain.

Sexually transmitted diseases (STDs) cannot be prevented.

Condoms are a contraceptive, but they also prevent sexually transmitted diseases. Vasectomy allows contraception without condoms, therefore, it does not prevent sexually transmitted diseases.

Some STDs can be easily cured with medication, while others, such as HIV, require a lifetime of medication. Some sexually transmitted diseases have different symptoms in men and women, and in women, they may progress without symptoms, leading to infertility or infection of the fetus.

While it is an advantage to be able to have sexual intercourse freely without a condom, one downside is the inability to prevent STDs. If you want to reduce the risk of STDs as much as possible, condom use is recommended.

Vasectomy Surgery Procedure

The following is the order of the events for vasectomy surgery at our clinic.

Before the surgery

Please make an appointment in advance and visit our clinic.
We will interview you, palpate you, and perform an ultrasound if you wish.
After consultation with the doctor, if you wish to have the surgery, you will undergo a blood test (for infectious diseases) as a preoperative examination.

During the surgery

During the surgery, local anesthesia will be used for you to relax while having a pleasant talk with the doctor.
The severed vas deferens can be viewed on a monitor in the room.

View images of the a severed vas deferens.

Warning: this is an image of the affected area after surgery.

After the surgery

The next day, showering is allowed.
2 weeks later bathing and drinking is allowed. Please masturbate to release old sperm.
After 1 to 2 months, perform a semen analysis. After confirming the absence of sperm, intravaginal ejaculation is possible


Differences from Female Sterilization

In contrast to male sterilization (vasectomy), female sterilization is called tubal ligation and involves ligating the fallopian tubes so that the egg released during ovulation from the ovary does not encounter sperm. Tubal ligation is the act of tying the fallopian tubes together with thread.
The surgery takes about one hour, but is performed under general anesthesia because of the intra-abdominal approach.
Due to the risk of complications, female sterilization is a more physically demanding procedure than male sterilization.

Frequently Asked Questions

  • Will I feel pain during the surgery?

    The injection of local anesthesia can be slightly painful, but after that there is very little pain. The reason for this is because the scrotal skin is insensitive. Our surgery is carefully performed under a microscope from the beginning for minimal pain.

  • Can a vasectomy be reversed?

    As explained in the disadvantages section, although reversible it is not 100% guaranteed. If after a vasectomy, the patient's circumstances change, such as remarriage, or a change of heart, and the patient wishes to become pregnant, a vasectomy reversal (vasectomy anastomosis) can be scheduled. 
    Vasectomy reversal is a surgical procedure in which the vas deferens is reconnected by using an operating microscope to re-anastomize the obstructed vas deferens.                
    Our vasectomy reconstruction is a one day procedure performed under a microscope and has the highest success rate with rate of 90% and a 10% chance of no sperm emergence. We also perform vasectomies to facilitate possible vasectomy reversal in the future. If you have a change of heart or your situation has changed, please consult us.

  • Is there any possibility of causing pregnancy?

    After undergoing the vasectomy, a semen analysis is performed. If the semen analysis shows no semen present, there is no chance of getting pregnant. Since there is residual sperm in the vas deferens, we recommend a semen analysis in the second month after the surgery. Until then, please use a condom. Although it is very rare, spontaneous reopening of the seminal ducts has been reported. We recommend a semen analysis every year just be safe.

  • Is there any change in sensitivity?

    You can continue to have sexual intercourse as before, and there is no change in sensitivity.

  • Will my sperm decrease?

    Vasectomy does not cause a decrease in sperm, but if the vas deferens artery is severed, testicular function is likely to decrease and male hormones may decrease.

  • When can I start having sexual intercourse?

    Sexual intercourse is possible after the postoperative swelling goes down. It varies from patient to patient, but about one week is the standard.
    However, there is a possibility that residual sperm may remain in the semen for a while after the surgery.
    The number of ejaculations until there are no more sperm in the semen varies from person to person, but it is generally about 15 to 20 times. Until a semen analysis is performed to confirm that there is no sperm, please use a contraceptive (condom) during sexual intercourse.

  • Will the scar be visible?

    The surgical scar will be about 1 to 2 cm. The scrotum, where the incision is made, has many wrinkles, so scars are not easily noticeable. It will be difficult for others to notice at a quick glance.

  • When can I return to my job?

    If your job does not require much physical activity, such as desk work, you can start working on the same day. With the exception of hard physical work, you can basically start working the next day.

  • When can I start taking a bath?

    Bathing and showing is strictly prohibited on the same day as the procedure. You can take a shower the next day, but please allow a period of about 2 weeks for bathing.

  • What are the benefits of vasectomy?

    Vasectomies is a contraceptive surgery with high success rates that allows for sexual intercourse without the burden of worrying about unwanted pregnancies. There will be no changes besides the absence of sperm in the semen.

  • Does a vasectomy provide reliable contraception?

    Although it is very rare, there have been cases of spontaneous re-opening of the vas deferens, with a probability of 1 in 2,000. At Ginza Repro Surgery, we specialize in microscopic vas deferens anastomosis, so we are familiar with the anatomy of the vas deferens and will not mistake other tubes for the vas deferens. Our procedure also preserves the vas deferens artery and prevents the loss of testicular function that produces male hormones.

  • Can a vasectomy be reversed?

    A Vasectomy can be reversed, but it is not 100% guaranteed, therefore, please have a thorough discussion with your partner before undergoing surgery. At Ginza Repro Surgery, we perform "one-day microscopic vasectomy reversal" to reconnect the vas deferens, with a sperm emergence rate of 90% and a 10% chance of no sperm emergence. We also perform vasectomies to facilitate possible vasectomy reversal in the future. If you have a change of heart or your situation has changed, please consult us.

  • Is there any change in sensitivity or vigor after a vasectomy?

    There is no change in sensitivity or vigor, but if the vas deferens artery is severed, testicular function is more likely to deteriorate and male hormone levels may decrease. Depending on the vasectomy procedure, postoperative pain (chronic epididymitis) may remain.

  • Is vasectomy surgery painful?

    There is a stinging pain during the injection of anesthesia, but this is a minimal invasive procedure that is done carefully using a microscope, so there is almost no pain during the surgery.

Precautions for Vasectomies

The following precautions apply to vasectomies.

  • Swelling and pain after the surgery
  • Risk of complications

Swelling and pain after surgery

Vasectomy is a procedure that involves a small incision in the skin. Therefore, there may be some swelling and pain in the affected area after the surgery.

Recovery is within a few days, but you should take it easy until the symptoms subside. If the swelling or pain persists or becomes severe, please contact us immediately.

Risk of Complications

Complications are very rare.. Bleeding or hematoma may occur after surgery. A hematoma is a condition in which blood that has bled does not drain out of the body, but accumulates and coagulates in the body's tissues.

The hematoma may be absorbed, but depending on the volume, removal of the hematoma may be necessary. If you have any concerns, please consult with us as soon as possible.

この記事の執筆医師

永尾 光一 先生

永尾 光一 先生

東邦大学 医学部教授(泌尿器科学講座)
東邦大学医療センター大森病院 リプロダクションセンター
東邦大学医療センター大森病院 尿路再建(泌尿器科・形成外科)センター長

昭和大学にて形成外科学を8年間専攻。その後、東邦大学で泌尿器科学を専攻し、形成外科・泌尿器科両方の診療科部長を経験する(2つの基本領域専門医を取得)。得意分野はマイクロサージャリーをはじめとする生殖医学領域の形成外科的手術。泌尿器科医の枠を超えた細やかな手術手技と丁寧な診察で、様々な悩みを抱える患者さんから高い信頼と評価を得ている。

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