This document provides information about the procedure for a vasectomy. It begins by describing the vas deferens and how interrupting or obstructing this duct inhibits sperm production. It then discusses that a vasectomy is an outpatient surgical procedure where a small segment of the vas deferens is removed and the ends are sealed to prevent sperm from passing through. The preparation of the patient, skin preparation, draping, equipment, instrumentation, supplies and special considerations for the procedure are outlined in detail.

1. VASECTOMY
Presented by----
Mrs. Usha Rani Kandula,
MSc.Nursing, Assistant professor,
Department of Adult Health Nursing,
College of Health Sciences,
Arsi University, Asella, Ethiopia.

2. VAS DEFERENS
-The vasa deferentia are the small
fibromuscular excretory ducts that carry
sperm upward through the spermatic cords
from the epididymides (which lie along the
upper portion of each testis) to the seminal
vesicles, the pouch like glands in front of the
urinary bladder near the prostate gland.

3.  Interruption of or obstruction to a vas
deferens inhibits normal spermatogenesis.

9. VASECTOMY
-Elective bilateral vasectomy is an established
method of male sterilization and is usually
performed as an ambulatory surgical
procedure.

10.  -Depending on the preference of the urologist,
the cut ends are either ligated with suture or
clips or the endothelium of the lumen is
coagulated with the ESU.

11. PROCEDURE
-The vas is palpated through the scrotum.
-A scrotal incision is made, the vas is seized,
and it is freed of surrounding tissue.
-A segment of vas is excised and the ends are
ligated, cauterized, or crushed with a clamp or
clip prior to ligation.

12. -The severed ends may be allowed to retract, or
they may be buried within the scrotal
connective tissue and sutured in place.
-The wound is closed.
-The procedure is repeated on the other side.
-A bulky dressing is applied.

13.  -A specialized clamp is used to grasp and fix
the vas transcutaneously.

14.  A puncturing forceps exposes the vas;
 the vas is divided, ligated, clipped and/or
cauterized.
 -The vas is returned to the scrotum.
 The small puncture wounds “self-close” and
do not require sutures.

15. PREPARATION OF THE PATIENT
-Anti embolitic hose may be applied.
-The patient is supine with legs apart;
-a small pad may be placed under the buttocks
to maximize visualization.
-A pillow may be placed under the knees for
comfort and to avoid lower back pain.

16. -Arms may be extended on padded arm boards,
or they may be padded and tucked in at the
patient’s sides.

17. -All bony prominences and areas vulnerable to
skin and neurovascular pressure or trauma
are padded.
-Apply electrosurgical dispersive pad.

18. SKIN PREPARATION
 Begin at the scrotum,
 -extending from above the pubic symphysis
to the lower thighs.

19. DRAPING
 Folded towels and a sheet
 or laparotomy sheet
EQUIPMENT
 ESU
INSTRUMENTATION
VASECTOMY TRAY

20. SUPPLIES
 Small basin
 Medicine cup,
 local anesthetic,
 Luer lok syringe, and #25 needle
 Label and sterile marking pen

21.  Electrosurgical pencil with needle tip Blade,
(1) #15
 Dressing, e.g., telfa, “gauze fluffs,” and
scrotal support
 Ice pack (at conclusion)

22. SPECIAL CONSIDERATIONS
-Apply Special Notes from Hypospadias, as
indicated.
-Maintenance of Perioperative Record.
-Avoid medication errors.
-Ice pack application over the scrotum for
post op pain reliving.
THANKING YOU .