Vasectomy

Male family planning surgery is mainly to prevent the discharge of sperm, that is, vasectomy. In addition, it also includes the treatment of re-cultivation after infertility or sterilization, that is, vas deferens anastomosis and vas deferens epididymal anastomosis. Vas deferens surgery refers to the use of surgical or non-surgical procedures to cause spermatic tract blockade. After the testis can still continue to produce sperm, mature sperm dissolved in the epididymis, there is still a normal ejaculation process during sexual intercourse, but there is no sperm in the semen. The vas deferens sterilization is simpler, safer, and has no complications of abdominal surgery than the fallopian tube birth control. The postoperative recovery is also faster. Therefore, it is currently the main birth control measure. The vas deferens sterilization includes cutting off the vas deferens, occluding the vas deferens by means of chemical or electrocoagulation, blocking the vas deferens in the lumen, or closing the vas deferens outside the tube. Currently, the most commonly used is vasectomy, followed by vas deferens occlusion. The vas deferens is mainly used for the vasectomy of the vas deferens after various reasons. The vas deferens is thinner and it is difficult to match. If microsurgical techniques can be applied, the success rate is greatly increased. Curing disease: Indication 1, after the vas deferens sterilization for special reasons need to re-fertility. 2, post-surgery epididymal deposition is not effective after non-surgical treatment. 3. Sexual dysfunction caused by mental factors after sterilization is not effective by multi-party treatment, and there is no contraindication for surgery. 4, trauma or surgery accidental damage to the vas deferens. 5, vas deferens obstructive azoospermia. Contraindications 1. The general health condition is poor and cannot tolerate surgery. 2. Local or reproductive system inflammation has not been cured. Preoperative preparation 1. Explain to the subject and family members the success rate of anastomosis, including recanalization rate, re-pregnancy rate, re-incubation rate and possible complications. Both parties are informed and sign the consent form. 2, detailed medical history, to understand what kind of vasectomy, whether it has done vas deferens and surgery, postoperative conditions. 3. Do a full physical examination. Check blood routine, urine routine, clotting time, and if necessary, do related auxiliary examination. Focus on the genitourinary system and semen routine to understand whether it is appropriate for surgery, to determine the operation and anesthesia. 4, local skin preparation, the perineal should be washed once a day 2 days before surgery. After the genitals are prepared, wash the lower abdomen, penis, scrotum and perineum with warm water and soap. 5, with procaine local infiltration anesthesia, should do a skin test. Surgical procedure 1. The surgeon wears surgical underwear, wears a hat and a mask, and wears sterile gloves after routine brushing. 2, position: supine position, the two lower limbs are slightly separated. 3. Spread the sterile towel and cover it with a sterile hole towel to expose the surgical field. 4, incision, separation of the vas deferens: the skin scar of the vasectomy is removed, the incision is enlarged to 2 ~ 3cm, the far and near ends of the vas deferens are clearly separated, and the ends are lifted with sutures. Then, the vas deferens are separated to the ends, and the anastomosis after the stump is removed without tension. It is not advisable to separate too much, so as not to affect the blood supply of the vas deferens. Excision of the distal and proximal stump scars. (1) Separating the vas deferens and removing the scar 5. Introduce the stent wire into one end of the vas deferens: insert the lumen from the proximal end of the vas deferens with a 7-8 needle, and pass through the wall 1.5 cm away from the broken end, and pass through the skin of the scrotum. The nylon thread is introduced into the needle cavity, the needle is withdrawn, the nylon thread is left in the lumen, the end is exposed on the outside of the skin, and the skin end is sutured to the skin with a silk thread. (2) Introducing the stent line 6. Insert the stent wire into the lumen of the other end of the vas deferens: insert the other end of the nylon thread upward into the distal vas deferens lumen 4 to 5 cm, and use it as a lumen stent. (3) Insert the stent wire into the other end of the vas deferens 7, anastomosis vas deferens: 7-0 nylon thread or 5-0 silk thread vas deferens intermittent suture 3 ~ 4 needle for end-to-end anastomosis. 8, vas deferens reduction: suture the tissue around the vas deferens with silk thread, usually only 2 to 3 needles to cover the vas deferens, and then suture the skin incision. (4) vas deferens anastomosis and suture skin incision

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