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 a sterilization method that injects drugs into the vas deferens to cause adhesion and blockage in the vas deferens. This procedure does not make skin incisions, does not detach, does not cut, and does not ligature the vas deferens. This not only reduces some concurrency caused by tissue damage. Symptoms, but also reduce complications caused by mental factors. Curing disease: Indication 1. Married men are undergoing family planning, and bilateral vasectomy is performed with the consent of both husband and wife. 2, one side epididymal tuberculosis and prostate, seminal vesicle tuberculosis, in order to prevent or reduce the risk of healthy epididymal infection, the contralateral vasectomy. 3, prostatectomy, in order to prevent epididymitis after surgery, bilateral vasectomy. Contraindications 1. The vas deferens and the spermatic cord have adhesions, and the vas deferens cannot be fixed under the scrotum. 2, bleeding disorders, mental illness, severe neurosis, sexual dysfunction, acute or severe chronic diseases. 3, acute or chronic inflammation of the genitourinary system, should be cured before surgery or other birth control measures. 4, scrotal skin acute or chronic inflammation, lymphedema or other skin diseases that hinder surgery, should be cured before surgery. 5, scrotal disease, such as inguinal hernia, hydrocele, varicocele, etc., should be cured after surgery, or surgery in the scrotum while performing vasectomy. Preoperative preparation 1. Pre-operative introduction of the knowledge of vas deferens in the operative and family members to eliminate ideological concerns and incorrect understanding. 2, acute and chronic infection of the urinary tract, scrotal skin disease and scrotal disease, to be cured before surgery. 3, pay attention to the history of drug allergy, do procaine skin test. 4. Bathe before the operation, clean the vulva, and replace the cleansing pants. Shave the pubic hair before surgery. 5. Dip the penis scrotum with 1:1000 benzalkonium solution for 5 min before surgery, then dry it, and then disinfect the skin with 1:1000 thiomersal or 75% ethanol; or disinfect it with 1:1000 Xinjieer solution for 3 times. Surgical procedure The vas deferens sticking device: the vas deferens fixed forceps, the vas deferens needle, the vas deferens injection needle and the vas deferens sticking syringe. The vas deferens blocking agent: a mixture of chemically pure carbolic acid 25g and "504" (n-butyl cyanoacrylate) 75g. 1. Fix the vas deferens with a fixed forceps and fix the vas deferens with a three-finger method. Then use the vas deferens fixed forceps to fit the vas deferens with the tight scrotum skin into the circle, so that the vas deferens is fixed in the shallowest part of the scrotum skin, and the caliper handle faces the lower limb of the subject. end. 2, puncture vas deferens with the left thumb, finger to pinch the vas deferens, the right hand with the vas deferens puncture needle in the vertical direction of the most prominent vas deferens in the vertical direction of the vas deferens anterior wall. When punctured into the vas deferens, there is often a "crunchy sex." The bevel of the needle should be aligned with the longitudinal axis of the vas deferens to avoid puncturing the vas deferens. 3. Insert the injection needle and pull out the vas deferens needle. Immediately insert the vas deferens needle from the original puncture needle into the vas deferens, and then point the needle tip to the seminal vesicle end and advance 3mm along the lumen. 4, there are two commonly used methods to verify the success of puncture, one is the seminal vesicle perfusion test, and the other is the blind tube compression test. The former is a syringe containing a 0.05 ml Congo red 5 ml, which is attached to the inserted vas deferens needle holder. The thumb of the operator's left hand gently pinches the vas deferens near the subcutaneous ring and then pushes the drug solution. If the puncture is successful, there is a sense of urinary sensation and no local swelling. The latter is a 5ml syringe containing air, which is attached to the inserted needle seat. The assistant uses the thumb finger to clamp the vas deferens at the subcutaneous ring. The surgeon tightens the vas deferens in front of the skin needle in the same way, and sucks the blood without blood. Push the piston to the 2ml mark. After 4s, release the finger that pushes the piston. If the piston automatically returns to the original scale, the puncture is successful. 5. Injecting the occlusion agent After the vas deferens have been successfully confirmed, use a syringe to remove the local fluid in the injection needle and the vas deferens, remove the injection needle, and use the dry gauze to absorb the liquid in the needle holder. Use a vas deferens to block the syringe, accurately absorb the vas deferens blocking agent 0.045ml, and connect the needle holder. The assistant uses the thumb to grasp the vas deferens about 1.5 cm in front of the needle tip. The surgeon uses the same method to clamp the vas deferens in front of the needle eye. The needle was withdrawn 1 cm and the drug was then fully injected into the blind cavity of the vas deferens about 2.5 cm long. After the 20s drug has solidified, the vas deferens injection needle is removed. 6, the same method of injection of the contralateral vas deferens. However, the seminal vesicle perfusate was 5 ml of 0.02% methylene blue solution.

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