Vasectomy should always be approached as a permanent sterilization and the effectiveness of the vasectomy for contraception is the primary goal. However, out of the half a million men in the United States who undergo vasectomy every year, 6% change their mind sometime in their lifetime. Six percent may not sound like very many, but that is actually 30,000 men out of this group. Vasectomy reversal is a good option for many of these men, so it is important to perform the vasectomy in a manner that makes it as effective of a form of contraception as possible, but also gives the best odds of reversal for men who elect to do so in the future.
Dr. Kavoussi shares these tips in the vasectomy section of his chapter on scrotal surgery in the 10th edition of Campbell’s Textbook of Urology for physicians who perform vasectomies. These technical tips include not removing a long segment of vas deferens, the vas deferens should be divided at least 3 centimeters from the epididymis adjacent to the testicle, and to minimize the inflammatory response while obstructing the vas deferens during vasectomy by using low voltage electrocautery to seal the inside of the vas deferens tubes and then interposing tissue that is adjacent to the vas deferens between the ends where the vas deferens is divided to make a wall to not allow the ends grow back together. It helps to avoid placing foreign objects such as clips or ties to minimize the inflammatory response in the area to make a meticulous vasectomy reversal in the future easier if needed.