<P> Men who are of a younger age at the time of having a vasectomy are significantly more likely to regret and seek a reversal of their vasectomy, with one study showing men for example in their twenties being 12.5 times more likely to undergo a vasectomy reversal later in life (and including some who chose sterilization at a young age); prevasectomy counseling is therefore of particular importance in younger patients . </P> <P> An association between vasectomy and primary progressive aphasia, a rare variety of frontotemporal dementia, was reported . However, it is unclear if there is a causal relationship . The putative mechanism is a cross-reactivity between brain and sperm, including the shared presence of neural surface antigens . In addition, the cytoskeletal tau protein has been found only to exist outside of the CNS in the manchette of sperm . </P> <P> The traditional incision approach of vasectomy involves numbing of the scrotum with local anesthetic (although some men's physiology may make access to the vas deferens more difficult in which case general anesthesia may be recommended) after which a scalpel is used to make two small incisions, one on each side of the scrotum at a location that allows the surgeon to bring each vas deferens to the surface for excision . The vasa deferentia are cut (sometimes a section may be removed altogether), separated, and then at least one side is sealed by ligating (suturing), cauterizing (electrocauterization), or clamping . There are several variations to this method that improve healing, effectiveness, and which help mitigate long - term pain such as post-vasectomy pain syndrome (PVPS) or epididymitis . </P> <Ul> <Li> Fascial interposition: Recanalization of the vas deferens is a known cause of vasectomy failure (s). Fascial interposition ("FI"), in which a tissue barrier is placed between the cut ends of the vas by suturing, may help to prevent this type of failure, increasing the overall success rate of vasectomy while leaving the testicular end within the confines of the fascia . The fascia is a fibrous protective sheath that surrounds the vas deferens as well as all other body muscle tissue . This method, when combined with intraluminal cautery (where one or both sides of the vas deferens are electrically "burned" closed to prevent recanalization), has been shown to increase the success rate of vasectomy procedures . </Li> <Li> No - needle anesthesia: Fear of needles for injection of local anesthesia is well known . In 2005, a method of local anesthesia was introduced for vasectomy which allows the surgeon to apply it painlessly with a special jet - injection tool, as opposed to traditional needle application . The numbing agent is forced / pushed onto and deep enough into the scrotal tissue to allow for a virtually pain - free surgery . Initial surveys show a very high satisfaction rate amongst vasectomy patients . Once the effects of no - needle anesthesia set in, the vasectomy procedure is performed in the routine manner . </Li> <Li> No - scalpel vasectomy (NSV): Also known as a "key - hole" vasectomy, is a vasectomy in which a sharp hemostat (as opposed to a scalpel) is used to puncture the scrotum . This method has come into widespread use as the resulting smaller "incision" or puncture wound typically limits bleeding and hematomas . Also the smaller wound has less chance of infection, resulting in faster healing times compared to the larger / longer incisions made with a scalpel . The surgical wound created by the No - Scalpel method usually does not require stitches . NSV is the most commonly performed type of minimally invasive vasectomy, and both describe the method of vasectomy that leads to access of the vas deferens . </Li> <Li> Open - ended vasectomy: In this procedure the testicular end of the vas deferens is not sealed, which allows continued streaming of sperm into the scrotum . This method may avoid testicular pain resulting from increased back - pressure in the epididymis . Studies suggest that this method may reduce long - term complications such as post-vasectomy pain syndrome . </Li> <Li> Vas irrigation: Injections of sterile water or euflavine (which kills sperm) are put into the distal portion of the vas at the time of surgery which then brings about a near - immediate sterile ("azoospermatic") condition . The use of euflavine does however, tend to decrease time (or, number of) ejaculations to azoospermia vs. the water irrigation by itself . This additional step in the vasectomy procedure, (and similarly, fascial interposition), has shown positive results but is not as prominently in use, and few surgeons offer it as part of their vasectomy procedure . </Li> </Ul>

Where are the incisions made for a vasectomy