Open ended vasectomy is when the lower section of the vas deferens is not closed during the vasectomy procedure.
Historically, the lower end of the vas deferens was closed off during a vasectomy because many providers were worried leaving the lower end open would cause more complications. Instead, the opposite seems to be true.
When the lower end of the vas deferens is allowed to remain open vasectomy complications are not increased and most men report less pain after vasectomy.
Additionally men who have an open ended vasectomy procedure may be more likely to have a successful vasectomy reversal.
Open Ended Vasectomy Procedure
All vasectomy procedures involve dividing each vas deferens (most men have a vas deferens on each side) and this results in permanent blockage of sperm transportation. Even after a vasectomy sperm continues to be produced in the epididymis but these sperm are unable to travel to their intended internal storage areas.
The key to understanding what “open ended” means is understanding what is done with the lower half of the divided vas deferens during the vasectomy procedure.
If the lower end of the divided vas deferens is closed with anything (suture or a titanium clip) then this is considered a closed ended vasectomy.
If the lower end of the divided vas deferens is left open after the division then this is considered an open ended vasectomy.
In the past, vasectomy providers were concerned leaving the lower end open would allow sperm to leak out of the open end and this would cause more inflammation and pain after vasectomy. There were also concerns this inflammation would cause more ‘reconnection’ of the two divided ends and more vasectomy failures. These two concerns about open ended vasectomy are not true.
Benefits of open ended vasectomy?
Although it may not seem like a good idea to leave the lower end open and allow sperm to ‘leak’ out, an open ended vasectomy is actually reported to have two important benefits over closed end vasectomy.
Less post vasectomy pain and higher chance of success with vasectomy reversal.
Open ended vasectomy: Less pain
Less pain seems like a good idea after vasectomy..doesn’t it?
When the lower end is closed off during a vasectomy, some patients will experience a sudden (within days) build up of pressure in the lower end and this pressure can cause swelling and inflammation in the epididymis. This will occur soon after the vasectomy but is mostly noticed within the first 2 weeks.
This pain should gradually improve but why go through unnecessary pain or discomfort if there is a chance you don’t have to?
Open ended vasectomy: More reversible
Sperm are produced in the epididymis. If you have a closed end vasectomy and sudden pressure buildup in the lower end then this pressure increase will be transmitted to the epididymis. The increased pressure can cause disruption of the epididymis and an inflammatory response.
In the short run, this inflammatory response can contribute to more pain and tenderness after vasectomy. In the long run, inflammation in the epididymis can cause epididymal disruption, decreased sperm formation, and may cause vasectomy reversal (should you ever need one) to be less successful.
Benefits of an open ended vasectomy
During an open ended vasectomy the small volume of sperm will be contained at the end of the open vas deferens. The body will form a small granuloma and sperm will be ‘recycled‘ in this small granuloma. This recycling and removal of sperm will relieve pressure build-up on the epididymis. This results in less acute pain after vasectomy and less disruption of the normal function of the epididymis.
What type of vasectomy procedure do we offer?
I perform an open ended vasectomy procedure. More specifically I use no needle anesthesia (use an air injector for the anesthetic), no scalpel opening (use a small skin spreader to make a small opening), minimally invasive (single small opening), coagulation to divide the vas deferens (heat energy to divide the vas deferens), open ended (leaving the lower end open and allowed to maintain decompression) and fascial interposition (placing healthy tissue between the divided ends) vasectomy.