Closed-Ended Vasectomy is a traditional vasectomy technique where both ends of the cut vas deferens are sealed. Here are the key aspects of this procedure:

Procedure

1. Local anesthesia is administered to numb the scrotum.
2. A small incision is made in the scrotum to access the vas deferens.
3. The vas deferens is cut, and both ends are sealed using one or more of the following methods:
   • Cauterization (sealing with heat)
   • Ligation (tying off with sutures)
   • Surgical clips
4. The sealed ends are then returned to the scrotum.
5. The incision is closed, typically with dissolvable stitches or surgical glue.

Characteristics

• Both the prostatic end (leading to the prostate) and the testicular end of the vas deferens are sealed.
• This method prevents sperm from exiting the testes, which can lead to a buildup of pressure.
• The procedure typically takes between 20-30 minutes to complete.

Effectiveness

Closed-ended vasectomy is considered highly effective for permanent contraception. However:

• It's not immediately effective; patients should use alternative contraception until a semen analysis confirms the absence of sperm.
• The failure rate is comparable to other vasectomy techniques.

Potential Drawbacks

1. Higher risk of post-vasectomy pain syndrome (PVPS) compared to open-ended vasectomy.
2. Potential for increased pressure in the epididymis, which may lead to discomfort or complications.
3. Slightly higher risk of congestive epididymitis compared to open-ended vasectomy (6% vs. 2%).

Considerations

• While effective, this method has been largely replaced by less invasive techniques like the no-scalpel vasectomy in many practices.
• Some urologists prefer open-ended vasectomy due to its potential benefits in reducing post-operative pain and complications.

Closed-ended vasectomy remains a viable option for permanent contraception, but patients should discuss the pros and cons with their healthcare provider to determine the best approach for their individual needs.