What Is An Open End Vasectomy?

The biggest question is how will the lower ends heal closed?

Will they heal shut immediately (closed end technique) or will they gradually heal closed (open ended vasectomy technique). The key word is gradual.

Do you want your bandage pulled off instantaneously or would you rather it be pulled off more slowly?

Traditional older vasectomy techniques

Historically, the lower end of the vas deferens was always closed off during vasectomy procedures. This was done using either clips or suture. Why?

It is a standard operating technique to always suture or clip closed what the surgeon cut open. The idea was to prevent a reconnection of the tubes. The concern was that leaving the lower end open would allow the ends to more easily reconnect or sperm to leak out of the open end and cause more inflammation and pain. There were also concerns this inflammation would increase the chance of a ‘reconnection’ of the two divided ends and a higher chance of vasectomy failures.

Instead, the opposite seems to be true.

When the lower end of the divided vas deferens is allowed to remain open vasectomy complications are not increased. In fact, patients tend to report less pain during vasectomy recovery after an open end vasectomy.

Additionally, patients who have an open ended vasectomy procedure may be more likely to have a successful vasectomy reversal. Why? We don’t know for sure.

The theory is that there may be less epididymal disruption as the lower ends gradually heal closed. The pressure build up in the lower end is slower and more gradual. The epididymis has time to adapt and decrease sperm production. You may have less distention, engorgement, and pain.

Open end vasectomy procedure

All vasectomy procedures involve dividing each vas deferens (most patients 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 end vasectomy.

An open end vasectomy is not a guarantee that you won’t have pain during your vasectomy recover. Even with an open ended vasectomy technique the lower end will heal closed eventually.

We believe this translates into an easier recovery but it is also equally possible when the lower end heals closed some patients can have epididymal engorgement and disruption later in their recovery phase.

So even with an open ended vasectomy procedure you can still have symptoms similar to patients who have closed end vasectomy. Each patient is different and every patient’s healing and response will be unique to them.

Benefits of open ended vasectomy: Less pain and better chance of reversal success.

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 thought to have two important benefits over closed end vasectomy:

Less post vasectomy pain
Higher chance of vasectomy reversal success

The medical research is on the fence about the benefits of open ended vasectomy. This is one reason why many vasectomy providers have not readily added this technique to their vasectomy procedures.

What is very clear in the medical literature is that open ended vasectomy is not more harmful and does not have a higher rate of failure. So at best the open end technique is beneficial and at worse it gives the same results as a closed end procedure.

Open ended vasectomy: Less pain

Open ended vasectomy is associated with less swelling, inflammation, and pain. Less pain seems like a good idea after vasectomy… right?

When the lower end is closed off during a vasectomy, some patients will experience a sudden build up of pressure in the lower end within days of their procedure. This pressure can cause swelling and inflammation in the epididymis. Most people commonly refer to the phenomenon as feeling like they have “Blue Balls”.

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 testicles and mature in the epididymis. This sperm travel up the tube and are stored behind the prostate. If you have a closed end vasectomy and sudden pressure buildup in the lower end of the divided vas deferens after your vasectomy, then this buildup of pressure will be transmitted directly to the epididymis and testicle. 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, epididymal scarring, and decreased sperm formation. These events can decrease the chance of having a successful vasectomy reversal. The tubes can be successfully reconnected but the ‘factory’ below the repair sites could be impaired as a result of the vasectomy procedure.

Benefits of an open ended vasectomy

During an open ended vasectomy, the lowed end of the divided vas deferens will slowly heal closed. The small volume of sperm will be contained at the very end of the open vas deferens.

Your body will slowly form a small nodule around the lower end and sperm will be ‘recycled‘ in this small nodule. Technically these small nodules are referred to as granulomas. Granuloma formation is a normal occurrence for some patients after any type of vasectomy procedure.

The continual recycling and removal of sperm in the vasectomy nodule/granuloma will relieve pressure build-up on the epididymis. This may result in less acute pain and less disruption of the normal function of the epididymis after your His Choice vasectomy procedure.