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If you look closely you’ll see small blood vessels along the side of the severed vas deferens. Above the the suture (the vas deferens and the suture have been enlarged about ten times) you’ll note that the blood vessels have been blanched by having been fulgurated. Below the suture (looks like a small brown rope) the blood vessels are red. These blood vessels are tiny and sometimes not seen by the urologist and then after the vas deferens retract back into the scrotum-they ooze.
Like a small oil leak, the blood continues to leak and accumulate until the surrounding tissues stop it. The result is a hematoma. Hematomas can vary in size depending on the size of the vessels and the amount of blood that leaks before the tamponade (presume that stops bleeding) of the surrounding tissues stop it.
Hematomas are not an infection and are not dangerous but both the patient and the urologist wish that it doesn’t happen after a vasectomy. The problem is that this collection of fluid stays around for weeks because it takes time for the body to absorb it. For the most part it is preventable if the urologist is careful to completely occlude these vessels around the vas deferens.
When I do a vasectomy (See A Vasectomy in Pictures) I remove a section and then fulgurate both sides of the vas deferens. This in the majority of cases will handle the small vessels along side the tubes but it doesn’t always. In addition to the above, I place a suture at the very base of of the vas deferens that is beyond where the vas has been dissected thus preventing inadvertent bleeding beyond where the vas has been fulgurated. (These are the red vessels you see near the clamps. The suture is placed and tied just beyond the clamp.)
So…when you talk to people about your upcoming vasectomy and they tell you that they had a lot of swelling of the scrotum that was black and blue…they had a hematoma and in most cases it could have been prevented. Some how attention to these pesky little vessels that travel along side the vas and cause hematomas…were not appropriately given the respect they deserve.
Did you know that if a surgeon needed to or inadvertently cut the testicular artery, that the vasal artery is sufficient enough to keep the testicles alive and viable?
This is why hematomas can be substantial and cause a significant post vasectomy issue.
“Respect thy vessels that accompany the vas deferens!”
A Reversal “Thumbs Up!”
Kalani was born December 31, 2022 at home under the care of a midwife and nurse at 8:11 pm. It was magical as the fireworks from the New Years celebrations exploded outside along the Florida coastline on a foggy sort of mystical night. Our boys are so in love with their baby sister!
Thank you so much for my husband’s successful reversal that you performed in October 2021. We found out we were expecting in the beginning of January and our son was born on September 7th.
Jen and Kristafur
Thankful for Dr. McHugh’s talent and the whole experience!
Dr. McHugh is very thorough and answered any questions we had prior to surgery. His team was very kind and thorough post surgery as well, following up via phone and email to be sure my husband had the best recovery he could. Our chances for conceiving were less than 50% and we just had our daughter a month before the one year mark from surgery. Leanna T. September 2022
We try to make it “fun!”
“Dr. McHugh is loads of fun. Really nice guy. Excellent staff. Easy, short, and (mostly) painless procedure. Great practice here.” D.D.
Thank you so much for the positive feedback. Enjoyed comparing “Beatles Trivia!” I hope you do well. John McHugh
Thank you back!
Dr. McHugh and his wonderful staff are without a doubt the best in the industry.
“You and your staff were wonderful! I love the relaxed and laid back atmosphere that y’all provided especially the Music! Definitely helped my anxiety. Thank you.”
I appreciate everyone’s friendliness and kindness during the multiple office visits and surgery center procedure. Thank you for the good care you gave me!
Even after a miscarriage, with time, prayers and of course a great surgeon we now have a healthy 7lbs 2oz baby boy! Thank you.
Two for the price of one!
After extensive research, we found that the technique performed by Dr. McHugh was the best fit for us. It was the least invasive, and offered the fastest recovery. Dr. McHugh & his team delivered a high caliber of service & comfort for me, & I am extremely thankful for his practice.
Naomi was born just 12 months after having my surgery, & we couldn’t be happier with our newest addition!
Thank you Dr. McHugh and staff!
Thanks for dropping by!
What a delightful surprise!
Fantastic bedside manner, office and surgical staff were top notch. This coming from a nurse of 12 years. I was never nervous or uncomfortable. (Microscopic Vasectomy Reversal)