Below are some of the most commonly asked questions about a vasectomy procedure.
If you have any questions that are not answered on this page please contact us for a consultation and we will be able to provide you with the information you need.
Why should I choose to have a vasectomy?
If you feel your family is complete or are certain that you don’t want to have children, vasectomy may be the right choice of contraception for you. Sterilisation of the male by vasectomy is the popular option because it is much easier and less traumatic than female sterilisation which requires a general anaesthetic. Vasectomy is a quick, simple and safe procedure. Over 30,000 procedures are performed in Australia annually.
What is the reliability of vasectomy?
It is an extremely reliable form of contraception. After confirmation of sterility has been documented, the failure rate is quoted as being around 1 in 1000 which is significantly better than most other forms of contraception.
Is the procedure painful?
The local anaesthetic can cause a short transient discomfort from the injection, but it starts working immediately and will make the area feel quite numb. You may feel some sensation of touch or pressure during the procedure but this should not be painful. Cold packs of some sort are recommended on and off for the remainder of the day to reduce the chances of bleeding causing a haematoma which can then be uncomfortable for many days afterwards. There is little to be gained from cold packs after the day of the procedure.
How do I prepare for the procedure?
In order to prepare for your vasectomy please follow these important instructions:
- Do not use aspirin or anti-inflammatory medication for 5 days before your procedure.
- Do not drink alcohol for several hours before your procedure. Food and non-alcoholic fluid intake is acceptable in moderation.
- You will need to remove all the hair from around the penis and the entire scrotum 1-2 days prior to the procedure – see the enclosed area on the diagram. Hair can remain in the pubic region above the base of the penis but most find it easier to remove it in total. Hair removal can be carried out using a razor or by applying an appropriate hair remover. This hair removal reduces the very slight chance of infection even more.
- Wear firm fitting jockey underwear on the day of your vasectomy – NOT boxer shorts. This allows padding to be held against the incisions for the trip home and should be continued for the first few days.
How long does it take for the vasectomy to work?
You will not be sterile straight away. As there will still be some sperm left in your tubes, you will need to use another method of contraception for at least 4 months until you have produced a sterile ejaculate. And so a semen sample will need to be produced no earlier than 4 months AND at least 20 ejaculations after the procedure. The sample is checked under a microscope to see if there are any sperm present. If sterility is confirmed you can then have intercourse without using another method of contraception. For more details please see flow chart on page 6 of the following consumer article on post-vasectomy testing: http://www.surgeons.org/media/16164/PVSAconsum1203(2).pdf. The post-vasectomy requirements in Australia are more stringent than for many other Western countries and cause some men frustration with the prolonged wait after the procedure to reach “sterility”. These requirements will hopefully change but it is unclear when.
What are the risks involved with vasectomy?
Vasectomy is a common, simple and safe procedure and long term effects are very rare. However, like all surgical procedures, there are some risks:
- You may experience some swelling and bruising, however this can be minimised by using an ice pack and resting especially on the day of the procedure. A small pea-sized lump which may be tender can develop on the operation site and remain for a while. This is part of the healing process and does not need treatment.
- A small risk associated with any surgical procedure is infection but extremely unlikely with a vasectomy where proper shaving has been carried out beforehand.
- You may sometimes get a small amount of bleeding from the small cut in the scrotum. On very rare occasions, and more so if you have been too active, internal bleeding may cause a swelling inside the scrotum [haematoma] and this will take some weeks to disappear. During this time pain can be significant. But a haematoma has no effect on the successful outcome of the procedure.
- Post-vasectomy pain syndrome can lead to long term scrotal awareness or discomfort. It is not well understood but is thought to be caused by a combination of testicular back pressure and chronic inflammation and other possible factors. It is very uncommon in Dr Anderson’s experience but patients should be aware of it. Most cases settle with simple measures such as anti-inflammatories and the passage of time. If persistent then reversal is found to be successful in a number of cases but reversal for this reason would be extremely unusual.
How long will I take to recover?
Immediately after the procedure you should go straight home, preferably lie down and apply ice to the scrotal area. You should be feeling perfectly well and comfortable so take advantage of the required down time – it isn’t much. For a week afterwards try to avoid long periods of standing or walking. Physically strenuous sports or exercise should preferably be avoided for at least a week.
Is vasectomy reversible?
Sperm are still produced after a vasectomy but are simply unable to pass along the vas deferens. Sperm are broken down to protein and resorbed. Vasectomy should be regarded as a permanent procedure although there are ways around it should circumstances change.
Reversal is possible under general anaesthetic with an operating microscope. Success can’t be guaranteed and is highest if the interval between vasectomy and reversal is short i.e. success reduces over the years.
It is also possible to harvest sperm in a day theatre procedure by aspirating from the tubules at the back of each of the testes [called the epididymis] or by doing a testicular biopsy. These collected sperm can be used for in-vitro fertilisation [IVF].
What is open-ended vasectomy?
After the vas deferens tube is cut the side closest to the testis is left open and not sealed by cautery but by a small purse string suture. This variation to the procedure has a higher incidence of success with vasectomy reversal should it ever be necessary. Dr Anderson is happy providing open-ended or closed-ended vasectomy.
What is no-scalpel vasectomy (NSV)?
With this technique the skin is broken under local anaesthetic using a pair of sharp, pointed forceps. Whether a scalpel or these forceps are used, the procedure should produce minimal trauma to the tissue. Dr Anderson performs NSV using the Li method.
Will a vasectomy affect my libido and sex life?
Vasectomy does not affect your hormone production and orgasm. Indeed many couples have found greater sexual freedom once they no longer have the worry of an unplanned pregnancy. And of course those using condoms and withdrawal [coitus interruptus] will be pleased to see the end of those contraceptive measures with resulting improvement in sexual function for both partners.
Does vasectomy increase the risk of cancer?
There is definitely no evidence that links vasectomy to cancer of the prostate or testes.
What are the alternatives to vasectomy?
Vasectomy, withdrawal or condoms are the only methods of contraception available to men at this time. Permanent sterilisation is available to women through tubal ligation but a general anaesthetic is required. There are also other short-term and long-term methods of contraception that your partner could use. Short-term methods include the pill, use of a diaphragm and NuvaRing. Long-term methods include IUCDs such as Mirena and Multiload, contraceptive implants such as Implanon or hormonal injections.
For more information there are many sites on vasectomy accessible on the internet, some more reliable than others.
One well respected site for male sexual health in general is that of Andrology Australia: www.andrologyaustralia.org.
You could also do a Quick Search for “vasectomy” at the Federal Government’s health information site called HealthInsite: www.healthinsite.gov.au.