Vasectomy

Vasectomy is a commonly performed minor surgical procedure intended to provide permanent birth control for men. It is a one-time procedure that is nearly 100% effective, it is safe and inexpensive, and it does not limit sexual pleasure.

How does it work?

Sperm is produced in the testicles and moves along 2 small tubes called the vas deferens (or sperm ducts) to the urethra, where the sperm join fluid from the prostate and seminal vesicles to form semen (semen is the fluid that is ejaculated during sexual intercourse). Vasectomy prevents the sperm from mixing with the semen by blocking each of the two sperm ducts. This renders you sterile.

How is it done?

The procedure takes approximately 15-20 minutes and involves making two small incisions in the scrotum, a small piece of each sperm duct are removed and the ends are sealed. A stitch is used to close the skin and this stitch will dissolve by itself. Although the operation can be done using local anaesthetic we use a general anaesthetic unless there are unusual factors in an individual’s case.

How will it affect me?

There will be no effect on your ability to have or enjoy sexual intercourse. Penile sensitivity and the production of male hormones are not adversely affected by vasectomy. The amount of seminal fluid ejaculated remains virtually the same, as the sperm themselves only contribute a very small percentage of the total ejaculated.

What are the benefits?

A vasectomy is a simple, safe and effective method of birth control. With the added freedom from fear of producing an unwanted pregnancy, some couples find that they experience a greater mutual enjoyment in their sexual relations. You may find that your desire for sexual expression becomes more spontaneous and more frequent.

Can it be reversed?

Vasectomy reversal is technically possible. We use microsurgery for this procedure to rejoin the cut ends of the vas. The success rate is approximately 80%, however, as time goes on after the original vasectomy, the chances of obtaining a successful pregnancy become much lower.

There are a number of reasons for possible failure of vasectomy reversal. Some of these issues can be overcome with Assisted Reproductive Technology (ART). This involves the collection of sperm directly from the testis or epididymis, and it is injected directly into an egg collected by IVF techniques. This process is called intra cytoplasmic sperm injection (ICSI).

Medicare funding for vasectomy reversal has recently been restored.

In spite of vasectomy reversal being possible, we still recommend that men only have a vasectomy if they are prepared for irreversible sterility.

Are there any complications or side effects?

Post-operative hematoma (bruising) is common but is rarely at all serious (~1:100). Infection is rare, but can occur in the first week after the procedure. Increase swelling, redness and tenderness on one side may mean you have an infection. Contact us and we will see you promptly for review and prescription of antibiotics.

There are no known long term complications of vasectomy, although, some men have described testicular discomfort occurring years after. This may be due to scar tissue or inflammation in the scrotum. These problems are amenable to fairly simple treatment.

There is a small chance that the cut ends of the vas join up again. Although this occurs rarely (about once in every 3000 cases), it can lead to an unexpected pregnancy and considerable distress. These cases usually occur in the early period after surgery and can often be recognized when the post-operative sperm count does not fall to zero. Thus, it is particularly important to have sperm counts as directed.

Some older studies suggested that there may be some connection between vasectomy and prostate cancer. More detailed subsequent studies have shown that this is not an issue. Similar concerns about myocardial infarction (‘heart attack’) have also been shown to be groundless. Vasectomy remains the most common method of obtaining permanent sterility around the world.

Where is the operation performed?

We undertake these procedures in properly staffed, equipped and accredited hospitals. We do not carry out this procedure in our office.

Currently, we operate in the following hospitals:

  • Warringal Private Hospital
  • Northpark Private Hospital
  • Bellbird Private Hospital
  • Epworth Eastern
  • Epworth Richmond
  • Mildura Base

Bookings are usually available within a few weeks. Most days of the week are available, although, not at all hospitals.

Do I need to do anything in preparation for the procedure?

  • Nothing to eat or drink for 6 hours prior to the procedure
  • Do not drive yourself to the hospital as you are not allowed to drive a car for 24 hours following an anaesthetic. You must make arrangements to be picked up following the procedure.
  • If you take any form of aspirin please inform the doctor.

What may I expect following the procedure?

The most common side effects are some discomfort, a small amount of bleeding (enough to stain the bandage) or mild swelling in the area of the incision. These are not unusual and should subside within 72 hours. Occasionally, the skin of the penis and scrotum may be bruised. No treatment is required for this.

All of the above may be relieved by support most easily provided by firm underpants worn day and night for one week. Panadol (or similar) may be taken for pain/discomfort.

Avoid strenuous activity, heavy lifting and intercourse for two weeks.

Continue to use some form of birth control until your sterility has been assured by the doctor.

You may shower after 12-24 hours following your surgery. Dry stitches well afterwards and do not use talcum powder until the wound has healed completely.

If your occupation involves strenuous physical activity, we usually recommend taking the day after the procedure off from work also.

If you experience any of the following, please phone our rooms on 9457 4445:

  • Severe bruising, swelling or pain
  • Difficulty in or unable to pass urine
  • Continuous bleeding (apply pressure with a clean cloth and contact the rooms, doctor or hospital)
  • Signs of infection of the wound – local redness, increase swelling or tenderness, increase pain, feeling fatigued, fever

What is the follow up after the procedure?

The most important part of your follow up is the Sperm count.

After a vasectomy, there are still sperm in the vas and seminal vesicles. Experience shows that it usually takes between 12 and 20 ejaculations until all sperm have been cleared from these reservoirs. It is only then that you are sterile and no longer need to take other contraceptive precautions.

We find that by eight – 10 weeks after the operation, most men (about 75%) will show no sperm in the ejaculate.

You will return to the rooms for your first appointment four weeks following surgery. As this appointment, you will be given a request form and jar for your sperm analysis.

Our requirements are that you have a single sperm count 10 weeks following surgery. This is done by ejaculating into a specimen jar and taking the fresh specimen to the Pathology lab in working hours. It will be examined microscopically and it is only regarded as clear if there are no sperm seen. We are very strict about this. If there is any sperm seen at all, we ask that you do not consider yourself sterile and you will have another test in another eight weeks. We will notify you in writing if the test is clear. If the test remains positive (that is, sperm can be seen), you will also be notified and in the letter will be another request form to repeat the test in 8 weeks.

Rarely, we strike a case where, even though a man is ejaculating regularly, his sperm count many months later still shows small numbers of non-motile sperm. The reason for this is not well understood and it needs careful discussion between the patient and his Urologist.