Vasectomy

Vasectomy is a safe, effective, and permanent method of contraception. It should be considered in men who wish for:

  • Permanent contraception
  • No preparation before or during sex
  • A high success rate and low risk of complications
  • No other children

Vasectomy definition

Sperm are produced in the testicles before moving into the epididymis, which sits on the back surface of each testicle. These sperm remain in the epididymis where they mature. Sperm then travel up each vas and are expelled at the time of ejaculation in the semen.

When a vasectomy is performed, the vas deferens are cut and sealed, preventing sperm from leaving the epididymis. This way, no sperm are expelled from the penis at the time of ejaculation.

Vasectomy success rates

Vasectomy is successful in more than 99 percent of men. Other methods of contraception are required until a semen analysis confirms there are no sperm in the semen.

The sperm count is checked approximately three months after the procedure. A man needs to have had at least 20 ejaculations after vasectomy to clear the ducts of sperm.

A sperm count requires that the man give a semen sample obtained by masturbation. When sperm remains present a repeat semen test will be required.

If the semen analysis shows sperm that do not move there is a small chance that a pregnancy may occur. Other methods of contraception should be continued until a clear test result is completed.

Vasectomy procedure

Men who are considering a vasectomy have a consultation before the procedure. At this appointment the doctor will explain the procedure and answer any questions.

Most vasectomies are performed in our accredited day surgery and take about twenty minutes.

A local anaesthetic is injected under the skin using a very small needle. Only the area around the vas deferens becomes numb. The injection will sting briefly.

Once the area is numb, you may feel a pulling sensation during the procedure. The Urologist finds the vas deferens by feeling the scrotum.

To expose the vas, a small incision is made. A loop of the vas is brought to the surface and a small segment removed. The cut surfaces of the vas are cauterized. Once one side has been completed, the other side will be treated.

The skin edges are closed with dissolvable stitches. There will be a small scar from the incision but this will not be very noticeable once healed.

After the procedure

You may go home shortly after your procedure. Preferably someone else should drive you home.

Rest is an important factor for a smooth recovery.

Ice pack for 20 mins every two hours.

Avoid strenuous exercise or lifting for seven days.

Do not bathe or swim for 24 hours after your procedure.

Sexual intercourse may be resumed after one week however other methods of contraception are required until you have had a clear semen analysis.

Pain control following vasectomy

After the vasectomy there may be some discomfort at the incision site. This can be relieved with a pain medication such as paracetamol. Ibuprofen and aspirin should be avoided for at least one week to minimise the risk of bruising and bleeding around the incision.

Semen tests

You will be given pathology forms and containers for your semen test. Three months and a minimum of 20 ejaculations postoperatively, take the specimen and the request form to the pathology laboratory within 2 hours of production.

It is your responsibility to ring the practice for your result one week after submitting the specimen. You will receive further instructions should another specimen be required.

A letter confirming a clear test will be posted to you. If you do not receive this letter please telephone the practice.

You are not clear to discontinue the use of other forms of contraception until you have been formally advised that you have achieved a zero sperm count at least three months following surgery.

Vasectomy complications

Vasectomy is a simple procedure. Complications are unusual but possible.

Bleeding

Excessive bleeding occurs in less than 5 percent of men. Most bleeding problems occur within 8 hours post-operatively. Bleeding within the scrotum can lead to a haematoma which is an expanding mass of blood within the tissues around the vas.

Infection

Infection occurs in up to 4 percent of men who have a vasectomy. This usually involves the scrotal skin around the incision. Occasionally, the epididymis will become swollen and is usually treated with a short course of oral antibiotics.

Sperm granuloma

A sperm granuloma may occur, which is a small lump that develops over time as a result of the body’s immune reaction to sperm leaking from the cut end of the vas.

Post vasectomy pain syndrome

A feeling of fullness from sperm congestion occurs in up to 6 percent of men after vasectomy. This is due to stretching of the surface of the epididymis from stored sperm cells. The full sensation usually resolves after a few weeks and requires no treatment, but a very small number of men may develop chronic pain.

Failure

Pregnancy can occur if a man fails to abstain from sex or use alternative contraception until one clear semen test has been achieved. There is a 1 in 2000 chance that the cut vas will spontaneously re-join, following a negative semen test.

Health effects of vasectomy

Sex drive

Having a vasectomy will not affect testosterone levels, sex drive, or the ability to have an erection.

Risk of cancer

Although there have been some concerns regarding a link between vasectomy and prostate and testicular cancer, several large studies suggest that there is no increased risk of any cancer.

Heart disease – similar to the situation with cancer, despite some concerns, studies have not found any link vasectomy and heart disease.

Contraception after a vasectomy

If the semen analysis shows no evidence of sperm you may discontinue the use of other forms of contraception. Vasectomy does not protect against sexually transmitted diseases such as HIV.

Where to get more information

Your Urologist is the best source of information for questions and concerns related to your medical problem.