Vasectomy

VASECTOMY Vasectomy is the only form of male sterilisation available and it is a simple, safe and effective method of contraception for men.

In vasectomy the vas deferens which is the tube that carries sperm from the testicles to the penis is cut. The semen is formed in the usual way and is ejaculated during sex in the normal way but after the vasectomy is completed and time has been allowed to flush sperm cells from the semen producing glands, there are no sperm cells present in the semen.

COMMONLY ASKED QUESTIONS

How can I be sure that I need a vasectomy?
If you are sure you don’t want to have any more children
If you want to enjoy sex without worry of pregnancy
If you don’t want to use any other form of family planning
If pregnancy and childbirth poses a risk to the health of your partner
If you want to save your partner from a tubal ligation, which has a higher rate of failure and complications

When should I not consider vasectomy?
Because vasectomy is a lifetime decision you should consider unforeseen changes in your life, such a divorce, death of your partner, or death of a child and the possibility that either of you might change your mind in the future regarding limiting your family size.

Although there are no hard and fast rules, vasectomy may not be right for you if you are very young, if you have no children or if you current relationship is not stable.

It may not be a good time to do it if you are under a lot of stress or during times of personal crisis. It is not suitable if you are counting on the possibility of reversal later on or if you hope it will solve sexual problems such as premature ejaculation, erectile difficulties or marital problems.

How is non-scalpel vasectomy different from conventional vasectomy?
I perform a no-scalpel vasectomy. In traditional vasectomy the scrotum was numbed in two places, either side above the testes and a small cut was made in the numbed area and the vas deferens on each side dissected out one after the other. The tube was cut and the ends tied and the cuts in the skin were also stitched.

In the no-scalpel vasectomy the skin and vas are anaesthetised in the midline below the base of the penis in the scrotum and the vas deferens is held in place with a special ring clamp. A tiny puncture is made in the skin with a special cautery instrument called a hyfrecator and the vas is brought through the puncture and sealed. I do not use a stitch to close the small opening.

What are the advantages of a non-scalpel vasectomy over conventional vasectomy?

Less discomfort
One small puncture in the skin instead of two incisions
No stitches
Faster procedure
Faster recovery
Less chance of bleeding and other complications
Just as effective

Does it work?
Yes, this is a very reliable procedure but it is estimated that there is a 1 in 2,000 chance that the man might become fertile again in the future. Rarely the divided ends of the vas deferens may reunite. Serious problems are very rare; less than 1 in a 100 cases even have a minor problem.

Is no-scalpel vasectomy painful?
The skin anaesthetic stings for a few seconds and once it is effective there should be little or no discomfort.

Will it hurt after no-scalpel vasectomy?
It will be a little uncomfortable or sore for a few days afterwards and I normally advise people to take Paracetamol or Nurofen if required.

How long does the whole procedure take?
The whole procedure takes less than 30 minutes.

Is no-scalpel vasectomy safe?
It is safe and simple and most men do not have any problems although, like all surgical procedures, it has some risks. There are no life-threatening complications associated with it. Minor complications are short-lived and generally resolve with rest, ice, anti-inflammatories, painkillers and time.

What are the possible complications?
Mild discomfort – and a mild aching sensation to the scrotum for a few hours to a few days after the procedure.

Bleeding – into the scrotum causing a small, painful swelling and bruising for a few days. Rarely a more major bleed can cause a grapefruit sized scrotum which can take months to heal but this is very rare with the no-scalpel vasectomy. Infection – redness and discharge of pus from the healing site opening. If this occurs it is easily treated with antibiotics but is rare.

Epididymitis – a tender swelling of the epididymis, the tube connecting the vas deferens and the testis.

Sperm Granuloma – sperm can leak from the cut end of the vas deferens and form a bead-like swelling in the scrotum. If this occurs they are usually asymptomatic or do not trouble people but they can be occasionally tender.

Failure – because a Doctor has inadequately blocked one or both tubes or because one or both tubes have rejoined.

When can I go back to work?
Generally, two to three days is plenty of time for recovery for most normal work. If your work involves very heavy work it is better to take up to a week off.

When can I start having sex again?
Sex can be resumed normally seven days after the procedure.

Will I be sterile right away?
No, after a vasectomy there are always some active sperms left in the system. Some sperm survive in the upstream part of the vas deferens for several weeks and can get into the semen for a while and it takes about 25 ejaculations to clear them. We advise you and your partner to use some other form of birth control until a test has been performed and it is confirmed free of sperm.

When would I have the semen test?
We do a single test 16-18 weeks after the procedure.

Will it affect my long-term health?
No, studies have shown conclusively that vasectomised men are no more likely to get heart disease, arthritis, cancer of the testicle or any other diseases and Post vasectomy Pain Syndrome is extremely rare.

Will vasectomy change me sexually?
The only thing that will change is that you will not be able to get a partner pregnant. The penis and testes are not altered and the body continues to produce male hormones. The operation has no impact on sexual performance and doesn’t change hair growth, muscles, sex drive, erections or climaxes.

Most men report that sex is better after vasectomy because of they no longer need to worry about unplanned pregnancy.

What happens to sperms after vasectomy?
Sperms are made as before but cannot get past the blocked vas deferens and are re-absorbed internally. As sperms make up about 1% of the ejaculate there will be no detectable difference in the volume of semen.

Will it prevent me from getting an STD or AIDS?
No. Condoms are still the best protection against these diseases.

What if I were to change my mind after a vasectomy?
A vasectomy should be considered permanent. Reversal operations are expensive and very often unsuccessful. If you are asking this question, perhaps vasectomy is not right for you.

Why not tubal ligation? Vasectomy is preferable over tubal ligation because tubal ligation :

Carries greater potential health risks for a woman
Requires a general anaesthetic
Is an intra-abdominal procedure
Post operative recovery is longer
Failure rate is more (1 in 200)
More difficult to confirm that it has been carried out successfully
If pregnancy occurs, it is more likely to be an ectopic pregnancy.