Clifton Beach Medical Centre is committed to helping men explore their contraceptive and fertility options and providing clear, detailed information in order for you to make a well-informed decision. Clifton Beach Medical Centre has successfully performed over 2000 vasectomies over the last 20 years and this procedure is conveniently performed in-house at your local doctor surgery.
Vasectomy Information
Thinking about getting a Vasectomy?
Vasectomy is a method of birth control which involves a simple, safe procedure that is more than 99% effective in preventing unwanted pregnancy. Below we have provided information for you in order to help you understand the benefits and risks of having a vasectomy.
The Effects of a Vasectomy
A vasectomy leaves your reproductive system unchanged. The only difference is that sperm cells are blocked from travelling through the vas deferens. The testes still produce sperm cells, but they die and are absorbed by your body. Your male hormone level remains the same and your secondary sexual characteristics, such as hair distribution and the pitch of your voice, are not affected. A vasectomy does not affect your ability to have an erection, nor does it interfere with urinating. In short, life seems just the same as before.
Having a Vasectomy
A vasectomy is usually performed in your doctor’s office, however, some are more suitable to be done in hospital, your doctor will determine this at your first visit. You will be asked to sign a consent form beforehand which states that you understand that there can be risks involved and that the procedure cannot be guaranteed to make you sterile.
Preparing for Surgery
Before coming in for surgery, you’ll need to shower, making sure you bathe your scrotum thoroughly the night before and the day of the operation with the antibiotic soap provided and leave it on for 2-3 minutes. Ensure hair removal from scrotum with hair removal cream or clippers but DO NOT use a razor. You should wear clean underwear to your doctors appointment.
What Happens During a Vasectomy
After you undress, you will be given a twilight anaesthetic. This will make you very relaxed but will not put you to sleep. A local anaesthetic will be injected into the scrotum to numb the area.
The anaesthetic will prevent you from feeling pain as your doctor makes one or two small incisions about 3-4 millimetres long in your scrotum. The vas deferens, which lies just below the skin, is then cut, and a section of the tube is removed. The upper ends are cauterised (sealed by heat) and stitched. The lower ends are buried in a small pouch. You may feel a sensation of pulling while the tube is being lifted out. The incision is so small it will not require stitches.
After Surgery
After the operation, you will probably rest on the operating table for a few minutes. When you first get up, you might feel wobbly, but you won’t experience pain; the anaesthetic is still working and probably won’t wear off for an hour or two. Your doctor can prescribe a pain medication if you need one, but the discomfort is usually not severe. Any discomfort will be greatest during the first 24 hours. You will need to have someone take you home following surgery.
Possible Complications
As with all surgery, there is the possibility of complications, even with a minor operation like a vasectomy. Complications that may occur soon after your vasectomy include the following:
Internal bleeding
Internal bleeding in the scrotum may cause increasing pain, great swelling, or an enlarging mass. If you have these symptoms, which usually occur within two days after surgery, please call your doctor.
Infection
Infection in the incision very rarely occurs a short time after surgery. Be sure to call your doctor if you suspect an infection.
Other complications, though also rare, can arise in the first few months after surgery.
Sperm granuloma
Sperm granuloma, which occurs in about 3% of all vasectomies, is a lump at the site where the vas deferens is tied off and is caused by a leakage of sperm. The lump usually dissolves by itself. Occasionally, surgery may be required to remove it.
Congestion
Congestion caused by sperm left in the epididymis may cause some aching about 3-12 weeks after surgery. The congestion usually disappears without the need for treatment.
Sperm antibodies
Sperm antibodies are a common response of the body to proteins formed from the absorbed sperm. These antibodies have not been found to be harmful in humans. Between 50 – 70% of men develop sperm antibodies after a vasectomy.
Spontaneous formation of a new vas deferens
Spontaneous formation of a new vas deferens, or recanalization through the scar tissue left by the vasectomy very rarely occurs. This can usually be detected by a semen test after surgery. Recanalization occurs in 1 out of 2,000 men after a negative semen test has been performed at 8 weeks or longer after surgery. The failure rate after vasectomy is 1 in 250-400 if you fail to do a sperm test follow-up.
When You Get Home
Once you’re home, there are several things you can do to aid your recovery and to help prevent any complications. This is outlined in your post-operative instruction sheet.
It is important to try and stay off your feet as much as possible for the next two days. This will reduce the chance of swelling. Apply ice or frozen peas (covered in a towel) on the scrotal region for the first 6 – 12 hours.
Avoid any heavy lifting or vigorous exercise for seven days after surgery. If your job is not a strenuous one, you can usually return to work on the third day after your surgery.
Sexual Activity can be resumed in about 10 days
It is usually a good idea not to bathe or shower the night after the operation. You can shower after 24 hours of the operation but no immersing the scrotum under water in a tub or pool for 10 days.
You will probably find it more comfortable if you wear a pair of cotton, jockey under shorts that provide some support. An athletic support may be too tight and confining.
Do not drink alcohol or take Aspirin or Nurofen for at least 24 hours after the operation
Healing After Surgery
For a period of time after surgery, you may have a dark discoloration around the genital area, and there may be a small amount of bloody discharge from your incision. This is considered normal. There may be slight pain and a little swelling too. You will be required to a mandatory review visit the following day.
Living With a Vasectomy
A vasectomy will not affect your manliness in any way because it has no effect on the male hormones produced by the testes. Nor will it alter your sexual functioning. You will still have the ability to have an erection and an orgasm, and the amount of semen ejaculated will not decrease noticeably.
Sexual relations will have the same sensations and excitability as before. If you had a good relationship before the vasectomy, it will be the same afterwards. Your mutual enjoyment may actually improve because you will no longer be afraid of unwanted pregnancy, sex may be more spontaneous because birth control is no longer necessary.
Reasons men regret Sterilisation or seek reversal
- Young at time of vasectomy
- Change of partner
- Death of child
- Vasectomy performed at a time of crisis
- Consent not freely given by the man
- Psychosexual problems
- Change in financial situation
Conditions that may make outpatient vasectomy inappropriate
- Bleeding problems
- Allergy to local anaesthetic
- Anxiety or tendency to fainting episodes
- Request by the man for a general anaesthetic
- Uncontrolled hypertension or other serious medical conditions
- Extreme obesity
- Presence of a varicocoele (may cause difficulty with haemostasis)
- Any condition that makes the vas difficult to mobilise or very sensitive
- previous surgery (eg orchidopexy, inguinal hernia repair)
- previous scrotal injury resulting in scar tissue
- Co-existing groin or scrotum conditions (eg hernia, large hydrocoele, varicocoele or epididymal cysts)
Common Questions about Vasectomy
What happens to the sperm after vasectomy?
Sperm continues to be produced by the testes, but are broken down and reabsorbed by the vas deferens, epididymis and rete testis.
Does the procedure cause any change in sexual functioning?
The vas merely transports sperm. It has no influence over male hormones, which continue to be produced at the same level. There is, therefore, no change in a man’s male sexual characteristics, libido, or ability to have erections, ejaculate or enjoy intercourse. There are no significant anatomical changes to the testis, prostate or seminal vesicles.
Will the ejaculate look different?
As sperm make up only about 2% of the total ejaculate volume, a normal looking ejaculate will continue to be produced by the seminal vesicles and prostate gland.
Can vasectomy be reversed?
Reversal requires difficult and expensive microsurgery and there is no guarantee of regaining fertility. While 60-80% of men have viable sperm after reversal, (at less than 5 yrs) the pregnancy rate is considerably lower. The chances of success are reduced by increased time since vasectomy, high levels of antisperm antibodies, advanced age of the partner and some technical considerations (such as removal of a long segment of vas at vasectomy).
Sterilisation should be regarded as permanent.
Does vasectomy increase the risk of Prostate Cancer?
This is a common misconception, there is no evidence with clinical studies to suggest a link between prostate cancer and vasectomies.
Does vasectomy increase risk of heart disease?
No! No evidence supported in clinical studies.
Post Operative Semen Examination
It is absolutely essential that you continue to use some method of birth control after your vasectomy until your doctor tells you that your sperm count is zero. To make sure no sperm are left in your semen, and that recanalization hasn’t occurred, you will be given a semen exam. The semen for analysis is usually collected at home and put in a small jar.
Your semen will be examined under a microscope. You are sterile only when there is no longer any evidence of sperm.
Your test will be at 3 months after surgery; Other tests may be required if you are not clear, some men rarely take up to 6 months to clear.
It is important that you use some form of birth control until your doctor says you can stop. Remember, one sperm can be too many!
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