Vasectomy

After completing your family, having a vasectomy is a common, safe and permanent form of contraception. A vasectomy involves dividing and tying off the vas deferens, the tubes that carry sperm from the testicles. This is performed with small incisions on the sides of the scrotum under either local or general anaesthetic. The procedure does not alter the production of the male hormone testosterone so the sex drive and libido are unchanged. Although vasectomy reversals are possible, vasectomy should be considered a permanent form of male birth control.

How a vasectomy is performed

There are two ways the operation can be done: the traditional scalpel or the no-scalpel vasectomy, which uses a small tweezer to open the skin and grasp the vas deferens.

The bottom end of each vas is left open (open-ended technique) to minimise postoperative discomfort. The incision is small and 1-2 dissolvable stitches may be used to close the skin. The procedure takes about 15 minutes and the area will be numb for 1-4 hours after the procedure from anaesthetic.

Recovery

Recovery from a vasectomy is relatively quick and straightforward. You may feel mild pain after the anaesthetic wears off and for 1-3 days after the surgery, which can be managed by paracetamol (Panadol) and ibuprofen (Nurofen). It is important to wear supportive underwear to aid in comfort levels. You may shower the next day but avoid swimming for 2-3 days. Most men return to work the day after the operation, but heavy lifting and physical labour should be avoided for one week. You can resume sexual activity about a week after the procedure.

It is important to note that having the surgery does not mean that you are immediately sterile. It can take up to 12 weeks for all sperm to be cleared from the vas tube after the surgery. During this period, you should use other forms of contraception to prevent pregnancy and will also need to ejaculate on average 20 times to clear all remaining sperm.

An ejaculate sample in a specimen jar (semen analysis) is required three months after surgery to confirm that the procedure was successful and there are no remaining sperm.

Risks

Most men have no problems after surgery. Problems are uncommon but include the following:

• Pain and bruising usually that settles within a week.
• Scrotal haematoma (5%): A blood clot within the scrotum.
• Infection (2%): Pain, swelling and redness of the scrotum. To minimise this risk, antibiotics are usually given at the time of the procedure.
• Sperm granuloma: Rarely, sperm may leak into the scrotum and form a swelling that may need treatment.
• Intermittent mild dull ache in testes (<10%): This may occur when there is congestion in the testicle from sperm. This usually settles within three months and can be minimised with the open-ended technique.
• Post Vasectomy Pain Syndrome (<1%): This rare chronic complication can arise any time after a vasectomy and may persist indefinitely.

Further information

Many men worry that the surgery could cause other problems — but these concerns are unfounded. A vasectomy WILL NOT:

– Affect your sexual performance
– Permanently damage your sexual organs
– Increase your risk of testicular or prostate cancer
– Increase your risk of heart disease

While a vasectomy is considered irreversible, vasectomy reversal and IVF may be viable options for future successful pregnancies. If you have any questions or concerns about vasectomy, Dr Sethi will be pleased to guide you further.