Vasectomy! Everything you would want to know but too afraid to ask...

vasectomy factsheet

What is vasectomy?

Vasectomy is the common name for male sterilisation – a permanent method of contraception. It is a simple surgical procedure which closes off the sperm-carrying tubes (vas deferens) in the scrotum to stop sperm from getting into the semen.

After the procedure, sperm produced in the testicles can no longer to mix with semen, and so the semen gradually becomes free of sperm.

Vasectomy does not usually require a general anaesthetic, and a highly trained doctor can perform the procedure in less than 30 minutes, in our surgical facility in Chatswood.

Intravenous sedation is preferred by many though the procedure can be performed under local anaesthetic. Please allow for longer for recovery time (approx 2 hrs) if you are undergoing conscious IV sedation.

We prefer to see you in the clinic for a consultation prior to booking in for the procedure, so we can explain everything and the doctor will examine you to make sure you are suitable to have vasectomy as an office based procedure. Then you make a booking.

How is the procedure carried out?

A local anaesthetic injection numbs the area and a very small incision (approx. 5mm) is made in the front of the scrotum. Through this opening, each vas deferens (tube) is cut and sealed off (see diagram). Once this heals you will have a very small scar on the scrotum which will become invisible soon after the procedure.

How effective is vasectomy?

Vasectomy is probably the most effective method of contraception that exists. The failure rate is much less than 1%. Sometimes the sperm-carrying tubes can re-join, however this risk decreases rapidly as healing proceeds. Don’t rely on it as a form of contraception until you have produced a semen sample and “been given the all clear” (this will be at least 3 months after the procedure).

Does it hurt?

Each person is different and we cannot guarantee you will feel no discomfort. Generally speaking, the injection of local anaesthetic brings a brief stinging pain, but it starts working straight away and will make the area feel numb. You may then have some sensation of pulling or pinching during the procedure, but this should not be painful.

You can opt to have IV sedation when you probably won’t feel anything or remember anything at all. You can opt for inhaled anaesthetic using a “green whistle” (penthrox) which provides excellent pain relief without intravenous sedation.

You may feel some slight discomfort after the vasectomy but ordinary painkillers and a cold pack will help and any soreness shouldn’t last very long.

Do I need my partner’s consent to have a vasectomy?

Only you can decide whether or not to have a vasectomy – our service is completely confidential. If you are in a relationship however, we would always advise that you discuss such an important decision with your partner.

Is my medical history important?

Any man can have a vasectomy, but we do need to know about any previous surgery on your testicles or about any procedures for hernia repair. Scar tissue from these procedures or obesity can make a vasectomy more complicated, and if so, you may not be suitable to have a vasectomy as an office based procedure. Please also tell us of any other significant conditions such as chest or heart problems or other serious illness. It shouldn’t affect your procedure, but it’s important for your safety that we are aware of such conditions.

Are there any alternatives to vasectomy?

There are still very few methods of contraception for men – either vasectomy or condoms. However there is a permanent procedure for women –female sterilisation. Female sterilisation is usually carried out by “tubal ligation” (having tubes tied) which requires hospital admission and general anaesthetic. There are also other very effective long-term (but not permanent) alternatives your partner could use. These include intrauterine devices (IUDs), contraceptive implants or injections.

If you have doubts about whether or not you will want to have children in the future, you should consider reversible contraception. We will be able to advise you and your partner on alternative contraceptive methods to suit your circumstances. Make an enquiry (no referral required) to speak to some of one of expert doctors who can help you decide which contraceptive option is best for you.

Is vasectomy reversible?

Vasectomy should be considered a permanent form of contraception. Successful reversal of a vasectomy may be possible in 50-80% of cases. Reversal is also generally very expensive (over $6000), particularly if you do not have private health insurance.

How much does it cost?

The cost of a vasectomy varies. If you have a Medicare card, some of the cost will be covered by Medicare.

As with most other private medical treatments or day surgery procedure there is a theatre fee and a gap between what Medicare will reimburse and the cost. You do not have to pay hefty hospital fees when you attend our clinic.

Costs are a little higher on Saturday than during the week.

For an accurate cost relevant to your circumstances, talk to us on (02) 9411 3411.

How do I prepare for my procedure?

In order to prepare for your vasectomy, please follow these important instructions:

  • do not take painkillers such as nonsteroidal anti- inflammatory drugs (NSAIDs) i.e ibuprofen (Nurofen®), or aspirin, for one week before your procedure. You may take Paracetamol based painkillers (such as Panadol or Panadeine).
  • do not drink alcohol 24 hours before your procedure.
  • you must shower the evening before, and again on the day of your procedure.
  • wear firm fitting underwear on the day of your procedure. (ie: do not wear boxer shorts).

If you choose to undergo conscious IV sedation you must not eat anything (including lollies or gum) for 6 hours prior to your appointment. You may drink small amounts of water only, but no other fluid, up to 2 hours before your appointment.

If you choose to undergo local anaesthetic you may have a light breakfast of tea/coffee, juice, toast or cereal. If you are unsure or need further clarification, please contact us on (02) 9411 3411.

What can I expect from a typical appointment?

All men have a pre-operative consultation with a doctor to discuss the decision and to talk about the procedure and go through the consent form and be examined.

This is a chance for you to ask any questions or raise any concerns. Your partner is very welcome to attend this session with you.

Following the procedure, we provide an aftercare service and advice free of charge when required. If you have any questions, just call the clinic on (02) 9411 3411.

Does the vasectomy work straight away?

No, you won’t be sterile right away. There will be some sperm left in the upper part of the vas deferens, beyond the vasectomy site. These sperm are gradually cleared after ejaculation over some weeks.

You will need to use another method of contraception for at least 3 months and until your doctor informs you that your semen is free of sperm. Three months after the vasectomy, we will ask you to supply a semen sample which is checked under a microscope to see if there are sperm. This test is very important. It can take up to 25 ejaculations to clear the tubes of sperm completely, so we may have to ask for a second sample if the first one is not yet clear.

When you have given a semen sample which has no sperm present, we’ll write and inform you that your vasectomy has been a success. Note that frequent ejaculations help to clear the sperm from your tubes faster. It is important to note that even once you’ve been given clearance, there is still a small chance of late failure. This will be explained during your preoperative consult.

What are the risks?

Every surgical procedure and anaesthesia has some associated risks. Vasectomy is a very low risk procedure but there is a risk that complications may occur. The common risks include:

  • Bruising and/or mild swelling is quite common in the first week and will subside over 1-2 weeks.
  • Bleeding: Superficial – Bleeding from the area where the tiny incision was made. This usually resolves with squeezing the skin and pressure.
  • Deep – Haematomas are a larger deeper collection of blood in the scrotum which results from over-exertion and a blood vessel bleeding internally. This can be as large as a grapefruit and can take up to 3 months to resolve.
  • Wound infection: infection can occur around the 1 week mark after the vasectomy in 1% or less of men. It may present as a tender, swollen, or red area in the scrotum and/or fever. It generally requires antibiotics.
  • Sperm Granuloma. This is a small inflammatory area which can occur as a result of sperm being released for the end of the tube. It resolves over time.
  • Congestion: A sense of pressure caused by sperm in the testes and epididymis may cause some discomfort for some 2 to 12 weeks after your vasectomy. Congestion resolves itself in time.
  • Post vasectomy Pain Syndrome: Less than 1% of men may develop an ongoing scrotal pain usually unilateral. Discomfort or pain may be felt in the scrotum, back and/ or lower abdomen. This usually responds to anti-inflammatory medication and resolves spontaneously. Very occasionally additional surgery is required.
  • Failure: Re-joining of the tubes sometimes occurs within the first 2-3 months and is picked up by the 3 month sperm test. Late failure after 3 months is extremely rare.

How much time will I need to take off?

You will only actually be at the centre for about an hour (or two if you have iv sedation) but it’s a good idea to take things easy for a day or two. You might want to take a couple of days off work. If your work is very physical you will need to take a week off and then light duties for one week. We are happy to give advice about your particular situation and can organise a medical certificate if you need one. You can drive home after your procedure if you have had a local anaesthetic. If you have conscious IV sedation or Penthrox, you should arrange for someone to collect you as you cannot drive until the next day.

How will vasectomy affect my body?

Your testicles will continue to produce sperm but, because the sperm can’t get through the tubes any more, they simply get reabsorbed into the body. Vasectomy does not affect your male hormones, nor does it affect ejaculation. The only difference when you ejaculate is that there will be no sperm in the fluid (sperm only make up about 3% of semen volume). Vasectomy will not affect your erection.

Will having a vasectomy affect my sex life?

With no change to your hormones, ejaculation or orgasm, there’s no reason why having a vasectomy should have a negative impact on your sex life. In fact, many couples find vasectomy improves their sex life, enjoying greater sexual freedom once they no longer have to worry about an unplanned pregnancy. You have erections as normal.

After your vasectomy you can resume usual sexual activity 5-7 days later

Does vasectomy increase the risk of cancer?

There is no conclusive evidence linking vasectomy to cancer of the prostate or testicles. However we advise all men, whether or not they have had a vasectomy, to have regular health screenings. It’s also important to get into the habit of regularly checking your own testicles for lumps or hardness.

How do I prepare for Vasectomy?

Shower thoroughly on day of procedure.

Trim hair over entire pubic area with nail scissors. Please shave the scrotum completely and upper thigh, so there is NO HAIR whatsoever on scrotum. You can “Youtube” videos on how to do this by searching for instance “Manscaping, shaving down there”.

Will vasectomy protect me from STIs?

No. Vasectomy cannot protect you against HIV or sexually transmitted infections (STIs). Condoms are the best protection against STIs if you are sexually active and have casual partners.

When can I play sport again?

You can do gentle exercise such as limited walking in the first week. You should avoid physical strenuous sports for at least two weeks (no cycling for 3 weeks) and contact sport 4 weeks. Keep the wound area clean and dry for 1 week after vasectomy. Please ask if you are unsure about any particular activity.

Price list

(Effective from the 21/9/16 – Subject to change)

Vasectomy Day Cost Medicare Rebate Out of Pocket
Local Anaesthetic Weekday (Medicare) $750 $269.8 $480.2
Local Anaesthetic Saturday (Medicare) $950 $269.8 $680.2
Local Anaesthetic (with Penthrox) Weekday (Medicare) $800 $269.8 $530.2
Local Anaesthetic (with Penthrox) Saturday (Medicare) $950 $269.8 $680.2
IV Sedation Weekday (Medicare) $870 $424.2 $445.8
IV Sedation Saturday (Medicare) $950 $424.2 $525.8

Note:
As you are having the vasectomy as an office based procedure, you will not have to pay hospital admission fees, or separate anaesthetic fees.

VASECTOMY ANAESTHETIC OPTIONS; Which one is right for me?

Intravenous (IV) Sedation

Vasectomy under IV sedation is ideal for men who prefer not to be awake for the procedure. IV sedation is a gentle clean mild anaesthetic, which is generally tolerated well, though men cannot drive for 24 hrs post sedation (due to impaired reaction time). IV sedation is not a full general anaesthetic but ensures the man is comfortable, relaxed and pain free during the procedure. It is preferred by most men, and carries a higher Medicare rebate (higher return payment to patient from Medicare back to the patient when receipt provided). It is particularly helpful for men who feel anxious, as the sedation helps them (and their scrotum!) relax.

  • Normal diet up to 6 hours prior to appointment. Clear fluids only for 6-2 hours prior to procedure
  • Completely Nil By Mouth ( nothing to eat OR drink) for 2 hours prior to the procedure
  • You will be at the clinic for approximately 2-3 hours in total.
  • You cannot drive after the IV sedation so you will need to arrange a lift home.

Vasectomy with Green Whistle (Penthrox Inhaler)

This is an option for men who do not wish to have intravenous sedation but would prefer something more than just local anaesthetic. It consists of inhaled quick acting anaesthetic and provides excellent pain relief. You will need to have someone drive you home. FAST FOR 2 HOURS ie nothing to eat or drink.

You will be at the clinic for approximately 2 hours.

Vasectomy with Local Anaesthetic Only

  • Local anaesthetic is delivered though a tiny needle and provides numbing directly to the area where the vasectomy is performed. The man is completely awake during the whole procedure, and may be aware of a pinching sensation, though this is short lived. Local anaesthetic is ideal for men who need to drive within 24 hrs of the procedure, or who don’t like the idea of being asleep. You will be at the clinic for approximately 2 hours.
  • Please have a light meal before attending for your operation and FAST FOR 2 HOURS ie nothing to eat or drink.
  • You can leave on your own if you have a local anaesthetic

Some things to watch out for and some advice regarding sporting activity......

Haematoma

(A collection of blood in the scrotum) these can be as large as a grapefruit and occur mostly in the first or second week post-vasectomy. They can take 2 to 3 months to go away. To avoid a haematoma, it is a good idea to return to physical activity slowly, as outlined below.

Day 1

Use a cold pack on the scrotum on and off. Do not do any lifting. Walking and standing for 5 minutes at a time only, with resting in between. Each day increase walking and standing by 30 minutes at a time until Day 7. Again, resting in between periods of walking or standing.

Day 7

Walking and standing all day. Carry 10-15kg only. No sport yet.

Day 14

Non-contact sport. Carry 20-30kg.

Day 21

Cycling

Day 28

Football, heavy weights, martial arts.

Pain and Aching

It is normal to experience a background aching feeling for 1 to 2 weeks post-vasectomy. It will eventually go away. Take Paracetamol (Panadol, Panadeine) as required. If aching continues for 1 to 2 months (Post-Vasectomy Pain Syndrome) then see your GP to get anti-inflammatory medication (if no contraindications to taking this) for 1 to 2 weeks which will help settle it down.



Clinic 66
31 Bertram St, Chatswood NSW 2067, Australia
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