Frequently Asked Questions we receive about Vasectomy at Clinic 66
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.
What anaesthetic options do I have and which one is right for me?
1. 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 you cannot drive for 24 hrs post sedation (due to impaired reaction time). This is not a full general anaesthetic but does ensure that you are comfortable, relaxed and pain free during the procedure. This option is preferred by most men, and carries a higher Medicare rebate. 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.
2. 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 two hours (ie nothing to eat or drink).
You will be at the clinic for approximately 2 hours.
3. 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. You will be completely awake during the whole procedure, and may be aware of a pinching sensation, though this is only brief.
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 but fast for two hours immediately prior to your appointment (ie nothing to eat or drink}.
You can leave on your own and drive yourself home if you have a local anaesthetic.
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 Vasectomy 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 and 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. However, if you are in a relationship, 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. You should NOT take aspirin, anti inflammatory medication, steroids, antiplatelet drugs, any kind of blood thinning medication including fish oils for one week prior to a vasectomy. If you are not sure, come and see one of our doctors before booking in, for a consultation.
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. If you are not sure whether you want to be able to continue to father a child by natural methods, dont have one! However, there are ways of fathering children such as ICSI or vasectomy reversal of a vasectomy. You can also freeze sperm, but storage costs will be incurred. Reversal and ICSI ( reproductive technology as part of IVF) is very expensive (over $6000), particularly if you do not have private health insurance. It may not be successful
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?
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.
Trim hair over entire pubic area with nail scissors. Please shave the scrotum and upper thigh area completely, so there is NO HAIR whatsoever on your scrotum. You can consult 'Youtube' for how to do this. See: Manscaping. Shaving down there
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 the local anaesthetic option 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, if you want her to. 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 including:
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 at 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 my 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 having a vasectomy increase my 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.
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.