SIX REASONS FOR A MAN TO HAVE A VASECTOMY
HOW CAN I BE SURE A VASECTOMY IS RIGHT FOR ME?
Be absolutely sure you do not want to father a child under any circumstances. Talk to your partner - it is a good idea to make the decision together. Consider other kinds of birth control - talk to a friend or relative who has had a vasectomy. Think about how you would feel if your partner had an unplanned pregnancy. Talk with your doctor, nurse or family planning counsellor. A vasectomy might not be right for you if you are very young, your current relationship is not stable, you are having a vasectomy just to please your partner, you are under a lot of stress or you are counting on being able to reverse the procedure later.
HOW DOES A VASECTOMY PREVENT PREGNANCY?
Sperm are made in a man's testes and travel through the two tubes in the scrotum (vas deferens) and empty into two small storage sacs (seminal vesicles) near the prostate. It is from these sacs that the sperm are released, mixed with fluid from the prostate and are ejaculated during climax. In a vasectomy the tubes (vas deferens) are blocked so the sperm no longer travel to the storage sacs. These sacs soon run out of sperm (within 15 to 20 ejaculations) and once they are empty a man cannot make his partner pregnant.
WHAT ARE THE WAYS OF DOING A VASECTOMY?
There are generally two ways of doing a vasectomy. One is called a "conventional vasectomy" in which, after the scrotal skin and tissues underneath have been numbed with local anesthetic, the doctor makes one or two small cuts in the skin and lifts out each tube, in turn, cutting and blocking them. Then the doctor stitches the cut closed.
In a "no scalpel vasectomy" the doctor feels for the tubes under the skin and holds them in place with a small clamp. The skin receives a local anesthetic to numb it and then the anesthetic is also placed beside each tube (vas deferens) so they become numb as well. Instead of making two incisions, the doctor makes a small puncture with a surgical instrument. The same instrument is used to generally stretch the opening so that the tubes can be reached. The tubes are then blocked using the same methods as conventional vasectomy.
My preferred method is to do three procedures to block the tubes. Firstly, I cut the tubes, then I cauterize them (burn them with a small cautery device) and then I sew one end shut on each side so that the two ends may not reconnect together. There is very little bleeding with the "no scalpel" technique and no stitches are needed to close the tiny opening in the skin which heals quickly, with minimal or no scarring.
This technique was developed by a surgeon in China in 1974 and has been used in over 15 million men throughout China since then. The technique was introduced in North America in 1988 and into Edmonton in 1993.
HOW MUCH PAIN OR DISCOMFORT WILL I HAVE?
Most men state that the only discomfort they felt was when the local anesthetic was being put in, for approximately 1 to 2 seconds. After this there should be no pain. Once the procedure is complete and the anesthetic wears off over the next hour or two, there may be some mild aching felt over the next several days. Some men find it necessary to use a mild painkiller such as Acetaminophen (Tylenol) or Ibuprofen (Advil or Motrin).
WHAT COMPLICATIONS CAN OCCUR?
-EPIDIDYMITIS - a tender inflammation around the testes that may occur after four or five days.
Treatment: Anti-inflammatory medication. Usually subsides within a few days.
-BLEEDING - from the skin incision.
Treatment: Controlled with direct pressure.
-INFECTION - of the scrotum.
Treatment: Antibiotic of other treatment.
-SPERM GRANULOMA - a tender knot in the scrotum where sperm has leaked out of the vas deferens. Avoiding ejaculation during the first week after vasectomy usually averts this problem but it can occur at later times as well.
Treatment: Usually no treatment is required as this resolves spontaneously over time.
-SCROTAL HEMATOMA - can be a large collection of blood inside the scrotum where a blood vessel has continued to leak. Swelling in the scrotum would occur within 48 hours after a vasectomy.
Treatment: Requires immediate treatment and possible surgery to stop the bleeding.
-ALLERGIC REACTIONS - or other unusual reactions to anesthetics or medications can occur even without a history of drug allergies. These reactions are very rare.
-SENSITIVE SCAR OR NEUROMA - may form along the vas at the site of vasectomy.
Treatment: Rarely bothersome enough to require injection with medication or surgical removal. However, sometimes anti-inflammatories may be used or rarely surgical removal is indicated.
Overall the rate of complications with conventional vasectomy is 31 per 1000 cases and with "no scalpel" vasectomy technique is approximately 4 per 1000 cases.
HOW SOON CAN I GO BACK TO WORK?
I would recommend a minimum of 3 days off work for people who work sedentary jobs, such as office work etc. For those who do physical work, including standing, walking, lifting or all types of laboring work, I would recommend 4 to 5 days off work.
WILL A VASECTOMY CHANGE ME SEXUALLY?
The only thing that will change is that you will not be able to make your partner pregnant. Your body will continue to produce the hormones that make you a man. You will have the same amount of semen. A vasectomy will not change your beard, muscles, sex drive, erections or climaxes and you won't sing soprano. Some men say that without the worry of accidental pregnancy and the bother of other birth control methods, sex is more relaxed and enjoyable than before.
WILL I BE STERILE RIGHT AWAY?
No. After a vasectomy there is always some active sperm left in the storage sacs (seminal vesicles). It takes about 20 ejaculations to clear them and you and your partner should use some other form of birth control until your tests show that your semen is completely gone. This test is usually done either after 20 ejaculations or 3 months (sperm only lives for 60 days and by 90 days they are all dead and removed).
WHEN CAN I START HAVING SEX AGAIN?
It is recommended that you wait one week after your vasectomy to resume sexual activity. Remember to use some kind of birth control until your semen test shows that you are sterile (no sperm).
DOES A VASECTOMY CAUSE ANY MEDICAL PROBLEMS?
Vasectomy has been used since the early 1900's and over 15 million men in North America have undergone the procedure. There have been no long-term adverse effects associated with vasectomy. There have been over 8 very large well-run studies and none of them have found any links to cancer, heart disease, etc.
DOES A VASECTOMY EVER FAIL?
Once you have brought in your semen sample and there is no sperm noted, it is very unlikely that failure or pregnancy will occur. Several studies have looked at this question and have found that the odds of a vasectomy failing or a reconnection of the tubes occurring at a later date is quite uncommon. When using the method of cutting the tubes, cauterizing the tubes and sewing one end shut on each side, the failure rate is approximately 1:7000 to 1:7500.
CAN A VASECTOMY BE REVERSED?
Yes, this can be done with the use of microscopic surgery and a skilled and experienced surgeon. This usually requires a day procedure in hospital. The success rate is variable with 40 to 70% being quoted as the success rate upon completion of surgery. A vasectomy should be considered a permanent operation.
WHAT ARE THE BENEFITS OF A NO SCALPEL VASECTOMY VS. A TRADITIONAL TECHNIQUE VASECTOMY?
Doctors and patients report that:
HOW EFFECTIVE IS A NO SCALPEL VASECTOMY?
It is as effective as any other form of vasectomy procedure.
CAN A NO SCALPEL VASECTOMY FAIL?
Yes, as mentioned above the failure rate can be between 1:7000 to 1:7500.
IS NO SCALPEL TECHNIQUE EASIER TO REVERSE THAN THE INCISION TECHNIQUE?
No, it is not any easier to reverse than any other vasectomy procedure. All vasectomies should be considered permanent. If you are thinking about reversal, perhaps a vasectomy is not the right procedure for you.
CAN I STORE MY SPERM FOR FUTURE USE?
Yes, (currently the year 2000), there is the availability in the Edmonton area to have sperm stored. If you wish to look into this, please discuss it with your physician.
PREOPERATIVE VASECTOMY INSTRUCTIONS
POST OPERATIVE VASECTOMY INSTRUCTIONS
- If you have a fever within one week of surgery
- Any bleeding or pus in the wound
- If there is pain or swelling around the wound that gets worse or does not go away
- If your partner misses a period or thinks she is pregnant; it is very important as this may mean the operation has failed and your partner may be pregnant