Vasectomy is the name given to the operation which makes men infertile by producing a block to sperm movement from the testes and is the most efficient form of contraception currently available. Sperm are produced in both testes (testicles) and are then carried by a tube called the vas (plural=vasa) deferens on each side to a sponge like area of vas near the seminal vesicle at the back of the bladder where they are stored.
Most of the fluid ejaculated (approximately 98% of the semen) is actually produced by the prostate gland, the seminal vesicles and Cowper’s gland. This means that when you ejaculate after a vasectomy the semen is gradually depleted of sperm so that eventually it will be free of sperm although the volume of the ejaculate is not noticeably changed. The production of the male hormone testosterone by the testes is completely unaffected as it all continues to go directly into the blood stream, so sex drive and libido are unaltered.
The procedure is very simple and takes about 10-15 minutes. The anaesthetic is applied to the vasa using a fine needle. There are never any injections into the testes.
A single small opening, only 2-4mm in size and which will close rapidly and heal without needing stitches, is made in the centre of the scrotum below the penis without a scalpel (‘No Scalpel’). The vasa are located and gently drawn through the same opening one at a time. The top end of each vas is sealed then the vas is divided and the top end is covered with tissue (‘fascial interposition’) using either a tiny clip or dissolving thread to further prevent them rejoining. The bottom end of each is left open (‘open ended’ technique) to minimise post-operative pain.
Using this method there is much less chance of complications and the patient usually feels much more comfortable.This is in contrast to the traditional method, often performed under a general anaesthetic, involving cutting through the skin and its blood vessels to pull the vasa out and excise sections of the vasa.
Ideally stop taking aspirin, ginkgo, olive leaf extract, fish oil and other natural medicines for 1 week before your procedure as these may increase bruising and bleeding. This however is not essential.
if you are taking aspirin prescribed by a doctor or if you are on any other anti-coagulant (Isocover/Co-Plavix Pradaxa, Xarelto, Eliquis or warfarin) please let us know at time of booking and ask for more information and instructions before ceasing these medications or if you have had previous surgery for undescended testes as a child
Ring and confirm your attendance 48 hours before the procedure
At home on the morning of the procedure, please shave the underside of the penis and all of the front wall of the scrotum. To make it easier you can trim first with hair clippers (always use a No.1 or 2 guard to prevent catching the skin). We suggest that you don’t use depilatory creams such as Veet and Nair as these can cause chemical burns. If you can stand the pain waxing does work well.
Post vasectomy pain varies unpredictably from usually having little to none but rarely there can be significant pain and swelling. Pain can start from 1 hour after the operation (when the local anaesthetic wears off) or start a few days or weeks later. It is usually due to inflammation of the epididymis and testes and not infection. If significant pain and swelling occurs try to rest your feet up and take ibuprofen (an anti-inflammatory) 200mg, 2 tablets 3-4 times a day after food.
Excessive or increasing swelling +/or pain which is not responding to anti-inflammatories is not normal and you should contact us on 1300 377 647 or see your local doctor or emergency department.
Bruising of the skin on the scrotum is not a concern as long as it is not associated with scrotal swelling as it reflects only blood just under the skin and will disappear with time.
In the rare case that the wound bleeds, ‘pinch’ over the wound with some gauze or a tissue for ten minutes, then let go very slowly.
Shower as normal but do not have a bath or go swimming for 2 days until the wound heals.
It is advisable to continue to wear supportive underwear for 2 days (place a piece of gauze or tissue over the wound till healed).
Activity and sex
Take it easy for 2 days, after which your level of activity including sex should be guided by your degree of comfort. More strenuous activities (running, bike riding, prolonged walking, climbing and repetitive lifting) should be avoided for the first week. Excess activity may cause pain but will not cause any ‘damage’.
You are not sterile yet! Sterility takes approximately 8-12 weeks after a vasectomy to occur. At 12 weeks most are ‘all clear’, only rarely are repeated monthly tests needed. Your operation cannot be considered successful until you have confirmed with us that you are ‘all clear’
Instructions for Collecting a Semen Sample
You will be given a pathology request slip and a specimen jar at your visit. At 12 weeks get a semen test done using the collection jar, pathology request form & bag provided. You can use any pathology provider but check with the pathology service first to see if they have any special requirements. Screw the cap onto the jar firmly and label the jar with your name, time of collection and date. Please phone us on 1300 377 647 three days later for the result. This will either confirm that you are ‘all clear’ or the need further testing.