Vasectomy

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What is a Vasectomy?

A vasectomy is an operation to divide the vas deferens, the tube that carries the sperm from the testis to the penis. This prevents sperm from travelling to the penis as part of the seminal fluid. It should be considered a permanent form of contraception, and so you should be certain you do not wish to have any more children before you proceed.  Although a vasectomy reversal is possible in some men, a vasectomy should still be considered irreversible.

A vasectomy is usually performed using local anaesthetic.  If it appears necessary, though, it can be performed with sedation or a general anaesthetic.  The success rate is very high, 99.8%, but there are some issues and potential complications you should be aware of.

What are the alternatives?

There are many different forms of contraception.  If you are uncertain as to whether you want a permanent form of contraception, you should consider a form that is reversible.

About the operation

Local anaesthetic is injected first.  The operation is done through 1 or  2 small incisions in the scrotum.  Once the anaesthetic has taken effect, the vas is found and divided on each side.  A dissolvable stitch is used to close the small wound.  Afterwards we give you a pad and ask you to wear firm-fitting underwear (not boxers).

Sex and Contraception

It is essential that you continue to use an alternative form of contraception after your vasectomy. Most episodes of failure occur when this precaution is not followed, or  follow up semen testing does not take place.  We would suggest waiting 1 week after the vasectomy
before recommencing intercourse.

Preparation for your procedure

  • Have a shower or bath on the day of your procedure.
  • Shave the hairs from your scrotum.
  • Bring 2 pairs of firm-fitting underwear.

What to expect afterwards

You are likely to have a small amount of bruising and pain.  The pain will most likely subside within 7 days but it may last for up to a month afterwards.

Complications

The complication rate is low, but there are some specific complications you should be aware of before proceeding.

  • Infection – The rate of infection is very low.
  • Bruising – It is likely you will have some bruising afterwards. We suggest you limit activity and wear firm-fitting underwear. Occasionally bruising can be severe (haematoma).  This can be painful and take quite some time to resolve.
  • Pain – You should expect some pain afterwards. This is usually controlled with tablets.  Although the worst of it will subside within a week, it is not unusual to have some discomfort for up to a month afterwards.  Rarely (0.5-1%), a patient can have persisting testicular pain that does not resolve.  This may require ongoing medication or a further surgical procedure.
  • Sperm granuloma – This would be recognised as a lump at the operation site. It can be painful.  If it occurs and is troublesome it can be removed surgically.
  • Failure – There is a failure rate with all forms of contraception. It is possible that sperm will not disappear from the seminal fluid.  If this happens then continued monitoring is necessary and alternative contraception is required.  Occasionally a further procedure is required.

There is a very small chance (1 in 10,000 men), that the tubes may re-join each other (recanalisation).  This would allow sperm to pass through again and it would be possible to achieve a pregnancy.

After discharge from hospital

We advise taking it as easy as possible for the first 2 days after the procedure to minimise the risk of bleeding and bruising.  Wearing firm-fitting underwear also helps to minimise this. Sexual activity can be resumed after 1 week if you are comfortable.

If you have any concerns after your procedure, then please contact our office and speak to one of the practice nurses.

Driving

You should not drive for at least 24 hours after having sedation/ general anaesthetic  (or as instructed by your Urologist).

Patients who are travelling outside the metropolitan area are required to check when they are able to travel, and will be required to stay in the metropolitan area for 24 hours (or as instructed by your Urologist).

Emergency Contacts

In the event of an emergency, call our office within business hours and speak to our Practice Nurse.  If out of hours, please call our office to contact our On-Call Urologist, or present to your nearest Emergency Department.

Ashford Hospital (8375 5205)

55 Anzac Highway, Ashford SA 5035

Emergency Department is open 7 days a week, 8:00am until 10:00pm

Wakefield Hospital (8405 3440)

300 Wakefield Street, Adelaide  SA  5000

Emergency Department is open 7 days a week, 24 hours

**For patient’s outside the Metropolitan area, please present to your nearest hospital
emergency department.

Follow up

It is vital that you provide us with a semen sample for follow up at 12 weeks to ensure that all sperm have been cleared from the tubes.  We will provide you with specimen jars and pathology forms for the follow up seminal fluid analysis.  Once we have confirmed this you can cease using other forms of contraception.

If you have any concerns after your procedure, then please contact our office and speak to one of our practice nurses.

The content provided within this document is intended as a guide only and does not apply to all patients.  Additional information, including patient specific potential risks, must be obtained during consultation with your Urologist.