What is vasectomy?
Vasectomy is the name for male sterilisation. It involves a simple surgical procedure which cuts the vas deferens, which are the small tubes that carry sperm from the testes. There is no change in the volume or appearance of the ejaculate. Vasectomy is a safe, effective, and permanent form of contraception. Around one in four men in Australia over the age of forty have had a vasectomy.
How effective is vasectomy?
A vasectomy is over 99% effective. About one in every 700- 1,000 vasectomies fail and you may stay fertile or become fertile again. This can happen if the tubes are not fully blocked off, if they grow back together, or if a third vas deferens exists.
Normally this is picked up when the sperm count is done three months after the operation, but it can occur at any time, even years after the vasectomy.
Is vasectomy right for me?
A vasectomy is intended to be a permanent method of birth control. It can be difficult to reverse, especially if it was done a long time ago. It is suitable for those who are sure that they do not want to have any children in the future. If you are in a relationship and considering a vasectomy it is better for the decision to have been discussed with your partner and agreed upon, however you do not need permission from your partner to have a vasectomy.
Vasectomy may be right for you if:
- You and your partner are sure you have completed your family.
- You would not change your mind if your circumstances changed.
- You want to take responsibility for family planning.
- You want an effective, permanent method of contraception that does not need ongoing treatment.
Vasectomy may not be right for you if you are:
- Relatively young and do not have any children
- Not in a relationship, or you have recently separated or divorced
- Are having a relationship or marriage problems.
How is vasectomy done?
A vasectomy is a simple procedure which only takes about 15 to 30 minutes to perform. It is done using local anaesthetic to numb the area. Some doctors may also use a light sedation, which means you are in a light sleep during the procedure.
The doctor usually makes a small opening in the front of the scrotum (below the base of the penis), locates the vas deferens and cuts both sides. Sometimes a small part of each vas deferens is removed. The opening in the skin of the scrotum is then closed with a stitch or by pressing the skin edges together. The local anaesthetic may sting and there may be some sensation during the procedure, but it is generally not painful.
You will usually spend up to 2 hours in total in the clinic. As the local anaesthetic wears off there can be some tenderness and discomfort in the scrotum and groin. This can be managed with rest, oral pain relief, ice packs, and wearing firm, comfortable underwear. After the vasectomy, you should rest for the remainder of the day, preferably with your groin elevated a little to assist in minimising any swelling.
You can return to normal activities the next day if you have a desk job. Normal day-to-day activity is not harmful, but if your work is physically strenuous you may need to take some sick leave.
Sexual activity can be resumed whenever it feels comfortable to do so.
When is the vasectomy effective?
Sperm can be present in the semen for up to three months after a vasectomy. You will need to use additional contraception until you have had a sperm test three months following the procedure.
Where do the sperm go?
Sperm continues to be produced in the testes after the operation but they are harmlessly re-absorbed by the body.
Vasectomy is a simple and safe procedure. It is common to experience some tenderness following the operation. Some may also experience some minor bruising and swelling which may last a few days. As mentioned, rest, ice packs, oral pain relief and supportive underwear will minimise these symptoms.
A small number of people experience bleeding or infection after a vasectomy. Rest, support of the scrotum, pain relief and antibiotics will resolve most problems quickly. Occasionally sperm can leak from the ends of the cut tubes and produce small, hard lumps at the site of the operation. These usually do not cause any problems. Very occasionally the spontaneous re-joining of a tube may occur leading to sperm in the semen. This is called recanalization and can occur at any time after a vasectomy.
Some people form antibodies to their own sperm after the operation, but these do not appear to affect any other part of the body or cause any disease or discomfort. This would usually take years after a vasectomy to occur. These antibodies may be one of the reasons that some people who have had a vasectomy cannot father a child even after having a reversal operation.
Very rarely discomfort in the scrotum may persist following vasectomy. While this usually settles with time, very occasionally it does not, and further surgery may be needed to relieve this discomfort.
The vasectomy operation does not involve removing the testes, will not affect your ability to produce semen, and does not change sexual function or characteristics in any way. You will still be able to enjoy sex as you did before and ejaculation should feel the same. The only difference will be that the semen will not contain any sperm.
Reversal of vasectomy
Some surgeons have been reasonably successful at re-joining vas tubes that have been cut. However, these surgeons normally only take on cases they consider to be straightforward, and even if the operation is successful, there is no guarantee that you would then be able to father a child.
If you are considering a vasectomy, you should regard it as a permanent decision. If you think there is any possibility that you may want to father children in the future you should not have a vasectomy.
How to arrange vasectomy
Vasectomy is performed by some GPs, specialist urologists, or at some sexual health centres. Call Sexual Health & Family Planning ACT on 02 62473077 or make an appointment online for more details.
VASECTOMY BROCHURE PDF
Last updated April 2019
References: Contraception: an Australian clinical practice handbook. Andrology Australia: Vasectomy 3. FPNSW: Fact sheet: Vasectomy