Vasectomy

What is a vasectomy?

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What is a vasectomy?

Vasectomy refers to the vas, which is the tube that takes sperm from each testis (where the sperm is made) to storage depots called seminal vesicles.  The seminal vesicles work with the prostate gland to produce the fluid known as semen that is ejaculated with an orgasm.

A vasectomy is the surgical procedure where a piece of vas is removed, in order to prevent sperm getting into the semen. No sperm means no babies.

If you feel above each testis, you can feel a bundle of cord like structures. These are veins, arteries, nerves and the vas.  Only the vas itself is cut - everything else is left alone.

Does a vasectomy have any side effects?

There is no evidence that vasectomy has any long term complications. 

Occasionally, a small lump or thickening may develop at the end of a vas some time after the vasectomy.  This may be tender for a while before resolving itself.  It is extremely rare for chronic testicular pain to be reported after a vasectomy.  This may be related to a grumbling infection, nerve damage or psychological factors so can be difficult to treat in some cases.

Some past studies that appeared to show an increase in the risk of prostate cancer following vasectomy have since been proven incorrect.

What is involved?

What actually happens during the vasectomy procedure?


I use a technique known as the "No Scalpel Vasectomy".

In the vast majority of patients this is what it involves:

Before you arrive at the surgery for your vasectomy, you will need to shave the front of the scrotum (or ball bag) to make the procedure easier to perform.

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  • First of all, the scrotum is washed with antiseptic.
  • Then, the vas is carefully manipulated to the skin surface.  A small amount of local anaesthetic is injected into the skin and tissues underneath to make the area numb. The ouch factor is minimal - it feels like a sting.
  • A tiny split (1mm to 2mm) is made in the numb area to expose the vas. It is carefully dissected from the other structures through this keyhole and then gently pulled out about 2 centimetres, and clamped at each end. 
  • Then, the 2 centimetre segment is cut and cauterised (heat sealed) with an electric needle.  Thanks to the anaesthetic, none of this can be felt.  After each vas is cauterised, it falls back inside the scrotum.
  • The split in the scrotum is gently squeezed shut, without the need for stitches. 

 

                                   The total procedure usually only takes about 15 minutes.

 

 

Recovery

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How do I recover from the vasectomy procedure?

It takes about four hours for the anaesthetic to wear off, leaving a heavy feeling on each side. Firm underpants will help this, and two Paracetamol every four hours can also be taken if needed.

When you get home after the procedure, apply an ice pack to the scrotum (from outside the underpants) for ten minutes. Then, take a ten minute break. Repeat ten minutes on, ten minutes off for three hours. Frozen peas can be a convenient ice pack.

It is really important to rest for the next two days. Heavy lifting and exercise can cause internal bleeding or leaking of fluids in the first couple of days after the procedure.

Avoid Aspirin or Aspirin related drugs, as they can impair blood clotting and aggravate bleeding.

Some swelling and bruising in the skin of the scrotum and penis is normal, but really hard swelling is not normal and usually indicates bleeding. This can be managed by sitting down with your feet up, more ice packing and some Paracetamol.

 

When will I be able to resume sexual activity?

You can resume sexual activity as soon as you feel comfortable. Most people take anywhere from four days to two weeks. It will take a few weeks for the sperm to totally disappear from the semen, and the more sexual activity, the faster this will happen.

Is any follow-up required after I have recovered from the vasectomy procedure?

After about twenty ejaculations following the procedure, a semen sample can be collected in a specimen jar, and dropped off at the laboratory for testing. If no sperm are found, a second sample can be taken a week or two later to confirm the success of the vasectomy.

If sperm are found in the first sample, another sample should be tested several weeks later. You are sterile when your first sample is confirmed as clear of sperm, followed by a repeat sample that is also clear.

Your partner will not need any other contraception after this confirmation. Sometimes a few dead sperm are reported in the semen sample up to several months later. These are from the walls of the seminal vesicles and are being shed with normal cell turnover. They are of no concern.

What changes after a vasectomy?

When you look under the microscope, there are no sperm in the semen of someone who has had a vasectomy. Other than that... a vasectomy makes absolutely no difference to sexual performance. The testes look and feel just the same and there is no difference in hormone levels.

 

 

Are there any long term considerations after having a vasectomy?

There is no method of contraception that gives 100% guaranteed safety, however it is very rare for a vas to grow back.

The procedure described here is very good, and while exact figures are not available, approximately only 1 in something like 5000 to 7000 may fail after using this technique and having two subsequent negative sperm counts.

Research from the United States shows that after ten years, about 6% of men regret they had a vasectomy. Virtually all of those men (98%) were with a new partner. It appears safe to say that if you stay with your present partner, you will not regret having a vasectomy. 



Costs

How much does the vasectomy procedure cost?

The cost of the pre-surgery consultation is $65

The cost of the surgery is $410

Dr Paul Bennett is an Affiliated Provider to Southern Cross for vasectomies.  For eligible Southern Cross members this means:

  • you don't have to pay for the procedure and then wait to be reimbursed
  • you dont need to send in a claim form - your Affiliated Provider will manage the claims process directly with Southern Cross

 

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Booking

Please phone reception at Broadway Medical Centre  to enquire about booking.

Phone:   03 477 4335

Fax:        03 477 4337

E-mail: enquries@broadwaymed.co.nz