The surgery is quick, the pain is low and recovery is usually straightforward.
Dr Low has done over 5000 vasectomies in the last five years. He has trained in the “no scalpel, open ended” vasectomy technique that is only performed by a few other doctors in Sydney. This significantly reduces the incidence of the rare post vasectomy pain syndrome. Dr Low has developed a gentle, minimal pain technique.
Dr Brumby is the owner of our vasectomy clinic. She provides counselling, sedation and back up for Dr Low. She has been doing this for thirty years.
Vasectomy is a minor procedure that prevents sperm traveling from the testes into the semen and should be considered permanent. Semen is the fluid that is ejaculated during sexual intercourse. If there are no sperm in the semen then pregnancy will not occur.
Vasectomy involves cutting and sealing the two tubes located in the scrotum on either side of the penis.They carry sperm to the prostate gland where it is mixed with semen. These two tubes are known as the vas deferens.
A vasectomy will not alter any of the characteristics which influence masculinity. The testes will continue to produce the male sex hormone, testosterone, as normal. Testosterone is released by the testes directly into the bloodstream and is therefore not affected by having a vasectomy.
Vasectomy is a simple, straightforward operation which is safer and more effective than female sterilisation (tubal ligation). The surgeon will make a small hole in the scrotum with forceps. The vas deferens are picked up and a small amount of each tube is removed. The open ends are sealed and the opening in the scrotum closed by pressing the edges together. The procedure takes about 15 minutes and is performed with either local anaesthetic or intravenous sedation.
Local anaesthetic will numb the scrotal area. This will sting slightly, but after this you will not feel any pain. If you have local anaesthetic you can leave immdeiately after.
If you choose to have intravenous (IV) sedation, you will be given pain killers and drugs that have an amnesiac effect. It is unlikely that you will have any memory of the procedure. If you have had IV sedation, you will be asked to rest in the recovery area for about half an hour after the operation. In total you should be in the clinic for about one hour with local anaesthetic and two hours with sedation. If you are having sedation you will need someone to drive you home.
Phone the clinic for an appointment. You will be asked for a deposit of $100.00. This will be non-refundable if you decide to cancel less than 48 hours prior to the operation time.
If you are having IV sedation, then do not have anything to eat or drink for five hours prior including milk. You may have water up to two hours before your appointment.
The night before the surgery, you will need to shave and trim your pubic hair. Check the diagram and shave within the area indicated with a safety razor. Don’t use an electric razor or depilatory cream. Trim the hair around your penis and scrotum with a pair of scissors. Try and get this right because if you don’t, we will have to do it again and you will be spending more time at the clinic.
Stop taking anti-inflammatory drugs (NSAIDs) such as Nurofen or Aspirin a week before the operation. If this is not possible you must stop them at least 48 hours prior as they can increase the chance of bleeding. This can lead to side effects such as more bruising, haematoma and infection. If you need to keep taking pain killers, panadol, panadiene, digesic and panadiene forte are safe substitutes. Digesic and panadiene forte need a prescription from your doctor.
If you are taking medicine that your are unsure of check with our receptionist, your doctor or a chemist. You can go back on your medicine straight after the operation.
Washing your genitals with antiseptic soap regularly for two to three days prior to the operation greatly reduces the chance of infection. You must have a shower before the operation, so if you are coming after work, make sure there is a bathroom you can use. You must wear either an athletic support or firm fitting underwear.
When the anaesthetic wears off, you may feel a mild ache at the operation site. This can be helped with pain killers and by wearing snug-fitting underpants. If you have had IV sedation, you must stay for about half an hour for the effects to go and you cannot drive or operate heavy machinery until the next day.
You may experience some soreness, bruising and/or discomfort for a few days after the operation. You should arrange to rest for the next few days and avoid strenuous physical activity for one week. If you have an occupation where you mostly sit down, you may return to work the next day. A medical certificate can be written for any time that you need to take away from work.
Three months after the operation you will need to have a sperm count performed. This is to ensure that the operation was successful and that no sperm remain in the vas deferens. It is a good time to check that the vas has not rejoined.
Occasionally a man wanting a vasectomy requests that his sperm is stored in case there is a change in his circumstances. There are private facilities that will do this for a fee. The sperm needs to be stored preferably before the vasectomy. You will need a letter of referral either from us or your GP.
After the vasectomy the sperm count and more importantly the quality of the sperm begins to decrease quickly, even after 7 days.
The sperm can be used in the future to fertilise a partner but there can be problems. Artificial insemination with previously frozen sperm has a lower pregnancy rate than “naturally” conceiving. Also, most men who have vasectomies are older and have lower quality sperm compared to a young man and their partners are usually older and less fertile than a younger woman.
We are happy to give prospective vasectomy patients information on sperm storage. However, it is not a failsafe option if there is a change of circumstances and more children are wanted.
Local anaesthetic will numb the scrotal area so that you will only feel an ache in each testicle for a few seconds. After this, you won’t feel any pain, only slight tugging as the doctor performs the operation. If you choose intravenous sedation, you will feel very relaxed and sleepy and no pain.
Vasectomy is a safe, minor surgical procedure. Complications are uncommon and can be treated.
Despite great care being taken there is a failure rate. This means that the vas have regrown and sperm is in the ejaculate. Eighty percent of failures will show up at the three month sperm count. This is why it is really important to get the test done. If the sperm count is clear the chance of failure at three months is 1:2,500 and reduces even further over time. By six months it is 1:500,000.
Locals are very safe and reactions, including allergy, are extremely rare. Fasting is unnecessary and because there is no drowsiness afterward, you can drive home.
This has more potential complications but they are still uncommon. Allergic reactions to modern anaesthetics are rare; approximately 1:50,000. If you have had a bad reaction in the past you must tell the doctor or anaesthetist before you have the operation.
Under sedation the contents of your stomach may enter your air passages creating a lack of oxygen in your brain. You must fast for a minimum of five hours prior to the procedure. Do not eat or drink anything. Water is okay up to two hours before the operation. Tell the doctor if you have eaten during the fasting period.
Intra-venous sedation (twilight) is a combination of a pain killer and a drug that affects the ability of the brain to store memory for about half an hour after it is administered. Almost all patients will forget the operation, however, amnesia cannot be guaranteed. You can’t drive a motor vehicle, operate machinery, drink alcohol or use recreational drugs, sign important documents or make important decisions until the next day.
Take it easy for a few days. Most men take 1 – 2 days off work, or a week if you do heavy physical labour. We can give you a medical certificate for this time off. Avoid sport for one week, heavy contact sports for two weeks. You can resume sex when you feel comfortable. Wear supportive firm underpants for the first week. Showers are okay but no swimming or baths for the first four days. Remove the waterproof dressing from the wound after four days.
After the anaesthetic has worn off there can be a mild aching pain for a few days. This can treated with Panadol or anti inflammatories like Nurofen. Bruising around the testes and up into the penis and groin may occur — it is of no concern. If there is swelling of the scrotum an ice pack (a bag of frozen peas or some ice cubes in a plastic bag wrapped in a tea towel) applied for ten minutes every half hour for a few hours will reduce the swelling. If the pain and swelling don’t reduce after 24 hours of rest and ice packs, or if it is increasing or severe, contact the clinic.
If there is pain and redness around the wound you may have an infection. If you think you have an infection, see your GP. It is easily fixed with antibiotics.
There may be some minor bleeding from the wound. Pinching the site firmly between finger and thumb for five minutes should stop it. If this doesn’t work call us.
Three months after the vasectomy you need to have a sperm count. It is a good idea to have had at least 16 ejaculations since the operation to flush the stored sperm out of your system. The specimen must be delivered to the lab as soon as possible — within two hours. Keep it at room temperature and don’t put it in the fridge. You can get the sample by masturbating straight into the jar or by using a condom to catch the sperm then emptying it out into the jar. Don’t send the condom.
A haematoma is a collection of blood in the scrotum that can be as large as a grapefruit and occur mostly in the first or second week post vasectomy. They can take 2-3 months to go away. To avoid haematomas return to physical activity slowly as outlined below.
Cold pack on scrotum on and off. No lifting. Walking and standing for 5 minutes at a time only with resting in between. Each day increase walking and standing by 30 minutes at a time until Day 7. Again, resting in between periods of walking or standing
Walking and standing all day. Carry 10-15kg only. No sport yet.
Non-contact sport. Carry 20-30kg.
Football, heavy weights, martial arts.
It is normal to experience a background aching feeling for 1-2 weeks post vasectomy. It will eventually go away. Take Panadol as required. If aching continues for 1-2 months (Post Vasectomy Pain Syndrome) then see your GP to get anti-inflammatory medication (if no contraindications) for 1-2 weeks which will help settle it down.