FREQUENTLY ASKED QUESTIONS ABOUT VASECTOMY

Will it decrease my sex drive?

Changes in sex drive are rare, far more rare than the changes in drive experienced by women who take contraceptive pills and shots.  A study published in the Journal of Sexual Medicine in 2014 showed that the sexual drive and responses of women often improve after their partners undergo vasectomy.

Will it decrease my performance?

90% of men notice no change, but when there is a change, it is usually a positive one.

Will it decrease testosterone production?

 

There is no change in testosterone production

Is it reversible?

Yes, however the chances of vasectomy reversal success depend on how much time has passed between the vasectomy and the reversal.

How is vasectomy done without a scalpel?

A pointed hemostat is used to make a tiny opening into anesthetized skin of the scrotum.  A ring clamp is then used initially to secure each vas tube through this opening. The pointed hemostat is then used to spread all the tissue layers surrounding the vas tube to then deliver a small loop of the vas through the opening as the ring clamp is released. The vas tubes are then divided and the upper end cauterized with a hand-held cautery unit so that it will seal closed.

How is vasectomy done without a needle?

Traditionally, a local anesthetic has been injected into the skin and alongside each vas tube using a needle.  However, most people do not like needles... A MadaJet® is a spray applicator which delivers a fine stream of liquid anesthetic at a pressure great enough to penetrate the skin to a depth of about 3/16", deep enough to envelop the vas tube held beneath the skin. Each vas is positioned in turn beneath the middle of the front scrotal wall and given 2 or 3 sprays. This numbs the skin and both vas tubes adequately for 99% of men. The other 1% (usually men who have thick skin or scarring due to prior surgical procedures in the area) will require a bit more anesthetic delivered with a fine needle, usually with no pain at all because of the partial anesthesia achieved with the MadaJet.

 

 

 

 

 

 

 

 

 

 

How are the ends prevented from rejoining?

After the vas is divided, the one end is allowed to slide back down into the sheath, while the other end is held outside the sheath. A small clip (the size of a grain of rice) is then used to close the empty portion of the sheath between the 2 ends. It would be like making a lengthwise opening in a wire's insulation, reaching in and dividing the wire, lifting one cut end out through the insulation, then putting a clip on the empty portion of the insulation, thereby holding one end outside and one end inside, the insulation itself serving as a barrier between the two ends. Most clips are made of titanium, a non-magnetic metal used for many types of implanted medical devices such as dental implants, heart valves, and joint replacement.

Where does the sperm go after the vasectomy?

 

A man does not eliminate all of the sperm he produces throughout life. The body is able to break down and re-absorb what is not otherwise ejected. The small volume of spermatic fluid containing the sperm is thus reabsorbed after vasectomy in a process that was present before the vasectomy. The prostate continues to make semen, however, which is ejaculated in the normal fashion after vasectomy…there’s just no sperm in it anymore. You don’t notice any difference after vasectomy in this way.

Can I take a Sauna/bath/Jacuzzi/Whirlpool after the vasectomy?

 

Wait at least 5 days and until the small hole in the scrotum is completely healed.  Showers are fine starting the morning after the vasectomy.

Is there anyone else in the room during the procedure?

 

On occasion the doctor has other physicians visiting to observe the procedure. All physicians greatly appreciate the opportunity to learn from others…but you may decline if you feel strongly otherwise. On the same note, however, no family members or partners will be allowed to attend. There is a difference between watching to learn as a physician and watching a loved one go through a surgical procedure.

Why wait 12 weeks for testing after the vasectomy?

 

Because the sperm live for some time in your body. We want to be sure that enough time has passed so that all the sperm ‘downstream’ have died before doing the test. If your test shows zero sperm, it won’t be an issue. However, if a second test is necessary, and we find a few dead sperm (which is not unusual) we can be sure that they are just ‘leftovers’. Doing the test earlier risks finding these ‘leftovers’ still alive and then we have to wonder if they are new (meaning a failure of vasectomy) or old.

How soon can I travel afterward?

 

The considerations here are two-fold. Firstly, should a problem arise, it is a good idea to be able to come back to see the doctor to check things out. Secondly, you want to avoid lifting luggage. It’s probably best to consider avoiding travel for 7-10 days after the vasectomy.

Do the clips set off airport metal detectors?

 

No.  Clips are made of titanium and only a couple millimeters in size.  They are placed in a way that you should not be able to feel them.

Do I have to wear the support 24 hours a day? To sleep?  

 

You should wear snug fitting underwear while you are awake for the first 7 days and then anytime that you work out or exercise for the first month.

When can I pick up my kids?

 

No lifting for the first week.

How can a vasectomy fail if you’re cutting and burning the tubes?

 

The body has a remarkable ability to heal itself and, in rare cases, the tubes will ‘rejoin’ (about 1 in 2000 on average). Nothing in life is 100%. However, vasectomy has the lowest failure rate of any form of contraception. Period. Can it fail even after a clear test at 12 weeks? Yes, but this is extremely rare. You can test your semen every year, if you choose, but this is very seldom done.

What was the “older” technique and what is the advantage of “no-scalpel-no-needle”?

 

A scalpel, or knife, was used to cut through the skin and all the layers of tissue to get down to the vas deferens, the tube that carries the sperm. That means that we cut through blood vessels on the way down. With no-scalpel technique, we make a tiny opening and stretch it just enough to pull out the vas deferens and block it. By stretching a tiny opening, we push the blood vessels to the side instead of cutting through them. You would think that this results in less bleeding and that is precisely what it does…by about 90%. And remember that bleeding is the major painful complication of vasectomy. No-needle anaesthesia (numbing) uses air pressure to push the anaesthetic solution through the skin quickly and easily. Instead of a needle, you feel a ‘pop’ like a small rubber band against the skin. Aside from the fact that “you don’t have to get a needle down there”, this method results in a more rapid (seconds) and profound (deeper) numbing. Many men feel nothing during the vasectomy, others may feel some mild pressure or pulling.

Will it hurt to pee (urinate)?

 

No.

What holds the testicles if you cut the tube?

 

The vas deferens, the tube that carries the sperm, is only one of many structures that hold the testicles in place. There are blood vessels and other tissues that provide support and these are not disturbed. Your testicles will still be supported after the vasectomy, they won’t roll around loosely in your scrotum.

How soon will I know if there are complications?

 

Most complications will occur in the first week. This is the really critical period. But you don’t want to traumatize the area (like horseback riding) for the first month. Most other activities that don’t involve an impact to the scrotum are unlikely to cause problems after the first week. Rarely problems can arise after the first week.

How do I know if it’s okay to start exercising?

 

You’ll have to take my word for it, ease back into your exercise after one week. Of course, you’ll know if you can’t start exercising if you continue to have pain or discomfort. Otherwise, if you are feeling okay, consider that a sign that you can go ahead.

Does no sex for 7 days also mean no ejaculation at all?

 

Yes no ejaculation for 7 days.

Men with fewer than two children 

 

If you are less than 30 years old and you have had fewer than 2 children, please consider the following points before having a vasectomy:

  1. Vasectomy should be considered a permanent and non-reversible procedure because vasectomy reversals are not always successful. Before having a vasectomy, know all of your options.

  2. You may regret it. Men who have vasectomies when they are in their 20's, especially if they have had fewer than 2 children, may be the ones most likely to seek vasectomy reversal at a later date, often regretting their vasectomy decisions if their reversals are not successful.

  3. You may change your mind. Many men who think they will never want children when they are in their early 20's are delighted with fatherhood when they are in their 30's. You may be totally convinced now that you will never want children, but people change and you may have a much different outlook 10 years from now.

  4. Women may change their minds. Similarly, women who have no desire for children when they are in their early 20's may have a much stronger desire when they are in their 30's and when many of their friends are having children of their own.

  5. Relationships end. You may not be with the same partner ten years from now and a new partner may have a much stronger desire for children than your present partner does. Just because your present partner claims that they will never want children, their decision may change 10 years from now, or they may not be your partner in 10 years.

  6. Have you discussed your decision with your parents? If not, consider this: You're an adult, yes, but they helped you get there. How would you feel if your son came home one day and said that he had had a vasectomy? That he had done something to limit his future potential (to be a father) and to limit your own potential (to be a grandparent). Having a vasectomy is still your decision, but at least you granted them the respect of letting them render an opinion. And if they succeed in discouraging you, because they know you better than any doctor does, you may one day thank them. If they don't succeed in discouraging you, they may split with you the cost of sperm storage and feel much better about your vasectomy in doing so.