VASECTOMY

WHAT IS A VASECTOMY?

A male sterilisation procedure
Sperm travels from the testicle on each side via the vas deferens tubes (“vasa” (plural) or “vas”(singular)), ultimately to join with fluid from other glands which is then expelled from the penis in ejaculation
The vas on each side is cut to prevent sperm from being able to join the ejaculate

Mr Jassal usually performs vasectomy under general anaesthetic in an operating theatre as a day case procedure
5mm incisions are made on both sides of the scrotum and the vas on each side brought to the surface and divided
Further measures are taken to reduce the chance of the divided vasa ever joining up again

The usual pre-operative recommendations apply (see Preparation for surgery)
Notify Mr Jassal of any previous scrotal or testicular surgery
Wear supportive / elasticised underwear to surgery
Shaving / waxing is not necessary – if required, clipping will be performed in theatre when you are asleep

The usual Post-operative instructions apply
Pain is usually mild and self limiting
Ice packs in the first 24 hours may help
Paracetamol +/- an anti inflammatory such as ibuprofen may be all that is required
Showering is fine but avoid swimming for five days
Wear supportive / elasticised underwear for the first week and avoid strenuous activity
Minor bruising may occur, but contact Mr Jassal’s rooms with any increasing swelling of the scrotum

Sterility will usually take six to twelve weeks from surgery as residual sperm are flushed out of your system through ejaculation – as a guide, this might take about 20 ejaculations
STERILITY IS NOT CONFIRMED UNTIL YOU COMPLETE A SEMEN ANALYSIS TEST SHOWING A ZERO SPERM COUNT
You will be provided with a referral for semen analysis and collection jar, to be utilised at the six to twelve week mark post surgery
Until a zero sperm count is confirmed, you should use alternate contraception such as condoms or the oral contraceptive pill

Mr Jassal recommends Doreveitch Pathology or Melbourne Pathology
An instruction sheet and collection jar will be given to you
Semen analysis is recommended six to twelve weeks post vasectomy – or after about 15-20 ejaculations – and after abstinence from ejaculation for between two and seven days
Ejaculate should be performed via masturbation only, directly into collection jar and without use of creams, lubricant or a condom
Once produced, your sample should be kept in the sealed collection jar, labelled with your details, time of ejaculation and kept at roughly room temperature (or in your pocket)
The sample should be delivered to an open collection centre (drop off times as advised on the pathology instruction sheet) within one hour
Ensure you get your result from Mr Jassal after 48 hours

Avoid intercourse for five days – thereafter, be guided by your level of comfort
Vasectomy DOES NOT protect against sexually transmitted infection

There will be some soreness in the scrotum reducing significantly after the first few days
You will not notice a difference to ejaculation as 98% of the ejaculate does not come from the testes
Testosterone production in the testes is unaffected and is delivered into the bloodstream as per usual
Sex drive / libido should not be affected once healing is complete

Vasectomy is a common, safe and effective procedure, however all surgical procedures carry some risk
Early risks include anaesthetic complications, allergy to something in the operating theatre, bleeding and infection
Later risks include epididymo-orchitis (inflammation of the testicle or it’s adjoined epididymis), chronic pain and tenderness (in under 2%), and development of anti-sperm antibodies

Less than 1% of men will fail to achieve a zero sperm count on semen analysis after vasectomy – you may need repeat testing if the count is not zero by six to twelve weeks after vasectomy
Failure to achieve zero sperm count may be due to your body’s re-joining of the divided vas, or possibly a technical failure of the operation; but usually, more time and a repeat test is all that is required to show zero sperm count
Once zero sperm count is proven, vasectomy failure (potentially resulting in unexpected pregnancy) is exceedingly rare – between 1 in 2000 and 1 in 4000 patients (0.025-0.05%)
Vasectomy is the most reliable contraceptive method currently available

When planning vasectomy, you need to consider it irreversible, as no reversal or fertility technique is failsafe (and significant financial cost is likely)
Surgical reversal of vasectomy can be performed with success rates as high as 90% if performed within three years of vasectomy, but dropping to 30% by ten years after vasectomy
IVF (In-vitro fertilisation) can be performed with sperm stored from before vasectomy or via sperm harvested from the testicle even after vasectomy; successful pregnancy rates vary according to multiple factors

The above information is a general guide only – please feel free to seek further information and/or clarification from Mr Jassal