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Common Questions and Important Facts About Vasectomy


Vasectomy is the most effective of all the methods of birth control. It also ranks among the safest and most effective of surgeries. But nothing is perfect, and no surgery is 100% safe or effective.

The failure rate for this method of vasectomy is about 0.2%. That is to say, 2 out of 1000 men would remain fertile, even several months after the vasectomy. Failure can occur due to reconnection of the cut ends during healing, formation of a new channel through which sperm can travel, failure to identify and cut the vas, or duplication of the vas on one side. If your semen test remained positive, we would repeat the vasectomy procedure at no cost to you.

If you have a negative semen check once, there is an exceedingly small chance (about 1 in 2000) that you will experience a late failure, with spontaneous reappearance of sperm in the semen. You are welcome to bring in a fresh semen specimen for repeat testing at any time that you wish reassurance of sterility.

Most of our patients say the discomfort is minimal or mild, though many tell us that they experienced no pain at all, either with the procedure or afterward. Of course, each individual is unique, and no one can promise that yours will be a painless vasectomy experience, but we are committed to making your vasectomy as comfortable for you as it can possibly be.

For some men, thinking about it may be more discomforting than the actual procedure. That is why we have worked to eliminate the needle and scalpel and all sources of anxiety from the No-Needle Vasectomy procedure.

You are not likely to notice the anesthetic wearing off, because the area is small, about the size of a dime, and there is nothing there that hurts. The small opening we made in the skin is closed, has no stitches, and usually does not hurt at all.

Some patients will notice a mild ache in the testicles or the lower abdomen appearing later in the day or the next day. This ache, if it occurs, is usually mild and may be felt from time to time over the first few days, perhaps with activities such as getting up or moving quickly. It should not feel acute or severe. It will go away by itself. Anti-inflammatory medications can be of benefit, if needed.

Yes, we recommend having someone else drive you home, since you don't know exactly how you will feel. If you have a tendency to feel squeamish or to faint, then you must not drive after your procedure.

No problem. We are here to care for you. If you simply need pain medicine to rest comfortably, then Dr. Wilson can prescribe a painkiller for you. We do ask that you be sure to call Dr. Wilson if you are having significant pain so that he can determine whether you are having a complication. While men may be eager to return to activity, pain medicine is not a substitute for rest.

Men who initially think that would be the way to go for them, find themselves pleasantly surprised that they didn’t need it. Actually, sedation and general anesthesia effects can be more unpleasant, and they last for hours, compared with the 5 to 10 minute vasectomy using local anesthetic. You are able to leave the clinic with a clear head.

Sex drive, erection, orgasm, and ejaculation are not disturbed by the operation. Vasectomy only blocks the sperm from coming out. The male sex hormones in the blood do not change. If a man or his partner had negative feelings about vasectomy, like other feelings it could affect sexual performance. However, many men and women have said that the relief from worry about pregnancy has improved their sex lives after vasectomy.

Yes. The amount of semen a man ejaculates after vasectomy is only decreased by about 5%. Without a microscope, you could not notice the absence of sperm in the fluid.

The testes continue to produce sperm cells that go through the same life cycle as before. The unused sperm cells are reabsorbed naturally, as are other unused or old cells in the body. Sperm antibodies may form to help in the removal process, but these are not harmful to the body.

During vasectomy the vas deferens from each side is cut high in the scrotum. The sperm stored "downstream" in the channel leading to the prostate can still be ejaculated and cause pregnancy. The pathway needs to be emptied, which is complete in most men after 15 ejaculations and 6 weeks' time, though some may require longer to clear.

As with any surgical procedure, complications do occasionally occur. With this vasectomy procedure the risk is about 5%, or 1 in 20 men. Most of these complications are minor and temporary and are easily treated with rest and medication. More serious complications occur in less than 1% of all vasectomies, and less than 1 in 1000 at The Vasectomy Clinic.

Inflammatory response, tenderness along the vas or around the testis and epididymis may occur, usually just on one side, after 3 to 5 days in about 5% of patients. It is usually mild and it will resolve spontaneously, but it subsides more rapidly with anti-inflammatory medicine, such as Aleve or ibuprofen.

Rare: Less Than 1 in 100:
Bleeding from the skin incision, normally absent or limited to a few drops, if it persists is controlled with direct pressure, pinching the skin between gauze.

Sperm granuloma is a tender lump, larger than the normal pea-size scar where the vas deferens was blocked. It can occur in about 1.5% of patients, where sperm has leaked out of the vas deferens and stimulated a local tissue reaction in the scrotum. Delaying ejaculation during the first week after vasectomy may reduce sperm leakage, but it can occur at later times, as well. Anti-inflammatory medication may be used, though usually no treatment is required, as it resolves spontaneously over time.

Very Rare: Less Than 1 in 1000:
Scrotal hematoma, a large collection of blood inside the scrotum, occurs when a blood vessel leaks, usually within hours after vasectomy. This requires immediate treatment and possibly surgery to stop internal bleeding.

Infection of the scrotum can be avoided by not disturbing the incision. Medical evaluation and antibiotics may be required.

A scar or neuroma may form along the vas at the site of vasectomy and be sensitive to touch. This is rarely bothersome enough to require medical attention or surgical removal.

Allergy or other reaction to local anesthetic or other medications can occur even without a history of a drug allergy. These reactions are very rarely serious or life threatening and may require medication or observation.

With microscopic surgery by a skilled and experienced surgeon, the vas in most cases can be reconnected. This procedure usually requires general anesthesia and a stay in the hospital. But even after making this attempt, as many as 50% will not succeed in having children. Therefore, vasectomy should be considered a permanent operation.

Sperm banking -- freezing sperm for later use -- is available through regional fertility laboratories. While it offers the possibility of future pregnancy, the process of storing and retrieving your sperm, and the assisted fertility procedures of artificial insemination or in vitro fertilization are complicated and costly and introduce considerable uncertainty rather than security. If you have any reservation about giving up the ability to father children, you should not have a vasectomy, but should choose another method of birth control.

Vasectomy has been in use since the early 1900's. Over 20 million American men have had vasectomy for sterilization. No long-term adverse effects have been proven with vasectomy. Ongoing studies have not demonstrated that vasectomy plays any role in prostate cancer. Medical scientists continue to explore the minor changes in the body associated with vasectomy. While it is possible that there are undiscovered health risks, this possible risk should be weighed against the benefits of vasectomy.

Yes.

  • If a man does not want vasectomy and is having it because he is told he should, he may feel resentment.
  • If he is having problems with impotence or sexual fears or an unhappy marriage, it is not likely that vasectomy will help any of these problems.
  • If a man is unsure whether or not he is going to want more children, he should not have a vasectomy.
  • If a man's sexual fulfillment or his partner's satisfaction depend upon his being able to cause pregnancy, then sterilization would probably create a sexual problem for him.

Almost all men (99.2%) who have vasectomy are completely satisfied with the operation afterwards. They enjoy the freedom from other contraceptive methods, which can interfere with lovemaking, freedom from worry about an accidental pregnancy, and freedom from concern about the effects of the pill or IUD on their partner's health. A small number of men later regret having the operation. That is why it is so important to make the decision carefully, without any outside pressure. Your satisfaction depends largely upon your own preparation and thoughtful decision-making.

Activity Guidelines

The following table illustrates what you should and should not do in the week following vasectomy to prevent complications:

You must go directly home from the clinic after your vasectomy and rest until the next day.

 

YOU MAY DO THIS: DO NOT DO THIS:
DAY OF SURGERY

-Eat & drink normally
-Sit, lie, or recline
-Enjoy TV, videos, reading, computer work
-Take Aleve, Tylenol, ibuprofen, aspirin

-Return to work
-Go out to eat or shop
-Exercise, go for a walk
-Entertain guests or attend social gathering
-Engage in sexual activity

NEXT 7 DAYS

-Do office work
-Go walking
-Drive your car
-Lift and carry less than 40 lbs.
-Go shopping
-Take showers
-Do light physical work
-Write love letters

-Heavily exert yourself
-Go jogging or golfing
-Ride a bike
-Do weight lifting
-Roughhouse with kids
-Go swimming, bathing
-Jump or strain
-Disturb your incision

AFTER 7 DAYS there are no restrictions on activities.

Common Questions After Vasectomy

There is a scar in the vas deferens where we cut and sealed it. It usually feels like a knot the size of a BB or a pea. It may swell to the size of a lima bean and it may be tender for a few weeks after the vasectomy, but then becomes smaller and non-tender. Most men are unaware of the scar unless they are searching for it. It may be difficult for you to find on one or both sides.

About 5% of patients have a more vigorous than usual inflammatory response. It feels like a vague ache on one side, which might be referred to the groin or abdomen and aggravated by movement. Even though it typically doesn’t start until the 3rd to the 5th day, it is not caused by excessive activity, it is just part of the way your body heals. There is no way to predict who will experience this, but it is nothing to worry about. It is readily treated with an anti-inflammatory regimen, as mentioned in the After Vasectomy Instructions (pdf), which is continued for 7 days to prevent a recurrence.

When this rare complication occurs, it is usually painful, with a large purple lump, like a golf ball or larger, in the scrotum. Most hematomas occur within the first few hours after vasectomy, though it could also occur later in the week. A hematoma is not always due to overexertion or straining; it results from bleeding internally, which can occur spontaneously at the site of any surgery. Resting, especially the first day, is the best prevention.

Prostatitis and epididymitis are both common conditions in men, whether or not they have had a vasectomy. There does not appear to be a long term increase in these conditions due to vasectomy. Vasectomy probably helps protect against bacterial epididymitis, since the offending bacteria are blocked from ascending the vas deferens to reach the epididymis.

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