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How many vasectomies do you do per year?
On average at least 100 per year. I usually do not book more than 2 per day as I also have a general family practice to run.
For how long have you been doing vasectomies?
Since 2001.
Funny, nobody has ever asked me how many babies have I delivered. (the answer is between 30-50 per year since 1994)
Do you do vasectomy reversals?
No. I don't.
If you are even considering to have a reversal done in the future, then DO NOT GET A VASECTOMY AT ALL!
I have read all your information and instructions on this web site. Do I still need to come in for a consultation visit prior to having my procedure done?
Yes you do. I need to review your past medical and surgical history. I also need to ensure that your anatomy is normal and of such a nature that I can actually offer you a No-Needle, No-Scalpel vasectomy.
It is rather embarrassing to book you in for a procedure and then only to discover on the day of your procedure that I can not actually do the procedure.
What are potential anatomical abnormalities that will not allow me to be a candidate for a No-Needle, No-Scalpel Vasectomy?
Things like masses, or cysts in the scrotum. Some guys have very high riding testes and a tight scrotum in which case the vasa might not be able to be found. Obesity can make a vasectomy very difficult. If you have a bleeding disorder or are on blood thinners, then we need to take this in consideration.
Some guys may have only one tube, but two testes. It is important that I need to make sure that I can feel you vases through the scrotum skin, before the procedure.
Is it possible to have more than two vas deference tubes?
Yes it is possible. But it is also extremely rare.
But that is also why it is very important to make sure that you go for your follow up semen test.
What do you offer for anxiety?
I do know that this is an anxiety provoking procedure, however I also find that the majority of guys do not need anything for anxiety.
If you feel that the anxiety will get the worst of you, then please let me know. I will then prescribe you a small quantity of Ativan (lorazepam). I would recommend that you take one of these the night before as well as one tab one hour before your procedure. Bring the remainder in to the appointment with you as we may need to give you some extra while you are here.
I faint easily when getting stiches or when I see blood.
Unfortunately this can happen. If you are one of those guys, please let me know during your consultation visit and I will review with you some options to try and reduce the chance of this happening.
I have never shaved my genitalia.
Remember I only need a short trim of the hair on the front part of the scrotum. I do not need you to have a smooth shave and I do not need you to shave all your pubic hair.
So just be careful and you will be fine.
If you are used to shaving your genitalia, then I am certain you will not have any problem with this.
What happens with all the sperm? Will it just build up and one day explode?
You will still produce sperm, but your body has a natural recycle function and will just reabsorb those sperm. And no, you will not one day just explode. Remember, sperm only accounts for about 2% of the total volume of ejaculate.
What will my semen look like after I had a vasectomy?
Your semen (or ejaculate) will look exactly the same to the naked eye as what it did before the time. It will be the same colour and volume. The only difference would be that if you were to examine your semen with a microscope, you will not be able to see any sperm.
I had some blood in my semen. What do I do?
It is not uncommon to have a small amount of blood in your semen after you had a vasectomy for the first few times. We call this condition hematospermia.
If this happens for more than three months after you had a vasectomy, then you may need to be checked out as this can also be caused by some other urological conditions.
Will a vasectomy affect my libido (desire to have sex)?
No. It will not.
Remember, the only thing that we interfere with is the flow of sperm. You will still produce the same amount of testosterone that is directly absorbed into the blood stream. If you have loss of libido after a vasectomy, then it is not caused by the vasectomy. Some studies have shown men to rather more enjoy sex after a vasectomy as they do not need to worry about contraception anymore.
Will a vasectomy affect my erections?
No. It will not.
Again, the only thing that we interfere with is the flow of sperm.
The most important causes for impotence (ED) is anxiety, stress, smoking and poor fittness.
If you are having trouble with erections, then please go see your doctor as this is an independent risk factor for cardiovascular disease and requires further investigations.
Does vasectomies increase my chance of getting prostate or testicular cancer?
No it does not.
This has been well studied and no, vasectomies will not increase or decrease your chances of getting any of these cancers.
In fact, there are also studies that shows no increased risk for heart attacks, strokes or dementia either.
I am very sexually active. Can I do my semen test in less than the three months?
No you can not.
Sperm as they are forming sits attached to the inside wall of the vas deference tube and waiting to ripen. And they don't let go of that tube until they are ripe. For every guy that time is different, but for the majority of guys it will take about 3 months to clear out those sperm.
I had some guys that claim they can clean themselves out in less than a week!. Sorry, but it does not work that way!
I have lost my requisition or containers to do my semen test.
Please contact my office and we will certainly supply you with what you need.
You said I am not allowed to have sex within a week after I had a vasectomy. What if I accidentally get a spontaneous erection?
Let it be ... This too shall pass.
Is masturbation consider "having sex"?
Do I even need to answer this? Hmm... Yes!
How can lifting something within the first three days after a vasectomy cause me bleeding in my scrotum?
The blood supply to and from the testes originates from inside the stomach. When you lift something, you instinctively will increase the pressure in your stomach and thereby increase the pressure to these blood vesels which are now frail after performing the surgery. This then can cause bleeding.
What if I cough or have a constipated bowel movement? Can this cause bleeding?
Theoretically, yes. However these are things that we do not have control over, where as lifting things is something we do have control over.
My philosophy in life is: change the things that you can for the better, but accept the things that you can not change.
If you have a severe bad cough prior to your surgery, then please let me know and I will discuss this with you.
Will I have difficulty urinating after a vasectomy?
No you will not.
With a vasectomy I do not touch the urethra (the urine tube that goes through the penis).
Why do you charge a cancellation fee?
We only charge a cancellation fee if you did not show up for your vasectomy or if you cancel less than 24 hours prior to your booked procedure.
Prior to introducing this cancellation fee policy, I had too many guys just not showing up. Considering that this is an hour of time that I set aside just for you, it is unfair to me and to my other patients if you do not show up.
We have a routine to phone you the day prior to your procedure to confirm your appointment, however we greatly appreciate it if you can notify us ASAP if you need to cancel or change your booked appointment time.
Are vasectomies covered by my provincial health insurance (MSP)?
Yes they are fully covered.
(Vasectomy Reversal procedures are not)
I don't have provincial health insurance.
For patients without Provincial Health Insurance, fees are charged based on the BCMA fee guide. For details, please contact our office.
Please note, we only accept cash or cheques. No Interact or Credit Cards, sorry.
I have heard about the open end technique. What is this and do you do this?
With the open end technique the distal end is left open and the proximal end is closed off.
I do not perform the open end technique.
The surgeons who perform this procedure claims that this prevents having a swollen testicle or vas deference congestion. I still have to see one guy who has suffered these conditions following a vasectomy.
It is also felt that the open end technique may increase the chance of developing a granuloma as more sperm leaks out of the open end.
Some claim that this technique is easier reversible. This is not correct and it is unethical to perform a permanent procedure with the faintest of hope that you want to reverse it in future.
Are there any long term risks to using the titanium surgical clips?
No there are not.
Titanium has been used for a very long time for a variety of surgical procedures. It is a very inert material and does not cause any reactions in the body. We use these very same style clips for multiple other surgeries.
Will these metal clips set off the metal detectors at the airports?
No they will not.
Can I still have an MRI with these metal clips in me?
Yes you can. Titanium is not magnetic.
If you cut the tube, cauterize the ends and apply the clips, how is it possible that there is still a 1 in 2000 chance of the tubes reconnecting?
Who knows! I guess where there is a will there is a way. But we know it can happen. The human body is amazing! They say: "nothing in life is certain other than death and taxes!"
Should I have a repeat semen test ever few years to make sure that I am not that 1 in 2000?
No not really. Do you test yearly? every 3 months? For how long do you keep testing? We do not have any guidelines that tell us how often and for how long do you need to keep testing to prevent that 1 in 2000 chance. It has been suggested that you may need to do over 100 000 semen tests to prevent one single extra pregnancy. That is not logistically possible.
If you are however very paranoid, then there is no harm in doing more testing, but I can not tell you how often and for how long. You will need to decide that for yourself.
What does "Rare non-motile sperm" mean on a semen analysis.
At IHA labs this means that there is 0-1 sperm that are not moving per high field on a microscope. Some recent studies have shown that men who has 0-1 non-motile sperm per high field on a post-vasectomy semen analysis has only a 1 in 2000 long term risk of causing a pregnancy. That is the same for somebody who has a zero sperm count.
Ideally we are looking for a zero sperm count, but we do get some men who keep on shedding some dead sperm for a very long time. This recent study has allowed a change in the guidelines that for men who has "Rare non-motile sperm" on their semen analysis, we can reassure them and consider the vasectomy still successful.
So how do I apply this in my practice?
If by 3 months you have "Rare non-motile sperm" on your semen analysis, I will ask you to do a repeat sample 3 months later. Hoping that we can see that Zero Sperm count.
If by 6 months you still have "Rare non-motile sperm" then we will call this a successful vasectomy.
Can my partner come into the room with me during my vasectomy?
Yes. I even had partners come in to video record the procedure for them. Whatever you find helps to distract you is fine with me, but leave the kids home.
What is a "Laser" vasectomy?
A laser vasectomy is done the very same way, except in place of using a blade to cut through the vas a laser is used.
There really are no advantages in using a laser and this procedure is mostly used in countries where there is a financial incentive to use expensive equipment.
As far as I know, laser vasectomies are not offered anywhere in Canada.
I've heard one doctor comparing this to "changing your car's stereo wires using a blow torch. You can do it, but you don't have to."
Dr. Jomar Barnard
Tel: 250-545-2552