The Basics of getting a Vasectomy
This is permanent.
For all intents and purposes, you should consider a vasectomy to be PERMANENT.
The purpose of a vasectomy is to ensure that you will not conceive another child in the future. If you feel that you have had all the children you ever wanted, then this may be the right procedure for you.
Vasectomy reversal procedures are often unsuccessful, very expensive, and, in Canada, are not funded by provincial or extended health care. Therefore, it is important that you are certain this is the FINAL STEP.
Failure Rate of Vasectomies.
Vasectomies have a long-term failure rate of 1 in 2,000.
This means that for every 2,000 men who undergo a successful vasectomy, one may still conceive a child in the future. The greatest risk occurs within the first five years following the procedure, although failures have been recorded many years later as well.
We do not know why spontaneous reversals occur, but it is important to remember that no form of contraception is 100% effective at all times. However, among all available options for contraception, vasectomy remains still the most effective of them all.
Vasectomies takes at least 3 months to be effective.
Once the tubes (vasa) are cut, sperm remain in the upper portion of the tubes (vasa). For the average man, it takes a minimum of three months to clear out these sperm.
Therefore, for a minimum of three months you should consider yourself fully fertile. You are advised to continue using other forms of contraception and should not stop until you have completed your follow-up semen analysis. During this period, it is recommended that you ejaculate at least 20 times. The time required to clear all live sperm increases with less frequent ejaculation and with advancing age.
Our goal is to achieve a zero sperm count (no sperm seen on a concentrated sample, also called azoospermia). A small percentage of men do not achieve azoospermia but may continue to shed occasional dead-appearing sperm for a long time. This is referred to as “rare non-motile sperm.” The Canadian Urological Association considers a single semen sample after three months demonstrating azoospermia and/or rare non-motile sperm (<100,000 non-motile sperm/ml) as evidence of a successful vasectomy, provided the sample is tested within two hours of collection.
Keep in mind that sperm make up only 1–2% of the total volume of a semen sample in men who have not had a vasectomy. Therefore, your semen will look the same after your vasectomy as it does now. You will not be able to judge for yourself whether your vasectomy was successful. Only once your laboratory-tested semen sample confirms success may you stop using contraception.
If a successful semen sample is not achieved by three months, we will wait another three months before retesting.
Click here for instructions on how to do your semen analysis.
Complications of Vasectomies
All medical procedures carry potential risks. Overall, the chance of experiencing any complication from a vasectomy is very low, and it is still considered one of the safest surgical procedures. There are four important complications to be aware of:
1. Bleeding into the scrotum
Localized bruising is common after any surgical procedure. Occasionally, men may develop a larger bleed, called a hematoma, inside the scrotum. Large hematomas are extremely uncommon but may result in delayed healing and increased pain. The risk of a significant hematoma is very small, provided you follow the post-procedure instructions.
2. Infection
Wound infection is a risk with all surgical procedures. While every effort is made to prevent infections, they still occur in about 1 in 500 cases. If you develop an infection, you may require a course of antibiotics.
3. Sperm Granuloma
This is a delayed inflammatory reaction that affects approximately 4% of men. Typically, patients feel fine after surgery and heal as expected, but after a few weeks they may suddenly develop a painful lump and swelling at the site of the procedure. The peak time for this is between 2–6 weeks after the vasectomy. Because this is an inflammatory response, it is usually treated with a short course of an anti-inflammatory medication such as ibuprofen, which typically resolves the issue within one or two days without further consequences.
4. Chronic Post-Vasectomy Pain Syndrome
This is the only potential long-term complication of vasectomy, but it is thankfully very rare, occurring in about 1 in 1,000 men. The exact cause is not clearly understood, but it is commonly believed to result from scar tissue forming around the nerve bundle and/or congestion of the vas deferens. Men with this condition describe a dull, aching pain in the testes or groin, which may worsen with physical activity (such as sports) or ejaculation. This pain can recur for several months or even years.
Unfortunately, it is not possible to predict who will experience this complication, and treatment options are limited. Further surgery is not recommended, as it may cause additional scar tissue. The reassuring part is that this discomfort typically does not last forever. It often improves with time, though it may persist for months or even years.
If you experience any complications following your vasectomy, please contact me.
