What is vasectomy?
Vasectomy or male sterilisation is a simple, safe, effective and permanent method of surgical contraception for men. In vasectomy, the vas deferens which is the tube that takes the sperm from the testes to the penis is cut. Sperm are made in the testes and once the tube is cut, sperm can no longer get into the semen that is ejaculated during sex.
How can I be sure that I need a vasectomy?
- If you are absolutely sure that you don’t want to have any more children.
- If you want to enjoy sex without worrying about pregnancy
- If you don’t want to use any other form of birth control
- If pregnancy poses a risk to the health of your partner
- You want to save your partner from a tubal ligation which has a higher rate of failure and complications
When should I not consider a vasectomy?
Vasectomy is a lifetime decision. Consider the possibility of unforeseen changes in life-divorce, death of a spouse or child, or the just likelihood of you and your partner changing your mind about your desired family size.
A vasectomy might not be right for you if
- You are young
- You have few if any children
- Your current relationship is not stable
- You are pressurised by your partner or by circumstances
- You are under a lot of stress
- Vasectomy is performed during time of personal crisis
- You have a religious affiliation prohibiting vasectomy
- You are counting on being able to reverse the procedure later
- You hope vasectomy will solve sexual and marital problem
How is No-Scalpel Vasectomy different from a conventional vasectomy?
In a conventional vasectomy, the scrotum is numbed with an injection of local anaesthetic into the skin on either side above the testes. A small cut is then made in the numbed area with a scalpel and the vas deferens on each side dissected out in turn. The tube is then cut and the cut ends tied. The small cuts in the skin are then stitched.
The No-Scalpel vasectomy starts with a more effective technique to anaesthetise the skin and the vas. The doctor finds the vas deferens under the skin and holds it in place with a special ring clamp. Instead of making two incisions, a tiny puncture is made in the skin and the vas delivered and blocked with a special cautery instrument called the Hyfrecator. This effectively pushes the blood vessels and the nerves aside instead of cutting across them. No stitches are needed to close the small opening which heals quickly with no scar.
This technique was developed first in China by Dr.Shunqiang in 1974. It was introduced into the USA in 1988. In the UK, doctors have been performing this operation since 1995.
What are the advantages of No-Scalpel vasectomy over conventional methods?
- Less discomfort
- One small opening in the skin instead of two incisions
- No stitches
- Faster procedure
- Faster recovery
- Less chance of bleeding and other complications
- Just as effective
Does No-Scalpel vasectomy work?
Yes. This is very reliable procedure. However it is estimated that there is a 1 in 2000 chance that the man might become fertile again at some point in the future. Rarely, the two cut ends of the vas deferens can reunite. Serious problems are very rare; less than 1 in 100 cases even have a minor problem.
Is No-Scalpel vasectomy painful?
This is an almost painless procedure. Before the vasectomy, we can give you a mild sedative to relax you. You will experience mild discomfort when the local anaesthesia is administered. However, once it takes effect you should feel no pain. Some men feel a slight ‘tugging’ sensation as the tubes are manipulated.
Will it hurt after No-Scalpel vasectomy?
After surgery you may be a little sore for a few days. You might need to take a painkiller.
How long will the whole procedure take?
The whole procedure will take, on an average about 30 minutes
Is No-Scalpel vasectomy safe?
Yes. It is safe and simple and most men do not have any problems. However like any surgical procedure, it has some risks. There are no life threatening complications associated with No-Scalpel vasectomy. The minor complications are generally short-lived and resolve with rest, ice, anti-inflammatories and time.
So, what are the possible complications?
- Mild discomfort: Some men report a mild aching sensation to the scrotum for a few hours to a few days after the procedure.
- Bleeding: bleeding into the scrotum causing a small painful swelling and bruising for a few days. A major bleed can cause a grapefruit sized scrotum which can take months to heal, but this is very rare with No-Scalpel vasectomy.
- Infection: Redness and pus from the healing site opening
- Epididymitis: Tender swelling of the epididymis, the tube connecting the vas deferens and the testes.
- Sperm granuloma: Sperm can leak from the cut end of the vas deferens and form a potentially uncomfortable bead like swelling in the scrotum. Most cases are asymptomatic.
- Post vasectomy pain syndrome: A very rare complication of a persisting pain in the testicle where the inflammation does not settle down. It may resolve on its own or persist.
- Failure: Because a doctor has inadequately blocked one or both tubes or because one or both tubes has rejoined.
When can I go back to work?
Generally, two or three days rest is enough time for recovery before men can return to work and most normal, non strenuous physical activity. If your job involves heavy work, you should take a full week off.
When can I start having sex again?
Sex can usually be resumed seven days after the procedure.
Will I be sterile right away?
No. After a vasectomy, there are always some active sperm left in your system. Some sperms survive in the ‘upstream’ part of the vas deferens for several weeks after vasectomy and these can get into the semen for a while after the operation. It takes about 25 ejaculations to clear them. You and your partner should use some other form of birth control until your semen has been tested and confirmed free of sperm.
When would I have the semen test?
We do a single test 16 weeks after the procedure.
Will it affect my long term health in any way?
No. Studies have shown conclusively that vasectomised men are no more likely to get heart disease, cancer arthritis or any other diseases. Post vasectomy pain syndrome is extremely rare.
Will vasectomy change me sexually?
The only thing that will change is that you will not be able to make your partner pregnant. Your penis and testes are not altered in any way. Your body will continue to produce the hormones that make you a man. The operation has no impact on the man’s ability to perform sexually. Vasectomy does not change your beard, your muscles, your sex drive, your erections or climaxes.
Furthermore most men report that sex is better after vasectomy because they no longer need to worry about an accidental pregnancy. With the security and peace of mind permanent contraception brings, sex can be more relaxed and spontaneous.
What happens to the sperm after a vasectomy?
Sperms are still made as before in the testes. The sperm cannot get past the blocked vas deferens and are reabsorbed internally. Sperm make up about 1% of the ejaculate, so there will be no detectible difference in the volume. Vasectomy does not reduce the amount of semen you ejaculate during sex as most of it is made in the seminal vesicles and prostate upstream.
Will it protect me from getting STD or AIDS?
No. A vasectomy cannot protect you from a sexually transmitted disease including AIDS. Condoms are still the best protection against these diseases.
What if I were to change my mind after the vasectomy?
A vasectomy should be considered permanent. Reversal operations to reattach the cut ends are expensive and often unsuccessful. If you are asking this question, perhaps vasectomy is not right for you.
Why not a tubal ligation for my partner?
- Vasectomy is preferable to a tubal ligation because tubal ligation
- Carries a greater potential health risk for a woman
- Requires general anaesthesia
- Is an intra abdominal procedure
- Postoperative recovery is longer
- Failure rate is more
- More difficult to confirm the efficacy
- If pregnancy occurs, it could be an ectopic one