Patient information: Vasectomy

This is an accessible text-only version of the document called < Patient information: Vasectomy >
File name: 0375-Patient-Information-Vasectomy-190614.pdf (PDF, 569KB).

Contents

  • Interpreter services
  • What is a vasectomy?
  • Preparing for your appointment
  • What happens during my appointment?
  • What does the procedure involve?
  • What to expect after the procedure
  • Other matters
  • When can I return to work and resume activities?
  • When will my vasectomy be effective?
  • Surgical risks
  • Anaesthetic risks (for IV sedation)
  • Do you know your Healthcare Rights?
  • 24-hour aftercare

Interpreter services

Please let us know if you need a telephone interpreter to help you understand any of this information. If you need one at any time before or after your procedure, you can call TIS National on 131 450 and ask to be connected to Marie Stopes Australia on 1300 003 707.

Accessibility statement

An accessible text version of this document is available online at mariestopes.org.au/accessible

Patient information: Vasectomy

This booklet contains information about your vasectomy. Read this information carefully and keep it to look at later on. Ask us if you have any questions after reading it.

What is a vasectomy?

Vasectomy is the common name for male sterilisation – a permanent method of contraception. It is a simple surgical procedure, which divides the sperm-carrying tubes (vas deferens) in the scrotum. Vasectomy will not affect your sexual performance or ability to ejaculate, however the ejaculated semen will contain no sperm. The No Scalpel Open-ended technique used at Marie Stopes Australia has a failure rate of less than 0.1% or 1 in a 1000.

Vasectomy should be considered an irreversible procedure. Whilst vasectomy reversal services exist, they are very expensive, not normally covered by health insurance and do not have a 100% success rate. Before having a vasectomy, you should be sure that you have completed your family, or be certain you don’t want to have children in the future.

Preparing for your appointment

Hair removal

You will need to shave or have someone else help you shave the following areas no more than 24 hours before your vasectomy procedure.

Please use a dry or wet razor to shave the entire scrotum as well as 1-2cm up the shaft and the sides of the penis from the scrotum. Please include any long hairs that can reach to the front of the scrotum – see shaded area on the diagram below. Please only shave on the morning of the operation as shaving a few days prior may increase the risk of infection.

Diagram showing Area to be Shaved. Text in picture reads: Please shave the entire scrotum as well as 1-2cm up the shaft and the sides of the penis from the scrotum. Please remember to shave no more than 24 hours before your vasectomy procedure. Shaving earlier than this may increase the risk of infection.

Accessibility note: the designed version of this document contains an image titled “Area to be shaved”, which is a diagram of a penis and scrotum showing the area to be shaved (as described in the text). The image also contains the following text: “Please shave the entire scrotum as well as 1-2cm up the shaft and the sides of the penis from the scrotum. Please remember to shave no more than 24 hours before your vasectomy procedure. Shaving earlier than this may increase the risk of infection.” Accessibility note ends.

Ceasing Certain Medications

It is important that you avoid taking any form of aspirin, fish oil and non-steroidal anti-inflammatory drugs (NSAIDS) including Nurofen® for 1 week prior to and 1 week after surgery. If you are taking anti-coagulant (blood thinning) medication, you must stop taking this 1 week prior to the operation, generally. Please discuss this with your GP or specialist before stopping, however, as this may put your health in danger. Different medication will have different durations of action.

Patients having IV Sedation

If you are having IV sedation, you must follow these important fasting guidelines:

  • Do not eat anything for 6 hours before your appointment. This includes lollies and gum.
  • You may continue to drink a small glass of water each hour up to 2 hours before your appointment, but no other fluids.

If you are having IV sedation you must arrange for an appropriate support person to accompany you home. You cannot drive a motor vehicle for 24 hours following your procedure and you cannot travel home alone by taxi. Your support person must come into the clinic to collect you.

It is expected that you will spend around 2 to 4 hours at our clinic, depending on the type of anaesthetic chosen. This includes the time required for admission, consultation, procedure and recovery.

What happens during my appointment?

You will have a consultation with both a nurse and a doctor who will talk to you about your decision and ask about your medical history, especially any past surgery on your testicles or hernia repair. Your partner is very welcome to attend the consultation if you prefer.

The procedure will be explained, including any risks, and you can ask any questions you might have. You will also be provided with aftercare instructions and a pathology form and specimen jar for your follow up sperm count. The doctor will examine you to make sure both vas deferens can be felt.

Before your procedure you will be asked to give your written consent. Please make sure you have read and understood the information in this booklet, asked any questions and had them answered, and that you are not being forced or pressured to consent. If you do not understand the information, or feel you are being pressured, please let your doctor or nurse know.

What does the procedure involve?

The vasectomy procedure involves cutting and separating the ends of the tubes that move sperm from the testicles to the penis. After the procedure, ejaculated semen will contain no sperm. Sperm is the component that leads to pregnancy and after a vasectomy it will be reabsorbed into your body through your tissue instead of making its way into your semen.

The vasectomy procedure we prefer is called the no scalpel, open-ended method. A closed-ended vasectomy blocks both ends of the cut tube either with suture, clip or by diathermy. The closed-ended method used to be the standard procedure for vasectomies. However, it led to some patients experiencing congestive epididymitis (tenderness caused by pressure building up).

An open-ended vasectomy only closes the upper part of the tube, leaving the end connected to the testicle completely open. This allows the sperm to be released within the scrotum, which is not noticeable as the volume is very small. The sperm are naturally reabsorbed and there is less chance of congestive epididymitis and other complications.

Before the no scalpel method, many vasectomies would require a scalpel incision and therefore sutures. A no scalpel vasectomy only requires a single small puncture in the skin, and no stitches. We do this with a specially designed set of forceps. This decreases the chance of infection and minimises bleeding, bruising and pain.

At Marie Stopes Australia, our doctors use a local anaesthetic technique which results in most patients feeling less pain than expected, or no pain, during the operation.

What to expect after the procedure

Following the vasectomy, you should rest as much as possible for the first day or so, standing and walking for only brief periods at a time. You should use an ice pack regularly for the first 3 or so days (frozen peas wrapped in a tea towel also works well) for 15-20 minutes at a time. Remember, you do not need to freeze the area, just keep it cooler over a long period, instead of very cold and uncomfortable.

Your wound does not have stitches, as it is small enough to heal without them. Keep the dressing dry and in place for at least 48 hours by wearing close fitting briefs or trunks during the day and night. This will also help reduce pain and any swelling. Avoid swimming or bathing for the first week after your operation and do not use toiletries as they can irritate the area.

You may experience any of the following post-procedure, or you may experience none:

Pain: The local anaesthetic will wear off a few hours after the procedure and you may feel some discomfort or aching for a few days. This can be treated with a mild over-the-counter pain relief, such as paracetamol. Avoid ibuprofen or aspirin for the first week as these can increase bleeding and bruising. If you experience severe or persistent pain, or are at all concerned, please contact us on 1300 888 022 at any time.

Swelling and bruising: Most men will experience some bruising and a little swelling around the testicles. You can relieve this by applying an ice pack, as above. A small pea-sized lump may develop at the procedure site internally on both sides. This is part of the normal healing process. Please do not squeeze the lumps, as you can inflame them and cause tenderness for weeks.

If swelling is severe or painful, or you are at all concerned, please contact our aftercare nurses on 1300 888 022 at any time.

Bleeding: Some men may experience a small amount of bleeding from the area where the incision was made. You can stop the blood flow by pinching the skin edges of the wound together very firmly with your finger and thumb (wash your hands first), and holding it very tightly for five minutes. If the bleeding does not stop after this time, call us on 1300 888 022 at any time.

Other matters:

  • No sex or ejaculation for 7 days after the operation.
  • No swimming or baths in the first week. Have quick showers, in and out, and keep the dressing intact for 3-4 days and then replace with a new dressing for another 3-4 days.
  • If your wound opens up to a diamond shaped opening do not be concerned, it will still heal but will now take 2 weeks to close. Keep as dry as possible.
  • You may get a small drop or two of blood in the ejaculate during the first 1-2 months post-op. This is normal and of no concern, unless it continues beyond 2 months or is very heavy (ejaculate becomes red).
  • You can have 1-2 alcoholic drinks per day but do not exceed this in the first 7 days.

When can I return to work and resume activities?

Some men may return to work a day or two after a vasectomy, especially if the work mainly involves sitting at a desk. However, if your work involves any kind of lifting, reaching, stretching, or other physical exertion you will need to request light duties for your first week of return. If this is not possible, you will need to take the week off work.

Remember to ask for a medical certificate during your consultation, if required.

You should avoid any physically strenuous activities for a week after your procedure, including walking and standing all day, or carrying more than 10 to 15kg.

Avoid non-contact sport (golf, tennis, running, swimming, etc.) or carrying more than 20 to 30kg for 2 weeks after your procedure. Avoid road cycling for the first 3 weeks, although cycling on a stationary trainer bike is permissible after 2 weeks.

You cannot resume contact sport (i.e. rugby, soccer, martial arts), mountain biking or heavy weightlifting until 1 month after your procedure.

When will my vasectomy be effective?

You will not be sterile straight away, as it takes a number of ejaculations to clear the tubes of sperm completely. For this reason, it is very important that you use another method of contraception during sex until your semen is shown to be free of sperm.

Semen analysis: Around 3 months after the vasectomy, you will need to supply a semen sample, which is checked under a microscope to see if there are sperm. To help ensure sperm are cleared from the vas tubes we recommend at least 25 ejaculations before testing.

When collecting your semen sample:

  • Avoid ejaculation for 3 to 4 days before collecting the sample.
  • Collect the entire sample by masturbating directly into the container provided; do not use lubricants, interrupted intercourse or collection in a condom.
  • Do not refrigerate the sample.
  • Label the container “post-vasectomy,” with your full name, date of birth and time of collection.

The sample needs to be tested within 4 hours after ejaculation, so you must call your local pathology before dropping off your sample to ensure it can be tested on site or couriered to a lab within the timeframe. For any second or subsequent tests the sample needs to be tested within 1 hour after ejaculation.

Once we have received and reviewed your results we will contact you (usually within 7-10 days) to advise whether your semen is free of sperm (meaning you no longer need to use contraception), or if you need to repeat the test.

Surgical risks

Vasectomy is a safe, low-risk procedure, however, all surgical procedures have some risks. The risks mentioned below do not include all possible complications, but are the main complications associated with the procedure.

Failure: Vasectomy has an overall failure rate of less than 1 in 100 procedures (all techniques combined) but the no scalpel, open ended technique, which we practice, has a failure rate of approximately 1 in 1000 procedures. Despite cutting and sealing the vas deferens, the ends may grow back together, making you fertile once again. This usually occurs in the first 1 to 2 months and would be detectable on a sperm count after this time. In extremely rare cases (approx. 1 in 2000), the vas deferens may re-join later.

Haematoma: In 1-2% of cases, a collection of blood may form deep inside the scrotum during the first week or so after the procedure, causing swelling and discomfort. This is known as a haematoma and may be the result of physical activity or direct injury. It usually settles spontaneously with rest and support but if severe, the haematoma may need to be surgically drained. If the haematoma has become solid, it cannot be drained and can take 2-3 months to breakdown and reabsorb.

Infection: Superficial skin infections are uncommon. Deeper soft tissue infection (a risk of less than 1%) may occur between 5 to 7 days after the procedure, presenting as painful enlarged lump above the testicle and around the site where the vas deferens were cut. You may, in this case, develop redness and/or heat in the scrotum and/or a fever, requiring urgent medical assessment and possible antibiotics.

Sperm granuloma: Less than 1% of men may develop a hard, sometimes painful, lump about the size of a pea as a result of sperm leaking from the cut vas deferens. The lump is not serious and is almost always absorbed by the body in time. Usually simple analgesia is all that is required, but if it becomes troublesome, it can be removed surgically.

Congestion: A sense of pressure caused by sperm build up in the testes and epididymis may cause some discomfort for 2 to 12 weeks after your vasectomy. It has been reported in up to 14% of patients and may be more common when the close-ended technique is used. It usually settles with time and simple analgesia.

Post vasectomy pain syndrome: This is defined as chronic pain in the scrotum, groin and/or lower abdomen following vasectomy and lasting greater than 3 months. It occurs in approximately 1 in 300 cases. The exact cause is unknown but may be related to nerve sensitivity and / or sperm granulomas and / or chronic congestive epididymitis. This usually responds to anti-inflammatory medication and settles spontaneously. Very occasionally additional surgery is required.

Anaesthetic risks (for IV sedation)

The type of anaesthetic used with IV sedation is very safe. Please advise the anaesthetic doctor if you have experienced any problems with previous anaesthetics. Anaesthetic risks include:

Allergic reaction: This is rare (1 in 10,000). Please tell the doctor of any previous allergic reactions.

Airway spasm: Tell the doctor if you smoke, have asthma or have recently had a cold or chest infection.

Aspiration: It is very important that you follow the fasting instructions given. This will prevent contents of your stomach being inhaled into your lungs when you are under the anaesthetic.

Do you know your Healthcare Rights?

The Australian Charter of Healthcare Rights describes the rights of patients and other people using the Australian Healthcare system.

Marie Stopes Australia advocates these rights which are:

  • Access – you have a right to healthcare
  • Safety – you have a right to safe and high quality care
  • Respect – you have a right to be shown respect, dignity and consideration
  • Communication – you have a right to be informed about services, treatment options and costs in a clear and open way
  • Participation – you have a right to be included in decisions and choices about your care
  • Privacy – you have a right to privacy and confidentiality of your personal information
  • Comment – you have a right to comment on your care and have your concerns addressed.

At your appointment you should also receive a copy of the Australian Charter of Healthcare Rights brochure which you can also view in English and other languages at safetyandquality.gov.au.

24-hour aftercare

If you experience any of the following problems or have any concerns, please call our aftercare nurses directly on 1300 888 022 at any time:

  • Fever or feeling generally unwell
  • Worsening pain, even after taking pain relief medicine
  • Warm, red, swollen scrotum
  • Inflammation, redness or weeping of the wound
  • Continuous bleeding from the wound
  • Blood in the semen more than 2 months after the operation.

Appendix: About our charity work

Marie Stopes Australia is a not-for-profit organisation and is part of the Marie Stopes International global partnership, which provides family planning services to over 25 million people in need, each year, across 37 countries.

In the Asia Pacific region, Marie Stopes International Australia oversees programs in countries such as Papua New Guinea, Timor-Leste and Cambodia to ensure that the women and men there have access to safe and reliable sexual and reproductive health services. In addition to service provision, the focus in our region is to improve sex education and to help change attitudes towards contraception.

Through initiatives such as Marie Stopes Ladies, we empower entrepreneurial women to provide information to their communities around maternal health, contraception, birth spacing and abortion, where legal.

In the remote villages of Papua New Guinea, our Marie Stopes team also provides access to long-term and permanent contraceptive methods, like vasectomy. Vasectomy has become a popular choice in the area, as maternal mortality is very high and because it is less invasive than tubal ligation to perform. Having fewer children makes it much easier for men to support their families.

In Cambodia, our work with garment factories helps to educate female workers on birth spacing and its role in alleviating maternal mortality and other risks, as well as the role of contraception in assisting workforce participation. With local experience and a commitment to measuring the impact of our work, we are in a unique position to advocate for the women we support and to contribute to local and global family planning policy issues. To learn more about our international programs, visit mariestopesinternational.org.au

Our advocacy and outreach are also a crucial part of our domestic work, here in Australia. Marie Stopes Australia understands that not every woman in Australia can access sexual and reproductive health services. This can be due to domestic abuse, reproductive coercion, homelessness, poverty or cultural restrictions. For women facing these difficult circumstances we have established the Marie Choices Fund – a philanthropic endowment fund designed to support women who otherwise would not be able to access our services. This allows us to offer reduced cost and free services on a needs basis, with funds donated by brave donors and philanthropists, through our community partners. To make a donation, please visit mariestopes.org.au/donate/

When you choose Marie Stopes, you are choosing to put your sexual and reproductive health in the hands of the leading national, independently accredited safe abortion, vasectomy and contraception provider. But you are also choosing to support women. You are choosing to support the work we do both internationally and domestically. You are choosing to make a difference not only in your own life, but also in the life of others who may not otherwise have access to real reproductive choices.

Source PDF document ID#: NMAC-0014-1804