ntkWhy Vasectomy - The Vasectomist
  • WHY VASECTOMY?

    THE INS & OUTS OF VASECTOMY

WHY GET A VASECTOMY?

Vasectomy has come a long way from the old days, and is nowadays a very safe method of family planning. The emergence of The No Scalpel Vasectomy Technique has been a major step-change.

These are the common reasons why Guys get a Vasectomy:

  • You’re looking for the lowest risk of unwanted pregnancy.
  • The contraceptive pill is not suitable for the female partner.
  • The Intrauterine Device, implant or injection are not wanted.
  • Cost reasons. The cost of the pill over 10 years would be over $1000 for the cheaper brands with an annual visit to a non bulk-billing doctor.
  • You wants a Permanent Contraceptive solution - in other words, ‘be done with it.’
  • There is no anxiety about getting pregnant. This may in turn lead to improved sexual satisfaction.
  • Female sterilisation is a ‘bigger procedure’ than male sterilisation.

The saying ‘A stitch in time saves nine’ has a certain ring to it when you think of traditional vasectomy.

WHAT ARE THE MYTHS OF VASECTOMY?

  • Vasectomy reduces sex drive – it does NOT³
  • Vasectomy reduces male hormones – it does NOT.
  • Vasectomy reduces the semen in some way (quantity, texture or feel) – it does NOT.

WHAT IS THE FAILURE RATE RATE OF VASECTOMY?

Vasectomy has the lowest failure rate of any form of contraception with a failure¹ rate of less than 1%. Rarely, the vas deferens (tube) does re-join (recanalisation). The risk of recanalisation is highest in the first three months of the procedure. This highlights the importance of doing the post vasectomy semen test to get the all-clear.

Late Failure refers to a pregnancy after getting the all clear from the post vasectomy sample. Thankfully, this is rare at less than 1 in 2,000.

Get the post vasectomy semen test done, and in the unlikely event of a failure then something can be done about it.

WHAT ARE THE POSSIBLE VASECTOMY SIDE EFFECTS?

Vasectomy can, like any medical procedure, have side effects. These risks are small and are minimised with No Scalpel Vasectomy. Vasectomy is widely regarded as the best form of permanent contraception.

Bleeding. Some men get a little pin-point bleeding from the skin where the small hole was made. Bleeding can be stopped by pinching the skin together firmly for 15 minutes. Bleeding can occur in the scrotum sufficient to lead to scrotal pain and swelling. This is called a “haematoma” and occurs in 1 to 2% of patients.¹ Usually a haematoma will go away on its own. A large haematoma can take months to resolve.

It’s important to reduce strenuous activity after the procedure to reduce the risk of haematoma.

Infection. The rate of an infection is 1-2% of cases.¹

Pain. The Local Anaesthetic can be a bit uncomfortable for a few seconds. The initial anaesthetic is mixed with bicarbonate to reduce the acidity and is inserted with an ultrafine hypodermic needle just under the skin. An ultrafine needle helps.

Post Vasectomy Pain Syndrome is defined as discomfort that is present at 3 months, and is sufficient to interfere with quality of life. This occurs in around 1-2% of men. Only a small number will require a further procedure. Approximately 1 in 1000 of men who have had a vasectomy will have another operation for the post vasectomy pain although getting precise figures is difficult ¹.

There was some media concern in 2013 that Vasectomy may slightly increase the risk of prostate cancer.  The American Association of Urology have provided a reassuring statement in 2014 following a detailed analysis. They state that “vasectomy is not a risk factor for prostate cancer or for high grade prostate cancer. It is not necessary for physiciahttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958361/ns to routinely discuss prostate cancer in their preoperative counseling of vasectomy patients.”

There is further strong reassurance about vasectomy and prostate cancer in a Urology journal. The article was published in 2016 and is called “Vasectomy and prostate cancer risk: a historical synopsis of undulating false causality.”

CAN VASECTOMY BE REVERSED?

Even a guy who is sure he wants a vasectomy may change his mind afterwards. This is an area of concern to The Vasectomy Doctor. Vasectomy may be reversed but this may not work, and will be expensive.

Therefore, Dr Beatty will actively search for signs that you are completely ready for permanent contraception, and will ask you to come back on another day if you are not entirely certain of your decision.

Naturally, it makes sense to book an initial consultation when you harbour doubts. However, life isn’t always like that. The pre-operative counselling process is designed to uncover doubts you may not be aware of. Indeed, the doctor will say that “there is no rush at all to get it done today, and it is better to back when you are completely sure of your decision.” Six months is a good timeframe to consider the issues further and you will probably know by then whether vasectomy is right for you.

WHY DO SOME MEN CHANGE THEIR MIND AFTERWARDS?

Around 2% of men who have had a vasectomy seek a reversal within 10 years of the procedure‎⁴.

So let’s put this in perspective – the vast majority of guys who have a vasectomy will not regret it afterwards.

These are known risk factors for regret:

  • Age under 30 (particularly 25).
  • The guy hasn’t had any kids.
  • The relationship is unhappy.
  • The guy is single.
  • There has been a change in the relationship.
  • There has been the death of a child.
  • The guy is coerced into having a vasectomy (kind of obvious this will lead to regret!)
  • A very short time between pregnancy and the vasectomy.

Overall, around 10% of men who get a vasectomy have not had kids. Having no kids does not mean that you can’t have a vasectomy. But you’ll want to be sure it’s the right decision for you. A friendly and open chat with the doctor will help to bring up any issues.

What’s the worst thing that can happen to a guy who turns up for a vasectomy but isn’t quite sure about it?  Just come back in a few months to confirm your decision!

References
American Association of Urology 2012 Vasectomy Guidelines
Relationship between Vasectomy and Sexual Frequency; David P. Guo et al;  The Journal of Sexual Medicine; Article first published online: 14 AUG 2015
4: Dohle GR, Diemer T, Kopa Z, Krausz C, Giwercman A, Jungwirth A, et al. European Association of Urology guidelines on vasectomy. Eur Urol 2002; 61: 159–163.
5: FPs and Vasectomies: Help Your Patients Make a ‘Snip’ Decision John Cullen AAFP Nov 2018
Dr Beatty
Last Modified: 27/11/2017
First Published: 5/2/2015