• CONTRACEPTION

    YOUR CHOICES

    contraception & vasectomy

WHY VASECTOMY?

Why do men get a vasectomy?

  • Vasectomy offers the most highly effective form of contraception. No Oopsie’s.
  • Vasectomy is often the cheapest form of contraception over a few years – see the infographic below.
  • ‘Snip and Let Slip’ – there is no pill to forget, or no device to insert every few years.
  • You do not want to rely on your partner remembering to take a pill at the same time each day.
  • The wish to ‘share the load’ with your partner who says that she is ‘over hormones’!

Vasectomy offers virtually bulletproof protection against unintended pregnancy so that you are free to enjoy sex without fear of pregnancy.

Ultimately, it’s about setting family size rather than leaving it to chance.

CONTRACEPTION INFOGRAPHIC

Infographic comparing costs and failures of different forms of contraception.
Dr Dick Beatty, The Vasectomist
Dr Dick Beatty, The Vasectomist
SUCCESS RATESIDE EFFECTSMYTHS

HOW SUCCESSFUL IS THE SNIP?

Men often say to us that they want to ‘tick that box’ to prevent any future pregnancy.

The vas deferens (tube) does rarely re-join (recanalisation). The first three months is the most common time for recanalisation.

You must get a post-vasectomy semen test to get the all-clear.

The Vasectomist’s rate of vasectomy failure is around 1 in 500 test results.

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. Vasectomy ‘failure rate’ describes the lifelong risk of pregnancy whereas the failure rate of other methods of contraception are quoted over a 12 month period. Vasectomy is remarkably effective.

Get the post-vasectomy semen test done, and in the unlikely event of a failure then something can be done about it.
The saying ‘A stitch in time saves nine’ has a certain ring to it when you think of traditional vasectomy!

WHAT ARE THE POSSIBLE 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. A little pin-point bleeding from the skin may occur after the procedure which can be stopped by pinching the skin together firmly for 15 minutes. Post-Vasectomy Haematoma describes internal bleeding that is sufficient to lead to scrotal pain and swelling. The Vasectomist’s rate of serious haematoma is less than 1 in 300. Haematoma will eventually go away on its own, although a large haematoma may take several months to resolve.

 
Reduce strenuous activity after the procedure to reduce the risk of haematoma.
 

Infection. The Vasectomist’s rate of infection is less than 1 in 300

Pain. The procedure itself is basically painless thanks to the advent of No Scalpel Vasectomy and Anaesthesia using The very finest needle available.

 
Post Vasectomy Pain. Post Vasectomy Pain (PVP) Syndrome is defined as discomfort occurring three months after the procedure that is sufficient to interfere with quality of life, and occurs in approximately 1-2% of men. However, only a small number of men with PVP will require a further procedure. Approximately 1 in 1000 men who have had a vasectomy require an operation for post-vasectomy pain. The author finds PVP to occur in fewer than 1% of men.
 
 
 
 
 
A small minority of men read very extensively about post-vasectomy pain syndrome prior to their procedure. This is sure to increase anxiety and can make any niggle afterwards seem like impending doom. There is a general correlation between chronic pain and anxiety to the point that the science is overwhelming. The pain is certainly not in the guy’s head, it’s more a case that anxiety has the potential to excite the pain pathways. Therefore, men who are excessively anxious about the possibility of PSVP prior to the procedure should not, in my opinion, have a vasectomy.
 
 
 
 
Prostate Cancer

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 physicians to routinely discuss prostate cancer in their preoperative counselling 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.’

 
 
 
 

MYTHS

  • I don’t have time to get a Vasectomy.

    Do you have time for another baby?

  • Vasectomy is painful.

    Expert no scalpel vasectomy is not a painful experience.

  • I will be bruised and swollen afterwards.

    Our client’ dads often describe ‘blue balls’ – a thing of the past.

  • Vasectomy reduces sex drive

    Research suggests that sex is enhanced by vasectomy.

  • I worry that my semen will change.

    Semen is the same afterwards in all five senses.

  • My testosterone will be affected.

    Testosterone is completely unaffected.

REGRETREVERSALSperm Banking

WHY MIGHT A MAN REGRET VASECTOMY?

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

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 is single.
  • The guy hasn’t had any kids.
  • The relationship is unhappy.
  • There has been the death of a child.
  • There has been a change in the relationship.
  • The guy is coerced into having a vasectomy.
  • A very short time between pregnancy and getting a vasectomy.

Couples with babies might want to defer a vasectomy until their baby is >6 months of age. The Doctor will gently raise the risk of Sudden Infant Death Syndrome (SIDS) for men with young babies. The risk of SIDS or ‘cot death’ is around 1 in 2000 babies. The time of maximum risk occurs between the age of 2 and 4 months of age.

10% of men who get ‘the snip’ have not fathered children. Good for the planet, good for mankind, but the decision needs to be right for you in the long run. Having no kids does not mean that you can’t have a vasectomy. There is no harm in having a non-judgmental chat with Dr Beatty about your decision. The outcome from this consultation may be:

  • Book in for your vasectomy the following week!
  • Postpone the procedure for 3 to 12 months. Six months is a good timeframe to reconsider the issues further.
  • Sperm Banking.
  • Use a different type of contraception.
  • Referral to a psychologist is a rare outcome – and specifically to address any mental health issues.

Dr Beatty approaches vasectomy in young men without children by balancing:

  • Your ethical right for autonomy in making your own health decisions.
  • The risk that you might change your mind later.

How Does The Vasectomist approach a 23 year old male who has not fathered a child? Firstly, come for a good chat first. He is likely to be asked to come back 6 months later. The fact is undeniable that a significant percentage of younger men without kids will ask for a reversal later, so you will be asked to accept that.

A 23 year old man who says that ‘I know I will 100% never want kids’ isn’t acknowledging that they might change their mind as they get older. The young man who says that  ‘I know there is a chance that I may change my mind later, but I still want to get a vasectomy’ is sending a powerful message that he is a thoughtful person who accepts uncertainty in life. Ultimately, you have a right to make these decisions. Do not underestimate how brain development, maturity and life changes will change you as a person in the future – just ask any older man what they were like when they were 23. It’s your decision.

What’s the worst thing that can happen if you turn up for a vasectomy but are not quite ready for it?  Just come back in a few months to confirm your decision!

CAN VASECTOMY BE REVERSED?

Vasectomy can be reversed but reversal is expensive and may not work.

Please note that The Vasectomist does not perform vasectomy reversals. See your GP for a referral to a urologist who performs vasectomy reversals. Most Australian capital cities have a few urologists who perform reversals with perhaps 2 to 3 who perform most of them.

The success rate of vasectomy reversal ranges from 50% to 90% depending on the length of time that has elapsed since the vasectomy. Reversal is more successful after a Vasectomy performed <5 years ago compared to a vasectomy performed >10 years ago.

The total price for vasectomy reversal in Australia is typically in the order of $10,000 with a medicare rebate of under $1,000. Private health cover can reduce out of pocket expenses by several thousand dollars. The ‘out of pocket’ for a reversal may be as low as $3,000.

SPERM BANKING

Consider a vasectomy when you are certain that you do not wish to father any or any more children.

However, some men consider sperm banking prior to vasectomy as a form of insurance against unknown unknowns.

Each year we ask Brisbane-based sperm bank providers for their prices. Major providers of sperm banking include City Fertility and Queensland Fertility Group. The costs of sperm banking is approximately $600 for the initial banking, and $500 per year for freezing.

A referral from your GP may help to reduce the costs of the service.

Men rarely want to pay thousands of dollars over a 10 year period banking their sperm ‘just in case.’ What risk are you prepared to accept? What price would you pay for certainty? Younger men who have not fathered should consider putting off the vasectomy. However, a young man who is determined to get a vasectomy should certainly consider sperm banking because the risk of regret is so high.

Tests prior to sperm banking will generally include a semen analysis and blood tests. The precise blood tests required vary between providers, and include:

  • HIV
  • Hepatitis B&C
  • Syphilis

Contraception: The Stats

Female Contraception Overview
Risk of Pregnancy PER YEARMain BenefitsMain RisksIssues
Combined Pill7% per year (normal use)Low Failure Rate, can reduce period bleeding, can have cycles back-to-back. Often Beneficial for conditions like acne or hirsutism.Deep Vein Thrombosis & Cardiovascular Risk Factors to evaluate include Body mass index, Smoking, Migraine with aura, Family history, increasing age, high BP, Cholesterol, Diabetes, kidney disease etc.Can forget to take the pill.
Progestogen Only Pill9% per year (normal use)Used as a 2nd line oral contraceptive when the combined pill is not recommended. No increased cardiovascular or thrombotic risks.Australian licensed mini pills need to be taken in a 3 hour window each day.The minipill is unforgiving when forgotten – failure rates are high.
Progestogen Injection6% per yearNo increased cardiovascular or thrombotic risks. Periods often disappear completely within 12 months.Progestogenic side effects are usually manageable but women may sometimes report weight gain, mood or changes. Periods often erratic to start with.3 monthly visits to your doctor & practice nurse to get the injection. Need a pregnancy test if late for your next injection.
Progestogen Implant (rod)0.05% per yearPeriods often disappear completely within 12 months.Persistent bleeding beyond 6 months in around 15% of women may require the implant to be removed.3 yearly implant in the inner side of the left upper arm.
Intrauterine Device – Mirena0.2% per yearPeriods usually disappear completely within 12 months – often good for heavy or painful periods.Risk of uterine perforation is around 1 in 1000. Rarely infection or migration of the device.5 yearly re-insertion. Few GPs currently provide this service & most women need a referral to a gynaecologist.
Condom, Cap, RingCondom 18% Cap 12%Caps, Diaphgragm & Vaginal Ring.no systemic risks. Higher rate of failure than many other methods of contraception.Suits only a few women and couples – comes down to personal preference & guidance on use from a health practitioner.
Female Sterilisation0.5% riskLow failure rate at around 1 in 200Higher failure rate & risks (surgical + Anaesthetic) than The Snip.Day Case in a hospital.
Vasectomy1 in 3000 lifetime (after test)The lowest failure rate. Men can get involved!Post vasectomy discomfort affects around 1 in 50 guys.The most important thing is to continue contraception until you get the all-clear after the semen analysis.

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Dr Beatty

Last Reviewed / Modified: 3/3/2021

First Published: 2/8/2019