Why Vasectomy? - The Vasectomist
  • CONTRACEPTION

    YOUR CHOICES

    contraception & vasectomy

WHY VASECTOMY?

Men select vasectomy as the preferred choice of contraception for one of these reasons:

  • Contraception with the lowest failure rate.
  • ‘Snip and Let Slip’ – there is no pill to forget, and no device to insert every few years.
  • The wish to share the ‘burden’ of contraception with your partner indicated by your partner who says that she is ‘over hormones.’
  • The wish to take control of contraception perhaps because you do not want to rely on a partner remembering to use contraception.
  • Risk of unwanted pregnancy is almost completely eliminated. Sexual Satisfaction may improve.
  • You do not need to remember to take or use regular contraception.
  • Your partner is just ‘over’ hormones, implants & devices
  • 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.

MYTHS

  • I don’t have time to get a Vasectomy - Seriously?
  • I will be bruised and swollen afterwards - Nope!
  • I think that Vasectomy reduces sex drive – it does Not
  • I worry the hormones will be affected – they are Not
  • I worry that the semen is changed - Nope!

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 risk of vasectomy failure is around 1 in 300, and highest in the first three months of the procedure. You must get a 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. Vasectomy ‘failure rate’ describes the lifelong risk of pregnancy whereas the failure rate of other methods of contraception are given 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.

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. Haematoma occurs in fewer  than 1% of men and will 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 rate of an infection is 1-2% of cases.

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 of 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 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.’

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 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 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.

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 Dick 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 pychologist is a rare outcome – and specifically to address any mental health issues.

Dr Dick 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.

He will check that you are completely ready for permanent contraception prior to the procedure. Younger men without kids are asked to accept that there is a risk for regret.

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 reversal may not work, and will be expensive.

Reversals are performed by a small percentage of urologists.

SPERM BANKING

The best advice is not to get a vasectomy if you are uncertain about your desire to father children in the future.

Younger men without kids may change their mind later, and having sperm in storage does help to insure against this risk.

Sperm Banking may be considered as a form of insurance against ‘unknown unknowns.’ What risk are you prepared to accept? What price would you pay for certainty? There are very personal questions. Men rarely want to pay thousands of dollars over a 10 year period banking their sperm ‘just in case.’ However, younger men without kids should consider sperm banking.

Each year we ask Brisbane-based sperm bank providers for more information. 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 deep-freezing.

A referral from a doctor is generally necessary if you want to have the sample analysed before freezing. You might as well get the sperm tested before spending money at the sperm bank.

The precise blood tests required vary between providers. As a minimum you will need to get the following blood tests:

  • HIV
  • Hepatitis B&C
  • Syphilis

DIFFERENT METHODS OF CONTRACEPTION

The goal of contraception is to effectively prevent pregnancy.

All forms of contraception can fail, particularly condoms and the pill. 326 Australian women were interviewed about unexpected pregnancy in a 2018 study. Just 41% were using contraception at the time of the pregnancy, and of these:

  • 64% were using the contraceptive pill
  • 27% of couples were using condoms
  • 9% were using ‘the rod’ (hormoneal device that is inserted in the upper arm)

Vasectomy has the lowest failure rate.

Female Contraception Overview
Risk of Pregnancy PER YEARMain BenefitsMain RisksIssues
Combined Pill9% 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% lifetime 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.

Dr Beatty

Last Reviewed / Modified: 3/2/2020

First Published: 2/8/2019