Why Vasectomy? - The Vasectomist
  • CONTRACEPTION

    Where does Vasectomy Fit?

    contraception & vasectomy

PREVENTION OF PREGNANCY

The goal of contraception is self-evidently to prevent pregnancy.  ‘Failure of contraception’ simply means that a pregnancy has occurred whilst using contraception.

Vasectomy has the lowest failure rate but remember to continue contraception until you get the all-clear after your post vasectomy sample!

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)

CONTRACEPTION – YOUR CHOICES

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

  • You want contraception that has the lowest failure rate.
  • You want to share the burden of contraception with your partner.
  • You want to take control of contraception.

The following table gives an overview of the pros and cons of each form of contraception – including the 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.

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:

  • 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.

WHY DO GUYS PUT IT OFF?

  • 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?

Vasectomy is the best method of avoids an unwanted pregnancy.

Rarely, the vas deferens (tube) does re-join (recanalisation). The risk of recanalisation is 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.

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.

Approximately 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.

Naturally, it makes sense to book an initial consultation when you harbour doubts.

However, Dr Beatty will confirm that that you are completely ready for permanent contraception prior to a same-day procedure, and will ask you to come back on another day if you are not entirely certain of your decision.

Six months is a good timeframe to reconsider the issues further. You will probably know by then whether vasectomy is right for you.

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.

Dr Beatty

Last Reviewed / Modified: 3/10/2019

First Published: 2/8/2019