A vasectomy makes a man sterile by obstructing the flow of sperm through the vas deferens. A small puncture in the scrotum is used to isolate a section of the vas deferens. A small portion of the vas deferens is then removed and the vas is occluded.
The procedure is typically performed in the office using a local anesthesia, but can be performed at a surgery center under sedation. (Please check with your insurance carrier if you would like sedation, to make sure you qualify.
After a vasectomy it takes at least 3 months to completely clear your ejaculation of sperm. We provide you with containers to prove that your semen is sperm-free, and two, consecutive sperm-free samples (Note: some men have to leave multiple samples to achieve the necessary two, consecutive, sperm-free semen samples) are required to clear you for unprotected sex.
We believe that proving your sterility is your responsibility. We try to make it easy for you, but you are responsible. You must continue to use other forms of contraception until you prove that your semen is free of sperm.
SCHEDULING A VASECTOMY
Scheduling a vasectomy is easy. It will consist of a brief office visit with a surgeon to discuss the risks of the procedure and so the surgeon can make sure that you are a good candidate for a vasectomy. Once you are medically cleared and questions are answered, another appointment is made for the actual procedure.
POSSIBLE RISKS FROM HAVING A VASECTOMY
1. Recanalization: This word means spontaneous reconnection of the vas deferens and failure of the vasectomy. This complication is rare. Although it can occur at any time, even years later, it most often occurs during the first 6-8 weeks after the procedure. We can’t say this enough: Patients must prove that they are sterile by providing semen samples void of sperm before discontinuing other forms of birth control.
2. Pregnancy: Believe it or not, there are patients who prove they have no sperm in their semen but still father a child. The rate of pregnancy after a successful vasectomy reported in the literature is 0.05% or less.
3. Infection: Uncommon, and usually mild. Most often it can be treated with antibiotics.
4. Bleeding: Usually mild, although a large blood clot called a hematoma can develop and typically resolve by itself.
5. Pain: Pain usually lasts several days and goes away. Pain that lasts months to years is rare.
6. Sperm Granuloma: This is a small scar that sometimes forms where the vas is cut and is not harmful.
7. Sperm Antibodies: These antibodies help the body get rid of the sperm. They are not harmful to you but may make it difficult to achieve pregnancy if you ever choose to have the vasectomy reversed.
PREPARING FOR A VASECTOMY
How to choose a good appointment time: Carve a few days out of your busy schedule when you can recover. Too many men try to go back to normal activities too soon. Men with desk-jobs can usually go back to work after a weekend; men who do heavy labor may want to have a full week set aside to recover. Most men won’t need that sort of time, but for those who do it is nice to have.
Seven days before the procedure: Stop taking aspirin, ibuprofen (Advil, Motrin), vitamin E, herbal supplements, or any medication that you take to thin the blood. If you are on Warfarin, Coumadin or Plavix, call you physician regarding these medications.
Make sure you have some tight underwear or a jock strap to bring to the vasectomy appointment. Wearing supportive underwear for a few days rather than boxers helps to prevent swelling.
Buy some triple antibiotic ointment (Bacitracin, Neosporin, generic) to put on the puncture sites. You won’t need a big tube because the incisions are small and you only need to put it on for a few days.
The day of the procedure: Eat normally unless you are being anesthetized. Please shower or wash the scrotum before the procedure to help reduce the risk of infection. Remember to bring the supportive underwear or jock strap so you can wear it home. Having someone drive you is only mandatory if you are being sedated.
AFTER YOUR VASECTOMY
Go home. Relax. Show this sentence to your wife: Plan on being lazy for at least 24 hours. Place an ice pack on the scrotum (one hour on/one hour off-do not put ice directly on the skin) to minimize swelling.
You may shower after 24 hours. Be careful in the shower if you are taking any new prescription medication for the vasectomy, such as narcotic pain medication.
Do not lift anything over 20 pounds for seven days. After that, use your judgment. A good rule of thumb: if you are wondering if you should, you probably shouldn’t. Resume normal activity slowly.
Wait at least seven days before resuming sexual activity, preferably two weeks. It is normal to have discomfort with sex initially. Don’t worry, that gets better quickly.
It takes some men a few weeks to start feeling totally normal, so be patient. Don’t worry about calling with questions if you don’t think you are healing well enough; most of the time you just need a little reassurance. Issues that require a phone call are: fever above 100.5; bleeding that doesn’t stop for a couple hours after the procedure; progressive scrotal swelling; pus draining from the incision; pain that cannot be controlled with pain medication.
A FINAL REMINDER
You are not sterile until your semen is completely free of sperm. You must take the responsibility to bring samples into our office to prove your vasectomy is a success. If you follow the instructions above it should be.