Vasectomy

  • Is a safe and effective means of permanent contraception / sterilisation for a male
  • The tubes (vas deferens) that transport the sperm from the testes to the rest of the ejaculate fluid (semen) are divided
  • The aim of vasectomy is to prevent sperm from mixing with the semen
  • Sperm accounts for less than 10% of the ejaculate fluid
  • The rest is semen which comes from the prostate

AM I SUITABLE FOR VASECTOMY?

To be suitable for vasectomy you must:

  • Understand you will no longer be able to father children
  • Understand the operation is PERMANENT (although there are operations that attempt to reverse it)
  • Both you and partner have discussed and agree on this form of contraception
  • Be aware of alternatives (female tubal ligation, the pill, intra-uterine devices, condoms)
  • Have normal anatomy with both vasa (tubes) present
  • Accept the risks of the operation (below)

HOW SUCCESFUL IS VASECTOMY

  • Vasectomy is >99% effective at achieving medical sterility
  • It is more reliable than condoms, the withdrawal method, intra-uterine devices, the oral-contraceptive pill and diaphragms

WHAT ARE THE RISKS OF VASECTOMY?

  • Haematoma (bruising and swelling with bleeding) <10%
  • Infection <10%
  • Post vasectomy pain syndrome
    • in rare cases can be permanent (<1%)
  • Failure rate:
    • Surgical failure: moving sperm still present in the ejaculate 3 months after vasectomy 1/200
    • Recanalisation: The risk of the cut ends of the vas deferens rejoining 1/500
    • The risk of pregnancy after vasectomy is around 1/2000

WHAT HAPPENS AFTER THE OPERATION?

  • Resume normal activities (including protected sex) after 10 days
  • Avoid ejaculation in this first post-operative time period
  • Keep the wound dry for 24 hours and avoid baths, spas, swimming etc for 2 weeks
  • You must practice safe sex with another form of contraception until you are given clearance
  • Clearance is obtained with a semen analysis after 3 months and at least 20 ejaculations
    • 1/5 cases will require further testing as not all sperm will be cleared from the tubes at the 3 month mark

Frequently Asked Questions

How long does the operation take?
Usually around 30 mins
Is general (asleep) or local (awake) anaesthesia used?
Either approach is safe and effective. Speak with your surgeon and anaesthetist about the options
Where are the incisions made?
2 small incisions are made at the top of the scrotum to identify and divide the vas deferens.
Will I lose my masculinity?
The testes produce testosterone which gives men masculine characteristics (beard, voice, erections). The production of testosterone is not influenced by vasectomy
Will I lose sex drive, erectile function, or the ability to orgasm?
No. Testosterone production is unaffected and so these functions are not affected by vasectomy. You will still ejaculate but the ejaculate will not contain sperm.
If I change my mind can vasectomy be reversed?
Vasectomy should be considered a permanent procedure. Some operations aim to reverse / reconnect the divided tubes but the success of this is variable. If you have any concerns about the permanent nature of vasectomy you should consider other options for contraception.

Source Information:

Campbell-Walsh Urology, 10th edition
Royal Australasian College of Surgeons
Andrology Australia
https://www.healthymale.org.au/mens-health/vasectomy