Vasectomy

Vasectomy

This is a procedure for male sterilization. The two tubes called vas deferens that carry sperm from the testicles to the urethra are surgically disconnected. This operation is done as a day case and takes about ½ hour. Majority of cases can be done under local anesthesia. Through an incision 1 cm long over each side of the scrotum, a small section of the vas deferens is removed and the ends of the vas are stitched. The skin cuts are then closed with self-absorbable stitches.

Complications are rare, and include:

  • Scrotal haematoma (blood clot). This may need surgical evacuation if it is excessive.
  • Infection of the wound or epididymis. This results in increasing pain and fever. This may require 2 to 3 weeks of antibiotics.
  • Sperm granuloma, which is a small lump that forms when sperm leaks from the vas into the surrounding tissue. The majority of sperm granulomas are asymptomatic. Rarely do they require surgical excision.

Unlike female sterilization which is immediately effective, after vasectomy, there is still the need for back-up contraception because it takes about 2 months to clear the rest of the sperms within the vas. This is verified by sending a sperm sample anytime after 2 months post-surgery. Only when the sperm count is zero is it safe to have sex without contraception.

FAQS

Am I a suitable candidate?

  • As long as you and your wife have agreed that you have completed your family and do not wish to have any more children, it can be done anytime. This is because reversal is a much more complicated operation with no guaranteed of success.

Do I need any preparation for the procedure?

  • Stop any blood-thinning medication, such as Aspirin and Plavix 1 week beforehand as such medications increase the risk of bleeding.
  • You can shave off any excess hair over the scrotum as the hair interferes with the surgery and dressing.
  • After the surgery, wear briefs to support the scrotum. Rest for the next 2 days as any exertion increases the risk of scrotal haematoma.

What can I expect after the surgery?

  • Pain is usually minimal and lasts up to 2 days. Some bruising in the scrotum is expected but this slowly lightens with time.
  • If scrotal pain and swelling last beyond a week, then infection of the spermatic cord may have occurred and you would need antibiotics for 2 to 3 weeks.

When can I resume sex?

  • It is best to avoid sex until 2 weeks later. Occasionally, you may experience testicular ache after sex due to “congestion” effect. This ache settles on its own over time.
  • Remember to use back-up contraception as it takes 2 months to clear the rest of the sperms within the vas.

What is the difference between no-scapel vasectomy?

  • No-Scalpel Vasectomy is different from conventional vasectomy in that the skin overlying the vas deferens is punctured using a special dissecting forceps. The vas is divided the same way as conventional vasectomy.