What is a vasectomy?
A vasectomy is a method of male sterilisation. It is a minor procedure that involves cutting and blocking the vas deferens, the tubes that carry sperm from the testicles. It is performed under local anaesthetic in the doctor’s office and takes about 15–20 minutes.
Dr Foley uses microneedle anaesthesia and a No-Scalpel technique. This innovative technique, using a needle the size of a hair, reduces the pain and anxiety associated with the injection. Your vasectomy will be painless…or almost. Most men find it “less painful than going to the dentist!”
During a vasectomy, the vas deferens are brought outside the scrotum (the sac containing the testicles) and then blocked and cut, thus preventing the passage of sperm. This does not prevent ejaculation. In fact, sperm only represent, on average, 2 to 3% of the ejaculate. The seminal vesicles, located above the prostate gland (higher than the vasectomy site), produce the majority of the ejaculated fluid.
Sperm production by the testicles continues after the vasectomy. A balance is established between the cells produced and the cells that die, the latter being reabsorbed by the body.
Anatomical diagram to follow
A before-and-after illustration showing the vas deferens before and after the procedure.
What is a No-Scalpel Vasectomy?
No-scalpel vasectomy is a technique for removing the vas deferens from the scrotum. It involves the use of two specially designed instruments. These instruments allow the vas deferens to be removed through a single small incision in the middle of the scrotum that is closed with one dissolvable stitch.
This reduces the risk of complications from the procedure (infection and bleeding: less than 1%) and promotes faster recovery. The effectiveness of the vasectomy, which depends on how the vas deferens are blocked, is not affected by the no-scalpel approach.
How do you block the vas deferens?
Several different techniques are used to block the vas deferens during vasectomy. Dr Foley combines three methods to ensure proper occlusion of the vas deferens:
- The inside of one end of the vas deferens is cauterised (burned).
- The cauterised end is buried in the vas deferens sheath using an internal dissolvable stitch.
- A very small portion of the testicular segment is cut, leaving it open.
This “open-end” technique is considered advantageous. It reduces pressure on the testicle and the discomfort associated with epididymal congestion, which sometimes occurs transiently in fewer than 5% of men in the weeks following vasectomy.
How effective is the technique?
A vasectomy does not guarantee immediate sterilisation. Many sperm are still present in the vas deferens, above the surgical site. You will need to use another method of contraception until a semen analysis (a sperm test) shows no sperm in the ejaculate. Generally, 20 to 30 ejaculations and a waiting period of 4 months after surgery is required before the semen analysis can be performed.
The majority of men who have had a vasectomy will be sterile at the time of their first semen analysis after the procedure. Sometimes, more than one test is necessary before sterility is confirmed.
Very rarely, the two ends of one of the severed vas deferens spontaneously reconnect, allowing sperm to pass through and thus restoring fertility. This usually occurs before the first semen analysis. This early recanalisation, which is very rare with the technique we use (less than 0.3%), can be corrected by performing a repeat vasectomy. Spontaneous recanalisation can occur up to several years after a vasectomy, even after a semen analysis has shown sterility. However, this is extremely rare (less than 0.1%).
Is a vasectomy permanent?
Regardless of the occlusion technique used, a vasectomy should be considered a permanent procedure. Therefore, a vasectomy is only indicated if you desire permanent contraception. As long as you are uncertain about your desire to have children, you should use reversible contraceptive methods.
What are the possible complications?
Vasectomy, especially when the no-scalpel technique is used, is considered a very safe operation. Nevertheless, as with any surgery, some complications can occur:
- Bleeding (hematomas) or infection: approximately 1%.
- Testicular discomfort (congestive epididymitis): occurs a few weeks after the vasectomy and usually lasts a few days. Approximately 5%.
- A painful scar nodule on the vas deferens (granuloma): approximately 1%.
- Chronic pain: very rare, approximately 0.1%.
In light of studies conducted on several thousand men, vasectomy does not cause health problems such as cardiovascular disease or cancer. Some controversy has arisen regarding the relationship between vasectomy and prostate cancer. Analysis of currently available studies has not established that vasectomy causes prostate cancer, and the medical community recognises that vasectomy is not a risk factor for this disease.
As for sexual function, it remains unchanged. You will continue to have erections and ejaculate as before the vasectomy, except that the ejaculated fluid will no longer contain sperm. Remember that sperm only represent about 2% to 3% of ejaculate. You will also not experience any difference in sensation.
Prepare for Your Procedure
Read our detailed preparation and recovery guides.