Contraception

VASECTOMY  
(Please note this service is not provided at our clinic.)

Définition

A vasectomy is a male sterilization method. It is a minor surgery involving cutting and blocking the two vas deferens (sperm ducts or tubes), which carry spermatozoids to the penis. A small incision is made at the centre of the scrotum (i.e. the envelope containing testicles) under the penis. The vas tubes are tied and cut (1 to 2 cm), thus preventing spermatozoids passing through. The procedure is conducted under local anaesthesia in a doctor’s office and takes about 10 to 15 minutes.

Effectiveness

A majority of vasectomized men will be sterile at their first sperm analysis (i.e. a sperm test), three months after the procedure. It may occasionally take more than one test to attain sterility. On rare occasions (less than 1%), the tube will reattach on its own before a monitoring sperm analysis (it is called ."early recanalization", that is the two extremities of the cut tube reattach and allow for the passage of spermatozoids, the man then remaining fertile).

A late spontaneous recanalization, after a sperm analysis confirming sterility, may occur many years after a vasectomy, although this phenomenon is very rare (less than 0.1%).

Recommendation: A vasectomy is recommended if you wish to rely on permanent contraception. As long as you are considering having a child, you will have to use reversible birth control methods.

Contraindications

The main contraindication to vasectomy is your uncertainty about wanting children. Medically, there are very few motives preventing vasectomy – e.g. severe blood coagulation problems, scrotal hernia (i.e. part of the intestine in the scrotum).

Benefits

A vasectomy is a minor surgery that eliminates worries about contraception. You will be able to resume your daily activities in the few days following the procedure. Disadvantages: a vasectomy does not ensure immediate sterilization. Many spermatozoids are still present in the vas tubes, above the incision site. You must rely on another birth control method until the monitoring sperm analysis reveals the absence of spermatozoids in the ejaculated liquid.

Before doing a sperm analysis, 20 to 30 ejaculations or a two to three month delay after surgery are generally required. Vasectomy is a permanent sterilization method. Currently, there is a surgery that aims to recreate vas tube permeability. However, this process, a vasovasostomy, is not always effective. Only half of the couples who will attempt surgical recanalization will be able to have children.

Complications

Complications are not frequent. There may be bleeding, swelling or pain in the scrotum area. In light of research conducted on thousands of men, vasectomy causes no health problems such as cardiovascular diseases or cancer. Sexual functions are not affected: you will continue to have erections and to ejaculate, the only difference being that the ejaculation liquid will no longer contain spermatozoids.

Note that spermatozoids only account for about 2% of the ejaculate. This liquid is secreted by seminal vesicles (i.e. small glands located at the base of the penis that produce part of the ejaculation liquid). You will see no difference with regard to sensations.

Practical advice: before the vasectomy, shave the scrotum on the eve or the morning of the procedure: wear tight underwear on the day of the surgery.

After a vasectomy

• For the first 24 hours, cover your genital area with an ice pack (20 to 30 minutes, every two to four hours) to prevent or reduce swelling and pain. The scrotum may swell moderately and become bluish. Unless swelling is severe, this condition is normal. The colour will disappear within seven to 15 days.
   
• If you experience pain, use an analgesic such as acetaminophen. Avoid aspirin: take a shower on the next day, after removing the bandage. You can bathe 48 hours later.
   
• Avoid heavy physical efforts during the following five to seven days. Sexual activity may be resumed four to five days after the procedure.
   
• On the day of the procedure, a container and an information leaflet will be provided so you can take a monitoring sperm test two to three months after the vasectomy. You will receive the results of this test by mail, two to three weeks after the sperm analysis.
   
• As long as sterility is not confirmed, consider that you are still fertile and use appropriate birth control methods.
   
• If, during the months or years following your vasectomy, your partner experiences delayed or interrupted periods, advise her to take a pregnancy test as soon as possible and to consult with a doctor or a nurse.