One third of Australian men will undergo vasectomy during adulthood. This very fast and safe procedure provides a permanent contraceptive solution for couples who have finished their family. Unfortunately for such a common procedure it is often the subject of much myth and un-necessary fear.
Is Vasectomy right for me ?
Vasectomy may be an appropriate method for you if any of the following is true:
- You and your partner have all the children you ever want to have
- You and your partner don’t want to have children and you can’t or don’t want to use temporary methods of family planning
- You want a permanent, one time method of contraception
- You (or your partner) have a medical condition that limits the use of other family planning methods
- You want to enjoy sex without fear of pregnancy
What does it involve ?
Vasectomy is a simple operation which involves interupting the two small tubes that carry sperm from the testicles during ejaculation. This is achieved through two small holes (about 3-4 mm) either side of the scrotum, during which a section of the vas is removed. Two small dissolving stiches are then used to close the little holes.
The procedure can safely be performed by Dr McGregor in his office using local anaesthetic. Patients can also opt to have the procedure performed in hospital under sedation or general anaesthesia. This involves increased fees to cover private insurance excesses and the anaesthetists fees (usually only partially covered by insurance), but is an option when men are worried about the procedure.
Can I do anything to prepare ?
Shaving the sides of the scrotum where it touches the leg is very helpful. Taking some pain relief (two panadeine 30 minutes prior - NOT NUROFEN) serves to make the procedure more comfortable for men when the local is being injected. Injection of local anaesthetic usually only takes 5-10 seconds per side and the procedure is not painful after this.
What happens after ?
The tubes are sent to pathology to confirm that the vas have actually been removed. This is more an insurance policy for the patient and doctor as very rarely a man may have more than one vas each side and will remain fertile after the procedure. Two small dressings are placed on the small wounds and the area is kept dry for 24 hours.
Can we stop contraception ?
A Condom must be used for at least 12 weeks as sperm are still in the tubes left behind and it will still be possible to get your partner pregnant until all of them are ejaculated.
Following the 12 week period all men must undergo a test of the ejaculate (sperm test) which will confirm that the man is infertile. Dr McGregor will give you a form for this test at your vasectomy. The day after the test, patients ring Dr McGregor for the result. Only then will the patient and partner be able to have unprotected intercourse.
When I ejaculate, will anything come out ?
Most ejaculate is actually produced by the prostate gland and seminal vesicles and the actual contribution of sperm to the volume of the ejaculate is very low. Therefore, men do not notice any difference in their ejaculate.
Will vasectomy affect my "Manhood" ?
Vasectomy does not affect the function of the testicles or the penis and the testicles will still produce the male hormone testosterone. Sexual function is entirely unchanged by vasectomy.
What if I change my mind ?
Vasectomy is designed to be a permanent form of contraception. You will need to discuss your plans with your partner carefully. As your partner will be affected by the procedure we prefer your partner to also consent to the procedure.
Vasectomy can be reversed with microsurgery. This is very expensive and fertility only returns less than 50% of the time. Dr McGregor will take a history about your relationship and family to help counsel you about your options prior to vasectomy. Very young men will be carefully counselled about the procedure and other options for contraception.
What's the recovery ?
Recovery time is variable for each person. Most men will find they can return to normal activities after a few days. Generally, if the procedure is done towards the end of the week, men can return to normal after the weekend. Vigorous physically activity or sports should be ceased for at least a week. It is not advisable to fly domestically for 48 hours and internationally for 1 week following the procedure.
What are the risks ?
The main risk with vasectomy is bleeding. Is is usual to have some very minor ooze from your wounds for the first day. Heavy bleeding can occur rarely and may necessitate admission to hospital for pain relief. Infection is unusual but can occur with any operation. Antibiotics are usually not used after the procedure unless problems arise. It is normal to have tender and occasionally swollen testicles for a week of so after surgery. In the abscence of fevers or other problems this is normal and will pass with rest and pain relief.
I need a hernia repair. Can it be done at the same time ?
It is straight forward to combine vasectomy with other surgery being performed by Dr McGregor. In fact, patients undergoing keyhole ( laparoscopic) inguinal hernia repair can even have vasectomy performed through the same incisions. The vas deferens are simply removed higher up before they enter the prostate gland. It should be noted that performing vasectomy this way is 100 % irreversible.
How much does it cost ?
Initial consultation with Dr McGregor is $180 of which $75 is refunded by Medicare. Vasectomy under local anaesthetic is $500, of which $195 is refunded by Medicare.
The total out of pocket costs are therefore about $410. This is equivalent to the cost of the some forms of the pill for one year, making vasectomy a very cheap means of permanent contraception.
Vaasectomy in hospital is billed directly to your health insurance fund. Out of pocket costs occur for you health fund excess and the anaesthetists fee.
Can I have vasectomy the same day I see Dr McGregor ?
Certainly. Just advise our Practice manager Lorraine and she will ensure appropriate time has been booked for the procedure (about 30 minutes all up ).
Do I need a referral from my GP ?
To access Medicare refunds, you must have a valid referral from your GP or specialist. Otherwise out of pocket expenses will be $680.
What about "no scalpel vasectomy" ?
This is a gimic used by some doctors to try and market their vasectomy practice and give them the edge over other doctors.
Instead of using a scalpel blade to make a tiny 3-4 mm hole to perform vasectomy through, they instead use a very sharp instrument to effectively " tear" a 3-4 mm hole in either side of the scrotum. This "no scalpel" technique gives no added benefit to patients and in fact results in more localised tissue damage than a surgical incision with a scalpel blade.