NO-SCALPEL NO-NEEDLE VASECTOMY
Two spaghetti-sized tubes called vas deferens carry sperm from your testicles to seminal vesicles for storage. Only 5% of what you ejaculate is sperm! The rest is semen: carrying fluid made in your prostate gland and seminal vesicles.
How is it done?
I gently locate and hold your vas just under the skin in the upper middle part of your scrotum. Then I numb your skin and your vas with a jet injector that sprays freezing liquid through your skin without a needle! Then I make a small hole in the numb skin and spread it open to about 6 mm. I pull the vas out, heat-seal the upper end, cut the vas, and lock it away under a 3mm titanium clip. The lower end of the vas stays open – so that new sperm can drain into the scrotum where it is reabsorbed. I drop both ends back through the opening. Then I follow the same steps with the other vas, through the same opening. Finally, I pinch the skin closed and cover it with gauze. The single opening in your skin closes very well without stitches. For a small fee, I can apply skin glue, which seals the opening and allows you to shower right away. Otherwise, the closed wound becomes waterproof for a shower after two days.
Does it hurt?
The Madajet No-Needle spray pump instantly freezes your skin and vas. It feels like the snap of an elastic band on your skin. Once you are frozen, you feel no pain. The freezing wears off after about one hour. Most men have some mild aching, which settles in 2-10 days. Supportive underwear, a cold pack, and acetaminophen or ibuprophen help with discomfort.
How effective is it at preventing pregnancy?
It’s the best method we know. After a post-vasectomy sperm count of zero, only about 1 in 1,000 couples get pregnant.
What are the possible complications?
Hematoma (bleeding): about 1 in 200.
Epididymitis (infection): about 1 in 200.
Chronic pain (pain that lasts longer than 3 months): about 1 in 300.
Who shouldn’t have a vasectomy?
Don’t do it if you can think of any reason you might want a pregnancy later on. Reversal and sperm storage are possible, but they are expensive (not insured) and unreliable.
How many days off work will I need?
That depends. If you sit at a desk all day, you may be able to return to work the next day. If you lift heavy things all day, you will need to take at least a week off. If you are somewhere in between, like a tradesperson who could do light duties, you may be able to return to work earlier than seven days.
When can I go back to activities / sports?
That depends on the activity. I recommend that you do nothing on the day of the procedure. Then gradually increase your activity – a little more each day. If you have gradually improved and you want to try your sport, start slow. With running for example, go for a short run, and make sure you still feel well the next day before you run for longer distances. At the gym, for example, do half the weights and half the reps, and make sure you still feel good the next day before resuming regular training. Wearing supportive underwear will help.
What activities will I have to avoid?
You will want to avoid straining, like heavy lifting. On the day of the procedure, you will be sitting down all day. Then you will introduce activity slowly, a little at a time. For instance, you should only lift up to 15 pounds on the third day. As you feel better, you can do more. If you feel more sore, you should cut back on your activity.
Will the vasectomy work right away?
No. You’ll need to wait at least 3 months before checking to see if you have a zero sperm count – only the lab can say for sure! I will give you testing supplies on the day of your procedure. Use other birth control until your test shows zero sperm.
Will it affect my sex life?
The nerves and blood vessels that make your erections have nothing to do with the vas. It is impossible for the procedure to affect your erections. The testosterone (male hormone) that your testicles produce has nothing to do with the vas. It is impossible for the procedure to affect your level of testosterone or your maleness. Most men are happier about their sex life after the procedure – and are less worried about contraception.
Vasectomy does not prevent sexually transmitted infections.
Do I need a referral?
Yes, the Ontario Health Insurance Plan (OHIP) requires a referral. Get your family doctor to fax a simple referral to me at 613-777-4999. If your family doctor is not available, you can get a walk-in clinic doctor to do the referral.
Can I drive myself home?
Yes, with two exceptions. Get someone to pick you up if you tend to feel unwell after blood tests or visits to the dentist. You should also have someone drive you if you have already seen me for a consultation, and we have agreed to have you take an anxiety medication like Ativan before the procedure.
Can I take a sedative?
No. You need to be alert to give consent to the procedure. If you think you may need an anti-anxiety medication, then you need to book a consultation for us to discuss it. If we agree that it would be helpful for you, then we can arrange for you to take it at the appropriate time, and you will arrange for someone to drive you to and from the procedure.
How soon can I get in?
I run clinics on Wednesdays and Fridays and I like to keep appointments available within 6-8 weeks. When we receive your doctor’s referral, we will get in touch to make an appointment that suits your schedule.
How long does it take to get results from my sperm test?
At least 10 business days! Sometimes up to 3 weeks! The staff at the lab will often tell patients that results will be available within 2 or 3 days. That is not the case. I’m sorry to say that you will have to be patient. We will contact you as soon as the results are faxed to us.
I lost my post-vasectomy sample requisition. What do I do?
Text our administrative assistant at 613-214-7330 to arrange for replacement.
Does it cost anything?
Ontario’s provincial health plan covers the entire cost of the consultation and procedure. You can choose to pay for two additional options:
Skin Glue ($25)
I can apply medical cyanoacrylate glue at the end of the procedure to close the small opening instantly – making it waterproof and allowing you to have a shower right away. Without the glue, you simply have to keep the area dry for 2 days.
Athletic supporter + cool pack ($20)
This athletic supporter (X-Large, Large, or Medium) does a great job supporting your scrotum. The perfectly-sized gel pack is a great way to keep things cool.