Vasectomy

NO NEEDLE, NO SCALPEL
NO COST to patient — fully covered by BC MSP
Referral Required

What is a vasectomy?

Vasectomy is a simple, safe and effective form of permanent birth control.
It is usually performed in a doctor’s office under local anesthetic.
During a vasectomy, the vas tubes are disrupted, which then prevents the entry of sperm into the semen.

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willow-clinic-vasectomy

Images are provided with the permissions of VasectomyStore.com (owned & operated by AMI, Inc.)

No Needle, No Scalpel Technique

At Willow Clinic we use the No Needle, No Scalpel technique.

Studies have shown this method has a lower complication rate, quicker healing and return to sexual activity, and less intra-operative discomfort compared to the conventional method.

Local anesthetic is delivered using a spray applicator (MadaJet®) which delivers a fine stream of anesthetic that penetrates the skin and diffuses to each vas (tube).

Most patients (99%) require no more anesthetic for completion of the procedure itself without pain. About 1% of patients will require the injection of a little more anesthetic with a fine needle which rarely causes any sensation.

Instead of a scalpel, a special pointed instrument called a hemostat is used to create a tiny opening in the scrotum to deliver each vas (tube) to the skin. Since blood vessels in the skin are spread apart rather than cut, bleeding is less than if a scalpel is used, no stitches are required and the opening seals off by itself within a day.

Once the vas tube is lifted through the skin opening, it is divided and the prostatic end is sealed off using heat (cauterization). You will not feel anything when this is done. This prevents the passage of sperm but does not change the amount of semen. The testicular end of the sheath is left open. The vas sheath is closed over the prostatic end of the vas to create a barrier between the two ends. This is called fascial interposition.

The American Urological Association recommends the no needle, no scalpel technique in their Vasectomy Guideline. Visit link.

Vasectomy Advantages

• Gentle office procedure
• No change in erections, sex drive or climax sensation
• No change in the testes, no (noticeable) change in the semen
• If you have MSP coverage, your vasectomy is free
• No need to use other methods of birth control
• It relieves worries of an unplanned pregnancy

Vasectomy Limitations

• Considered permanent. A reversal procedure is an option but it is expensive and not always effective.
• Must use other forms of birth control until sperm-free (approximately 3 months).
• Does not prevent transmission of sexually transmitted infections (STI’s).

There are no proven long-term health risks (neither cancer nor cardiovascular disease) associated with vasectomy.
The risks of NOT having a vasectomy are all borne by the partners of people who choose to avoid vasectomy. And they are considerable!

PROCESS

• Fill out our booking form.
• Once we have received the booking form our physician will review your history.
• We will contact you within about a week to let you know if you are eligible for the procedure.
• We will book you 2 appointments.
• The first appointment will be either virtual (Facetime, WhatsApp) or in clinic
and will be about 20 minutes.
•  The physician will decide after reviewing your booking form which type of appointment you will need.
• The second appointment will be in the clinic for your procedure.
• You will be at the clinic for about an hour.
• 3 months after the procedure you will do a semen analysis to confirm that the process is complete.

1. Understand the alternatives to vasectomy so that you are confident in your choice :
Read Birth Control

2. Read the “Instructions Following Vasectomy* (below) so that you know what to expect.

3. SHAVE the underside of the penis and the entire scrotum, on THE DAY BEFORE the procedure. A bit of alcohol is used to clean the skin before use of the MadaJet® and it can sting slightly right after a fresh shave if the skin is chafed.

4. NO POWDER OR DEODORANT in the genital area on the day of your procedure.

5. Wear your athletic supporter AGAINST YOUR SKIN (under your underwear) to the appointment; This can be purchased at any sporting goods store or online. You will need to wear the supporter for a few days after your procedure.

6. Be prepared to sign the operative consent sheet upon your arrival in the office.

7. Arrange someone to drive you home.

8. Plan to do nothing but recline at home (sofa or bed) on the afternoon and evening of the vasectomy.

9. Do not take any aspirin-containing medication for five days before the procedure.

10. Eat before your procedure, a normal breakfast or lunch. Nervous patients who do not eat beforehand are more likely to become lightheaded during or after their vasectomies.

11. Take acetaminophen (Tylenol) 1000 mg, 1 hour prior to the appointment.

CHECKLIST:

Prior to your appointment
Buy an athletic supporter.
Buy some Tylenol 500 mg or generic for before and after your procedure.

5 days prior to your appointment
Stop taking any aspirin until at least 2 days after your procedure

On the day before your appointment
Shave the underside of the penis and the entire scrotum.

On the day of your appointment
Eat a normal breakfast or lunch.
Shower and do not use any powder or deodorant in the genital area.
1 hour prior to the appointment take acetaminophen (Tylenol) 1000 mg.
Wear your athletic supporter AGAINST YOUR SKIN (under your underwear) to the appointment.

Have someone ready to drive you home.

Pain beyond 3 days, especially if accompanied by some swelling of the vasectomy sites above the testes, may signify excessive inflammation and then ibuprofen and naproxen are good choices. Some patients will have more discomfort or tenderness 3-5 days after the vasectomy than they do for the first few days after their vasectomies. That’s because the body goes through a series of steps in responding to the new arrangement, and sometimes the later steps are more noticeable than the earlier steps. Usually no reason for concern.

It is normal to have some discoloration of the skin (black and blue) around the puncture site a day or two after the vasectomy. Some patients will develop considerable discoloration of the scrotum about 4 days after the vasectomy. Blood from the deep vasectomy site comes to the surface as a purplish-blue mark, gets darker and spreads out and then gradually disappears.

Some patients (about one in 20) will develop swelling and discomfort on one side, sometimes on both sides, starting anytime from 3 days to 3 months following vasectomy. This usually represents an exaggerated form of the normal inflammatory response necessary for sperm resorption and recycling. It is effectively managed with a 5 – 7 day course of ibuprofen 600 mg 3 times per day.
A small amount of bleeding from the site is normal. — Pinching the area for up to 5 minutes should stop it.

Have someone drive you home.
Do not drive for at least two hours after the procedure.

1. Spend a quiet evening at home, reclining in bed or on the sofa. Minimize activity. Some patients have no pain at all after vasectomy. Many have mild discomfort that does not require pain pills. You may have discomfort in the groins (lower down between your legs) or in your abdomen. This is normal and will go away within a few days.

2. You can expect only mild discomfort for a few days, for which you may take acetaminophen (Tylenol or generic). You can take two 500 mg tablets every 6 hours as needed, do not exceed 4 g per day (8 x 500mg tablets).

Avoid aspirin for 2 days after the vasectomy.

Ibuprofen (Motrin, Advil or generic) and naproxen (Aleve) are both pain medications and anti-inflammatory drugs. Inflammation is a normal part of the healing process. For the first few days after the procedure, it is best NOT to take an anti-inflammatory. 

3. No need for ice packs.

4. You may remove the athletic supporter and take a shower starting the morning after the procedure. Replace the athletic supporter and wear it whenever you are up and around for the next 2 days and during sports for the next 7 days.

5. On the day after the procedure, you may walk and drive as much as you like, but no sports, yard work, swimming, or heavy lifting. If your job is sedentary (office work or supervisor), you may return to work.

6. When the pain is gone and tenderness is minimal, you may return to the gym or to running, but on the first day back, do half of your usual workout: half the weight, half the reps, half the speed, half the distance, etc. If pain does not return, you may do your regular workout the next day. You may also swim in fresh or salt water two days after the vasectomy.

7. When you no longer have any pain or tenderness, you may ejaculate. We recommend waiting at least 2 days for sex, but the American Urological Association Vasectomy Guidelines recommends that patients wait a week. It is unclear whether sooner ejaculation prolongs discomfort. Blood in the semen within the first month or two after the vasectomy occurs in some patients, but it is no reason for concern. YOU MUST USE SOME OTHER METHOD OF BIRTH CONTROL until your semen is tested negative for sperm.

8. No follow-up visit is required. You will be given a 24 hour emergency phone number and if you have undue discomfort or any concerns, you can call any time after your vasectomy.

If you develop a large bluish lump inside the scrotum the size of a golf ball, in the first two days, it may be a hematoma (blood accumulation). It is important to treat this complication as soon as possible, please call our office @ 604-709-5611, Monday – Friday 9 – 5 or after hours our emergency # 604-244-5010.

If you have excessive pain or swelling, bleeding, or redness or pus around the incision with a fever, please call our office @ 604-709-5611, Monday – Friday 9 – 5 or after hours our emergency # 604-244-5010.

If you have any questions or concerns about how you are healing please call the office during regular office hours for advice. 604-709-5611 or email us @ willowvasectomy@gmail.com

Before you leave the clinic, we will give you a form to take to the lab. We will advise you on the earliest date you should go. You MUST have an appointment at the lab to drop off your sample. You will need to call Lifelabs @ 604-412-4495 as soon as possible to book. They are booking 3 – 4 months away.

Twelve weeks after your vasectomy, you need to have your semen tested to be sure that it no longer contains sperm and that it is thereby safe to stop other forms of contraception:

Please wait at least twelve (12) weeks and 20 ejaculations after your vasectomy (number of ejaculations and number of weeks are both important).

A semen sample tested before 12 weeks is less likely to be free of sperm. The sample should be produced on the day of examination, but can be 3 or 4 hours old.

After twelve weeks and 20 ejaculations (both), 98% of patients will have no sperm in their semen. Two percent will have to repeat the test at least once. Should you wish assurance against late failure, repeat semen tests are available at future times through Lifelabs.

If you have a valid BC Services Card (PHN), there is NO CHARGE to you for the consultation or the procedure.

If you miss or cancel the procedure appointment with less than 2 full business days’ notice, the cancellation fee is $200.00. 

If you show up for the appointment and you are inadequately prepared, or if the information on the booking form is incorrect or incomplete such that the vasectomy cannot be performed, you will be charged a procedure cancellation fee of $100.00
 
You will be asked to keep a credit card # on file with us. There will be no charges made unless we need to charge either of the fees above.
 
You will need to purchase an athletic supporter (Jock Strap) prior to your procedure appointment. This should cost you less than 20.00.
 
If you DO NOT HAVE A VALID BC SERVICES CARD:
 
The cost for the consultation will be 195.00.
The cost for the procedure will be 455.00
 

If you miss or cancel the procedure appointment with less than 2 full business days’ notice, the cancellation fee is $200.00. 

If you show up for the appointment and you are inadequately prepared, or if the information on the booking form is incorrect or incomplete such that the vasectomy cannot be performed, you will be charged a procedure cancellation fee of $100.00
 
You will be asked to keep a credit card # on file with us.  
 
You will need to purchase an athletic supporter (Jock Strap) prior to your procedure appointment. — This should cost you less than 20.00.
 
You will need to pay the lab directly for your follow-up semen analysis approximate cost is 65.00 per sample. You may need to go for more than one analysis.
Frequently Asked Questions:

Does vasectomy change your sex drive?
For most patients, not at all. If any change does occur, more patients note an INCREASED sex drive after vasectomy. Vasectomy does not affect the male hormones produced by the testicles. After vasectomy, sexual function does not change. Sensation, erection, and ejaculation are the same except the ejaculate no longer contains sperm.

Will I be able to notice any change in my semen?
No. The amount of sperm in semen is so small that patients do not notice any change. More than 95% of the semen in made in the glands above the vas tubes, the prostate and seminal vesicles, with only a small portion of the total volume being made in the testes. After a vasectomy the only way to tell the difference in the semen is with a microscopic semen analysis. Vasectomy does not prevent ejaculation.

What happens to the sperm after a vasectomy?
Your body reabsorbs the sperm cells. Our bodies are very good at recycling old or unused cells. For example, we make red blood cells every day and our bodies do not become overloaded with excess blood. Our bodies simply reabsorb the older blood cells, recycling their proteins and parts.

What is the recovery like?
Most patients feel some soreness for a night or two after the procedure and then feel fine. Wear an athletic supporter (jock strap) over your underwear for the first few days after the vasectomy to decrease your discomfort and chances of bleeding. Avoid any vigorous activity, including sports and sex, for the first 3-7 days after your vasectomy.

Why do I have to wait 3 months to get my semen checked?
You should not consider yourself “clear” until a semen check verifies that your semen no longer contains viable sperm. The semen check is an important part of vasectomy, but bringing the sample in too soon can give you a scare. Sperm can hide in the prostate and seminal vesicles for 2-3 months, so early on a sperm count could be positive even though the vas tubes were successfully sealed. Waiting allows the hidden sperm to be flushed out. There is a very rare chance that the tubes can grow back together after a vasectomy. After three months, the semen analysis should show if this occurred. The sample can be collected in the comfort of your own home. The semen check is a simple, last step in the process to ensure a successful vasectomy.

Will I be comfortable with a female physician?
As a family physician, our vasectomy doctor has extensive experience with patients of all genders. Our clinical expertise and communication styles allow us to put our patients at ease and to provide excellent care. Your safety and comfort are our goals. Our patients find our female doctor comfortable to talk with. We treat everyone with dignity and respect. We are extremely gentle with procedural care, and have the utmost respect for the privacy of our patients.

What does it cost for the vasectomy?
If you have a valid BC Services Card there is no charge to you for the procedure.
If you DO NOT have a valid BC Services Card the cost will be 650.00.

Can I bring someone with me to the appointment?
No, unfortunately at this time we are not allowing partners or family members into the clinic. You will need to have someone waiting outside for you to drive you home.

How long is the appointment?
You will be in the clinic for approximately 45 – 60 minutes. The actual procedure takes about 20 minutes and then we will ask you to rest for a few minutes afterwards before leaving the clinic.

What do I need to bring with me to the appointment?
You will need to bring your valid BC medical card and your athletic supporter. Please have a ride organized as well.

How effective is no needle, no scalpel vasectomy?
Vasectomy is the most effective of all the methods of birth control. However, nothing is perfect and the reported failure rate for vasectomy is 0.4%. This means that 4 out of 1000 will remain fertile. Failure can occur due to reconnection of the cut ends during healing, formation of a new channel through a sperm granuloma, failure to identify and cut the vas, or duplication of the vas on one side. If repeated semen analysis remain positive for motile sperm after several months, we can repeat the vasectomy procedure.

Can the vasectomy be reversed if I change my mind later?
Vasectomy should be considered a permanent operation. If you change your mind and want a reversal, this can be done with microscopic surgery by a skilled and experienced surgeon. This will usually require general anesthesia in the hospital, and the cost is not covered by our provincial health insurance (MSP). Even after a reversal surgery, as many as 50% will not succeed in having children.

Do you recommend sperm storage?
Yes, especially for those under age 35 and those with fewer than two children.

Who do I contact if I would like to store my sperm before my vasectomy?
Local fertility clinics provide this service.

Does vasectomy increase my chances of getting cancer?
No long-term adverse side effects have been proven with vasectomy. Ongoing studies have not demonstrated that vasectomy plays any role in prostate cancer. Medical scientists continue to explore the minor changes in the body associated with vasectomy. While it is possible that there are undiscovered health risks, this small possible risk should be weighed against the benefits of vasectomy and the risks of other methods of contraception.

How much bleeding should I expect?
A painless bruise or black-and-blue color might appear around the scrotum and the base of the penis on the second or third day. It is harmless and will fade over several days. If you develop a large bluish lump inside the scrotum the size of a golf ball, in the first two days, it may be a hematoma (blood accumulation). It is important to treat this (very rare) complication early, so call the clinic day or night.

How soon after the vasectomy can I have sex?
Wait at least 2 days. When you no longer have any pain or tenderness you may ejaculate. Go slow for the first week. After 7 days there are no restrictions, but YOU MUST USE A RELIABLE FORM OF CONTRACEPTION until you are cleared by a negative semen test.

I can feel a tiny pea sized lump – is this normal?
On each side of your scrotum, the tube ends will develop a BB to pea-size nodule where the vasectomy was done. This scar is normal and permanent. Initially it will be tender if you pinch it, (so don’t). The tenderness should resolve within a few months.

RESOURCES – coming soon