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 for men.
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.

willow-clinic-vasectomy
This image is provided with permissions of VasectomyStore.com (owned & operated by AMI, Inc.)

How is it done?

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.

Conventional Vasectomy

During a conventional vasectomy, a needle is used to numb the scrotal skin and a scalpel is used to make in incision over the left and right vas tubes. After the tubes are divided, the two incisions are closed with sutures.

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 men who choose to avoid vasectomy. And they are considerable!

CHECKLIST :

Prior to your appointment
Buy an athletic supporter.
Buy some Tylenol 500 mg or generic to have on hand 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 front wall of the 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.
Bring your athletic supporter with you.

Have someone ready to drive you home.

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 front wall of the 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. Bring an athletic supporter; 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 men who do not eat beforehand are more likely to become lightheaded during or after their vasectomies.

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 men 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, unless you really enjoy having ice on your scrotum.

4. You may remove the scrotal support (athletic supporter) and take a shower starting the morning after the procedure. Replace the scrotal support 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. Two days after the procedure, you may return to more strenuous work and regular activities wearing your scrotal support. 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 men 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 men, 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.

NORMAL EFFECTS

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 men 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 men 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 men (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.

WHAT TO WATCH FOR

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 emergency # 604-709-5611 day or night.

If you have excessive pain or swelling, bleeding, or redness or pus around the incision with a fever, please call our emergency # 604-709-5611 day or night.

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

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.

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 men 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.