What is a vasectomy?

The testicles produce sperm that travel through a tube called the vas deferens. The vas deferens or “vas” continues to travel through the prostate before joining with the vas on the other side to become the urethra, which exits through the penis. The goal in a vasectomy is to block the right and left vas. In doing so, you will ejaculate semen without sperm. A man cannot make his partner pregnant without sperm!

after vasectomy

What is a No-Scalpel Vasectomy?

No-Scalpel vasectomy is different from a conventional vasectomy in the way the doctor gets to the tubes, not in the way he blocks them. In a conventional vasectomy, the doctor makes two cuts into the skin and lifts out each tube in turn, cutting and blocking them. Then the doctor stitches the cuts closed. In a no-scalpel vasectomy, the doctor locates the tubes under the skin and holds them in place with a small clamp. Instead of making two incisions, the doctor makes one tiny puncture with a special instrument. The same instrument is used to gently stretch the opening so the tubes can be reached. This line accurately represents the actual size of the puncture: | . Through this tiny opening both tubes are temporarily lifted out and then blocked, using heat cauterization.

What are the benefits of No-Scalpel Vasectomy?

Studies have shown an eight times lower complication rate, quicker healing, and less intra-operative discomfort for a no-scalpel vasectomy compared to the more conventional approach. Not all vasectomy providers prefer this technique because it is much harder to learn how to do a vasectomy through a tiny 2mm central opening than it is to make sizeable cuts requiring sutures.

No-Scalpel Vasectomy

No-Scalpel Vasectomy:
Pulling out one of the two vas tubes

No-Scalpel Vasectomy

No-Scalpel Vasectomy:
No stitches are needed to close the tiny opening

Conventional Vasectomy

Conventional Vasectomy:
Two moderate incisions stitched closed

When is the right time for vasectomy?

It is best to get a vasectomy when you and your partner are sure that you are happy with the number of children you have. If you have a child under six months of age, you might want to wait because of “Sudden Infant Death Syndrome (SIDS)”, a condition where a child can die after a few months of life for no apparent reason. This might possibly affect the timing of your plans for vasectomy. Age over six months is often considered the threshold at which SIDS is least likely to occur.

Should I store sperm?

Choosing to have a vasectomy is a serious decision because it is carried out with the intention of creating permanent sterility. Our experience with patients over the years has shown that a significant number of men who opt for a vasectomy later change their minds about their desire to have children. Reasons for this include death of a spouse, death of a child, divorce, separation, or just changing their minds. That is why we encourage everyone to consider sperm storage. Sperm can be cryogenically frozen and preserved for years, which provides an insurance policy for the future. Currently we refer our vasectomy clients to Olive Fertility Centre for sperm storage. For more information you can visit their website at http://www.olivefertility.com/our-services/fertility-preservation/sperm-freezing.

What are the possible risks and complications?

  1. Bleeding (usually mild) into the scrotum (1-2%).
  2. Scrotal hematoma which is where a major bleed into the scrotum causing a grapefruit sized tender scrotum that could be disabling for two months (1-2%).
  3. Infection requiring antibiotics, although more serious infection such as an abscess formation is possible requiring intravenous antibiotics (1-2%).
  4. Congestive epididymitis resulting in swelling of the epididymis, which is where sperm is normally stored (1-3%). This almost invariably resolves with anti-inflammatories, ice and rest.
  5. Sperm granuloma is a lump made of leaked sperm that develops at the site where the tube was blocked. Sometimes this can become painful (1-2%). It also almost invariably resolves with anti-inflammatories, ice and rest or may require a local steroid injection.
  6. Chronic post-vasectomy discomfort is a rare complication of pain in the scrotum that can persist for months or years and may interfere with quality of life. Medical or surgical therapy such as vasectomy reversal can be effective, but not always, in improving this pain (1-2%).
  7. Re-canalization is a rare outcome for men who develop a channel for sperm flow after a vasectomy. It can occur early during the healing phase (1%), or late (months or years after semen has been declared sperm free after two samples (0.05%) resulting in an unintended pregnancy. The odds of the latter occurring is still far less than on any other form of birth control including tubal ligation.
  8. Vasovagal Reaction is a reaction where in rare cases some men feel faint minutes to hours after the procedure. While most men can drive themselves home, some men may feel more comfortable bringing a designated driver (<1%).

*all statistics from the American Urology Association Vasectomy Guidelines

Are there any long-term health risks associated with vasectomy?

No. There are no proven long-term health risks (cancer or cardiovascular disease) associated with vasectomy. The risks of NOT having a vasectomy, however, are real and should be taken serious by those who choose to avoid vasectomy, including the risks of hormonal contraceptives (blood clots, significant adverse reactions etc), pregnancy (miscarriage, ectopic, hyperemesis, gestational diabetes etc), and childbirth (vaginal laceration, stretch marks, hemorrhage etc).

Important message for men less than 35 years old with less than 2 kids

Please consider the following:

  1. Vasectomy should be considered permanent and non-reversible as reversals are not guaranteed.
  2. You may regret your decision one day. Younger men especially those in their 20s with fewer than 2 children are most likely to seek a reversal in the future often citing that they thought it was the right decision at the time only to be disappointed when their reversal procedure was unsuccessful.
  3. Men change. Many men are often totally convinced that they do not want kids. In our experience, many men develop a different attitude about having kids as they get older and their life situation changes.
  4. Woman also change. Many woman say they do not want kids only to change their minds as their maternal instincts kick in as they grow older and they see their friends all having children. Some who have had bad reactions to pregnancy feel they would never want to go through another pregnancy only to change their minds after a few years.
  5. Relationships fail. More than 40-50% of relationships in North America end in divorce. Despite how stable our relationships may seem, there is a chance that in a few years, you may be with a different partner who may have a strong or stronger desire to have kids than you.
  6. Sperm storage. Young men should consider storing sperm. Imagine meeting the love of your life years after your vasectomy. You may change your attitude about having children or she may have no children or want to have children with you. At least you can tell her that you made a responsible decision at the time and had the good foresight to store sperm.

How do I book an appointment?

After you have made your decision, please take some time to review the common questions section completely. When you are ready, you may book online (fastest and most popular allowing the entire procedure to be completed in a single visit) or you may call us to book an in-office consultation (limited availability and longer wait time). Please be aware that you will require a physician referral to one of our doctors prior to your appointment. If you do not have a family doctor, you can get a referral from a walk-in clinic.