This procedure is the most common form of permanent sterilization in North America, adopted by over 90% of couples. The technique involves cutting the vas deferens, which transports the sperm (produced in the testes) to the seminal vesicles (which are stored behind the prostate).
The technique is performed so that it is permanent; the vas is cut, a 1-2 mm piece is removed, the ends are cauterized, and a titanium clip is applied.
The overall failure rate is 1/10,000, meaning that one male in 10,000 who has had a vasectomy will father a child per calendar year. The procedure is covered by the provincial health care plan, but a reversal is not covered. The cost of a reversal ranges from $5000 to $10,000, with a 50% success rate in fathering a child.
This procedure is done on Thursdays in Suite 104 at 2555 St. Joseph Blvd. in Orleans and takes about 30 minutes. Prior to the procedure, the patient is requested to do the following:
- Shave the front of the scrotum of any long hairs that could enter the scrotum and introduce bacteria;
- Bring snug underwear to wear after the procedure so that the testicles do not move too much and cause pain;
- Refrain from driving for 1 hour after the procedure (the insurance company may not cover accidents);
We can provide a mild sedative (diazepam) 1 hour before the procedure for those who are feeling anxious. The procedure involves local anesthetic (1 cc) in the midline of the scrotum and then more anesthetic to each vas. A small puncture hole is made to access the vas, which is dissected. Once both vas return inside, the skin comes together and will close on its own. No sutures or glue are required.
After the procedure, there will be some swelling that should slowly reduce, and you should be able to do a sedentary job by Monday. Trauma to the area should be avoided – no sports, no repetitive heavy lifting and no intercourse – for one week. If the pain has not improved by Monday, please come to the office for an assessment. A prescription for pain can be provided.
A shower can be taken the next day, and a bath 3 days after the procedure.
After the procedure, there will be sperm in the ejaculate until the sperm stored in the seminal vesicles has emptied. A test is done 2 months after the procedure or after 20 ejaculates. The sample is collected at home and brought to the lab. The lab analyzes to see if there are any sperm (dead or alive) in the sample. A second sample is done 2-4 weeks later. Proof of success is to have 2 consecutive samples free of sperm. A copy of the results is sent to your family doctor and the patient. If there remains any sperm after 1 year, the procedure needs to be repeated (0.5% repeat rate).
Sperm continues to be produced (1 drop per day) but will no longer reach the seminal vesicles. Ejaculation, which is primarily prostatic fluid, remains the same. There is no effect on sexual pleasure.
Complications include bleeding (1%), infection (1%), testicular discomfort due to congestion of the epididymis in the spermatic cord (5%), scar nodule (1%) and chronic inguinal pain/discomfort (<0.1%).
