About Vasectomy

Look through these key questions to get some answers and become more familiar with vasectomy

You may bank sperm through the Diagnostic Semen Laboratory...

The initial charge is $350.00 and then $200.00 per annum for as long as it is stored. You may obtain further information from them at telephone no. 284-9410. In future if you would like to use your sperm for fertility needs, you will have to go through the in vitro process which costs around $10,000.000

Vasectomy reversal is possible by way of delicate and complicated micro surgery...

Success is, however, never guaranteed and is influenced by numerous factors including time since vasectomy. A third of reversals will be unsuccessful. Reversals are also not covered by Alberta Health and may cost in the region of $5,000.00 to $7,000.00. Another option available in Calgary is to have a PESA procedure. This stands for Percutaneous Epididymal Sperm Aspiration, which means a small and fine needle is inserted into the scrotum and if viable sperm is present, this may be extracted from the epididymis. This procedure costs around $1,000.00. Following this you will have to obtain pregnancy through the in vitro process which would cost another $10,000.00

Conventional vasectomy uses a scalpel to make one or two incisions...

...in the scrotal skin and is therefore a little more invasive and requires more manipulation of the patient's soft tissues which may cause more bruising and delayed healing afterward. It takes a little longer and may require more sutures (stitches) afterward. No-scalpel vasectomy uses special imported instruments to puncture the scrotal skin and hold the vas deferens in place requiring less invasion and less manipulation.

With both techniques the vas is lifted through the opening in the skin, tied off in two places, cut in the middle of the ties, cauterized and dropped back in place.

Dr van der Merwe makes one tiny puncture in the skin, which means no suture is needed and it will simply heal by itself over the next week.

We also believe that recovery time and complications are less with a no-scalpel method.

A big advantage of the no-scalpel method remains the psychological benefit of not having one's genitals cut by a scalpel.

Since we cut the vas deferens in the scrotum (sac)...

...above the testicles, it is clear that there is still sperm in the body above the cut. This is why you are not rendered sterile immediately after a vasectomy. It takes the body some months to clear the remaining sperm from your genital tract. During this time we recommend that you use your regular form of contraception and ejaculate at least every third day. This ejaculation may also be achieved by masturbation.

The doctor will provide you with a container and instructions to collect a sample of ejaculate 4- 7 months after your vasectomy. Please follow the instructions very carefully other wise the laboratory will not process your sample.

The doctor will then contact you with the results. Occasionally the result may still mention the presence of some sperm in your ejaculate, which does not mean that the procedure has failed. All it means is that your body is taking a little longer to clear sperm from your body. The doctor will then recommend that you continue protected ejaculations for another month or so and repeat the sample until no sperm at all is seen. Until he tells you otherwise, you are not considered sterile!

You will still need to use safe sex precautions...

...if you are at risk for contracting or transmitting STDs.

The cost of the surgical procedure is covered by Alberta Health and Wellness...

There is a $102 charge for our post vasectomy kit. This includes all post operative pain relief medication (no need to go to the pharmacy), a phone follow up with Dr. van der Merwe, post vas testing kits, ice pack, additional gauze dressing, batteries (used as part of the procedure - to reduce our environmental impact), post operative care instructions, phone follow up with the nurse with post semen sample results once results are received.

There is no need to return to the clinic to receive your results.

The post vasectomy kit is an uninsured service and the cost is not covered by the Alberta Health Care Insurance Plan.

If you have financial concerns, please discuss with Dr. van der Merwe. Our office is committed to ensuring that financial barriers do not impact your ability to receive the vasectomy procedure.

Failure rates for various forms of contraception:

vasectomy 0.02 - 0.2 %

tubal ligation 0.2 - 0.4%

oral contraception the pill 0.16 - 3%

condom 1.33 %

diaphragm 1.21%

IUD 0.5 - 5%

There is research data available that has found...

...no correlation between vasectomy and prostate cancer even after 25 years of follow up.

Permanent chronic pain in the testicles happens in less than 0.02 %...

...of patients after a vasectomy. If you have had significant injuries to the testicles requiring medical attention or sexually transmitted diseases in the past, this risk may be as high as 5%.

Failure of the procedure is 0.02% - 0.2%, which may happen outright or in the future by spontaneous reuniting of the severed vas.

Some men may have some testicular discomfort that may last days...

...to months and usually resolves spontaneously. In the area where the vas was tied small lumps will appear as a result of scar tissue formation. These usually do not cause any symptoms.

If you are considering a form of permanent contraception (birth control)...

...one option is for a male to have a vasectomy. The other is for a female to have a tubal ligation (tubes tied).

We recommend...

...you eat before you arrive and expect to stay for 30-40 minutes. Have a shower and shave the front and sides of the scrotum(sac) on the day of the procedure (if you shave the day prior to the procedure, you increase the risk for infection). Bring some tight underwear along with you so you may wear this immediately following the procedure. The sooner you apply good pressure to the scrotum, the less swelling and risk of bleeding occurs. Make arrangements to be driven afterwards since, in rare cases, some individuals may faint afterwards due to a reflex called the vagal reflex. This has nothing to do with how squeamish you are. It is a reflex that may occur when the genitals are manipulated during surgery. Our doctor does not allow spouses in the procedure room due to space constraints and it interfering with his concentration. Spouses and small children/babies are welcome in our waiting area.

Once you arrive you will be escorted to the surgical suite by a nurse. She will hand you a gown and ask that you strip from the waist down and lie down. The doctor will then enter and walk you through the procedure step by step, which includes cleaning the genitals with sterile antiseptic, covering your lower body in sterile drapes and performing the actual procedure. This takes between 10-20 minutes. A clear plastic dressing will be stuck over the hole in the skin. You may remove this after a couple of days. Since this dressing covers the hole, you may shower immediately afterwards. Avoid bathing, hot tubs and swimming for a week afterwards. The doctor will also pack a stack of gauze inside your underwear to exert pressure over the scrotum. This should be left in place for 24 - 48 hours.

Afterward you will be handed a package that contains a prescription for Voltaren Rapide (a powerful fast acting painkiller and anti inflammatory) to use as needed for pain control once the anesthetic wears off after a couple of hours. Also in the package are containers and instructions to collect the ejaculation sample in 4-7 months. Please read and follow the instructions for collecting the semen sample carefully. There are also some questions the lab requests you fill out. Please fill out all the questions, otherwise the lab won't process your sample. If you haven't heard from our office within 10 days re your semen sample test results, please call us so we may track your report.

You may notice a small amount of...

...blood leaking out of the skin under the plastic dressing which is normal and not cause for alarm, You may have some bruising of the scrotum which could be small or turn the entire sac purple and blue.

Sometimes the shaft of your penis may also turn purple. This is no cause for concern. You will have some swelling and the following steps are strongly recommended to reduce swelling, reduce pain and speed up recovery:

You should be home for two days after the procedure. During this time wear a snug athletic support(jock strap) or two pair of brief style underwear, one over top of the other. Elevate your legs while lying down or sitting for the most time. Apply an ice pack on the scrotum for 20 minutes at a time, 4 times a day. A bag of frozen peas works well.

For the following five days you should also abstain from any sexual activity and contact sport, but you may resume other activities as tolerated. There is no suture closing the little hole in the skin. It will heal well on its own. Occasionally you may see a slight bloody tinge in your ejaculate days to weeks after the procedure. This is entirely normal and will disappear eventually.

A vasectomy is a minor surgical procedure performed...

...to make a man permanently sterile, by cutting the vas deferens(the small tubes that carries the man's sperm from his testicles to the seminal vesicle). The seminal vesicle is located behind the bladder and is filled with seminal fluid. Here sperm mixes with seminal fluid to become semen. Thus sperm + seminal fluid = semen, which is then ejaculated during orgasm. Of the total volume of semen, only 2% is actual sperm, the rest (98%) is seminal fluid. Since we only block sperm(2%) after a vasectomy, you will still ejaculate seminal fluid(98%) and therefore not notice a change in volume, consistency or sensation during ejaculation.

The only difference is that your ejaculate will not contain any sperm so that the female's ovum(egg) can not be fertilized.

Some surgeons use metal or plastic clips to...

...tie off the cut ends of the vas. This technique still requires the same local anesthetic and exposure of the vas through a skin opening. Some surgeons also use a laser as a cutting tool for severing the vas. This method also still requires the same anesthetic and exposure of the vas and is merely another way to cut soft tissue. Our doctor uses an electric cautery to seal off the ends of the vas and to control any bleeding which is usually very minimal. We are not aware of any studies proving the benefits of clips and laser over tying and cauterization.

After all is said and done, the most important factor is to find a doctor who is experienced and comfortable with which ever procedure he/she is using.

The sperm is still produced in your testicles...

...but has nowhere to go. The body merely absorbs the unused sperm, so there will be no unwanted pressure afterward!

You may contact us at the office during office hours...

...The doctor will also phone you at home the day following the procedure to check on your well being. During this conversation you may ask any other questions you may have. In the following days and weeks the doctor will be happy to see you as a walk in at his office and will also readily return phone calls for advice.

The formation of a hematoma(collection of blood ) happens when...

...there is continuous internal bleeding. You will know this is happening by an increase in size of the scrotum. Some minor swelling is no cause for alarm, but if your scrotum swells up to the size of a grapefruit,you should contact our office for an assessment. No active intervention is usually indicated since the body will reabsorb this swelling. Unfortunately this may take weeks. Although this is not without discomfort, it is unlikely to cause you any long term problems.

The chance of a hematoma happening to you is less than 1%.

Signs of infection are fever, chills, local tenderness, pain and redness. If this occurs a course of anti-biotic therapy will resolve this complication.

The chance of infection occurring is less than 1%.

A vasectomy is more safe, cheaper and as effective as...

...a tubal ligation. A vasectomy is a simple procedure lasting a few minutes, performed under local anesthesia (freezing) in the doctor's office. A tubal ligation is a more complicated and lengthy procedure. It is done in a hospital, usually requires general anesthesia and a few hours of hospital recovery time. The patients abdominal cavity has to be entered and in doing so, serious complications may include puncture of organs such as bowel, bladder and arteries. Complications from general anesthesia may also occur and long term complications such as painful menstrual cycles and pelvic pain have been reported.

It is our opinion that after a frank discussion between spouses, a vasectomy is the best option when it comes to cost, risks and benefits. It is a loving choice for a husband who would spare his wife the burden and risks of tubal ligation.

The vasectomy only blocks sperm and has no effect on...

... the male hormones that enters your body through your blood stream. These hormones are what is needed to affect your sex drive and male characteristics like beard and voice.