FREQUENTLY ASKED QUESTIONS

It’s not ethical to do vasectomies on a hundred men and then go ahead and reverse them after and see how many are successful. There are those that claim open-ended vasectomy (the ‘technique within a technique’ done here) increases the reversibility…but such claims suffer from the same problem of not having any hard evidence. The bottom line is you can put the tubes back together in the majority of cases, but you cannot guarantee that a pregnancy will result. And that is regardless of the method of vasectomy and the time between the vasectomy and its reversal.

A man does not eliminate all of the sperm he produces throughout life. The body is able to break down and re-absorb what is not otherwise ejected. The small volume of spermatic fluid containing the sperm is thus reabsorbed after vasectomy in a process that was present before the vasectomy. The prostate continues to make semen, however, which is ejaculated in the normal fashion after vasectomy…there’s just no sperm in it anymore. You don’t notice any difference after vasectomy in this way.

A statistical study released in 1996 apparently showed a slightly increased statistical risk of prostate cancer in men who had undergone vasectomy (the same study also showed a reduction in most causes of death in men who had undergone vasectomy!). Subsequent studies and further analysis indicated that there is, in fact, no difference in risk of cancer in men with or without vasectomy. One study of autopsies in men over age 90 indicated a 100% risk of cancer of the prostate in all men over 90 with or without vasectomy (most have not had a vasectomy). The bottom line appears to be that vasectomy doesn’t improve health, but it doesn’t make things worse either.

Many studies have been done looking at tens of thousands of men over decades after vasectomy. There is no evidence to suggest that vasectomy increases the risk of erectile dysfunction (difficulty getting an erection) or changes one’s sex drive or male sex hormone level. It is important to note that erection problems are common (about 40% of men aged 40 and about 2/3rds of men aged 70) and that these problems are often associated with other medical conditions that increase in frequency with age…with or without a vasectomy. Male sex hormone levels decline naturally with age…with or without a vasectomy. All things being equal, age should not preclude the enjoyment of healthy sexual activity.

Some women feel that their partners exhibit demented behaviour with or without a vasectomy. More seriously, no. There was a single study involving a rare form of dementia in which the researchers suggested that antibodies to sperm may be the cause. However, this form of dementia occurs in men with or without vasectomy and there is no evidence in the medical literature to suggest that vasectomy increases the risk.

If you haven’t taken valium, yes. Alcohol and Valium do not mix and so alcohol should not be consumed for some time after having taken Valium. Consult your pharmacist to determine when it will be safe for you to have a drink.

You can take whatever you want. But if you want my advice, take what I prescribed for post-op pain.

You should try and not lift anything for one week after the procedure, including babies and children.

Refrain from all activities for one week after your vasectomy and try to stay off your feet as much as possible.

You can wait as long as you like. However, in my experience, unless you are talking about horseback riding (where you are practically sitting on your testicles), easing back into most sporting activities is okay after 7 days. If your vasectomy was on April 1st, you can start easing back on April 8th. Not the 7th. Not the 6th…

You don’t want to bathe the scrotum in hot water no matter what…hence the recommendation to ice the scrotum the day of surgery. Also, even if you have the wound closed with skin glue, it is pushing it a bit to be immersing yourself in water. Showers are fine.

It is a good idea to ice the scrotum the day of the vasectomy.  A reusable gel ice pack can be placed over the support, not directly on the skin, for 20-30 minutes on and 30-60 minutes off. Repeat this every hour or at least 3 times a day for a few days.

Funny you should ask. Out of some 10,000+ vasectomies, I have seen this occur only once. It is not an issue.

You will always be asked if someone else is to be present. On occasion the doctor has other physicians visiting to observe the procedure. All physicians greatly appreciate the opportunity to learn from others…but you may decline if you feel strongly otherwise. On the same note, however, no family members or partners will be allowed to attend. There is a difference between watching to learn as a physician and watching a loved one go through a surgical procedure.

The idea here is that you want to avoid trauma to the scrotum for 14 days after the vasectomy. If there is a risk of receiving a blow to the scrotum, wear a hard cup or don’t do it for 14 days. There is no harm in exercising…just not if you’re going to increase the risk of internal bleeding which will take you out of action for another few months.

About 4000 a year. You can do the math.

Because the sperm live for some time in your body. We want to be sure that enough time has passed so that all the sperm ‘downstream’ have died before doing the test. If your test shows zero sperm, it won’t be an issue. However, if a second test is necessary, and we find a few dead sperm (which is not unusual) we can be sure that they are just ‘leftovers’. Doing the test earlier risks finding these ‘leftovers’ still alive and then we have to wonder if they are new (meaning a failure of vasectomy) or old.

The considerations here are two-fold. Firstly, should a problem arise, it is a good idea to be able to come back to see the doctor to check things out. Secondly, you want to avoid lifting luggage. It’s probably best to consider avoiding travel for 7 days after the surgery.

For the most part, the Valium wears off after about 4 hours. You are advised to avoid driving for the remainder of the day of your vasectomy.

If the glue was applied, you can shower immediately, but wait until you get home. Otherwise wait 24 hours or until the wound is closed.

No. The physician puts on a sufficient amount to last until the wound begins to close naturally.

No.

Vasectomy doesn’t improve your voice or make you speak or sing in a high voice.

With the glue, showering is really not a problem and you don’t have to wait. Just be gentle and don’t scrub the area.

12 weeks regardless of the number of ejaculations. We also recommend at least 20 ejaculations during that time.

You can do the test before 12 weeks. But it will be useless regardless of the result. Most failures occur in the first 12 weeks. You can have a clear test at 11 weeks and then see sperm at 12. No matter how you figure it, 12 weeks is 12 weeks. Doesn’t matter if you’re going on a cruise or going to Las Vegas or whatever. We cannot give you the green light unless the test is done after 12 weeks and it is clear.

At our clinic, vasectomy is better than 99.9% successful in the first 12 weeks (that is, 1:2,000 fail in this time period). But 5-10% of men will carry dead sperm in their ejaculate for months or years after their vasectomy…so the second test is to make sure that whatever sperm are there are dead. Our success rate after 12 weeks is better than 99.99%! Vasectomy is the most effective birth control method. Period.

It is about 5 millimeters long and placed in such a way that you will not be aware of it. However…if you search for it and poke around, you will cause inflammation and pain. It is normal to have a tiny lump at the point of the vasectomy, with or without a clip. Leave it alone!

You should wear the support while you are awake for the first 7 days. You might be more comfortable wearing the support or snugly fitting underwear to bed, but that is your choice.

3 guesses and the first 2 don’t count. No lifting for the first week.

What you tell your partner is your business…but time is more important than the number of ejaculations. Do your test at least 12 weeks after the vasectomy regardless of the number of ejaculations, although I recommend at least 20 ejaculations.

The body has a remarkable ability to heal itself and, in rare cases, the tubes will ‘rejoin’ (about 3 in 1000 on average, 1 in 2000 cases for Dr. Bercier). Nothing in life is 100%. However, vasectomy has the lowest failure rate of any form of contraception. Period. Can it fail even after a clear test at 12 weeks? Yes, but this is extremely rare. You can test your semen every year, if you choose, but this is very seldom done.

We used to use a scalpel, or knife, to cut through the skin and all the layers of tissue to get down to the vas deferens, the tube that carries the sperm. That means that we cut through blood vessels on the way down. With no-scalpel technique, we make a tiny opening and stretch it just enough to pull out the vas deferens and block it. By stretching a tiny opening, we push the blood vessels to the side instead of cutting through them. You would think that this results in less bleeding and that is precisely what it does…by about 90%. And remember that bleeding is the major painful complication of vasectomy. No-needle anaesthesia (freezing) uses a piston to push the lidocaine anaesthetic solution through the skin quickly and easily. Instead of a needle, you feel a ‘pop’ like a small rubber band against the skin. Aside from the fact that “you don’t have to get a needle down there”, this method results in a more rapid (seconds) and profound (deeper) freeze. Many men feel nothing during the vasectomy, others may feel some pressure or pulling, as a result of the better ‘freezing’.

The body responds to any injury or insult with what is called an inflammatory reaction. Your immune system gets geared up and the healing process begins. Everyone is different and some may not feel these effects for several days. It is also a function of how you are built and how difficult the vasectomy was…how much the doctor had to pull etc.. The anti-inflammatories that were suggested to you are just the right thing for this kind of discomfort. Of course, everyone has a different ‘pain threshold’ and one man might feel discomfort while the next feels nothing at all.

No.

The vas deferens, the tube that carries the sperm, is only one of many structures that hold the testicles in place. There are blood vessels and other tissues that provide support and these are not disturbed. Your testicles will still be supported after the vasectomy, they won’t roll around loosely in your scrotum.

No and yes. The lab we recommend processes literally thousands of tests each year for us according to our exacting specifications. Other labs may also infrequently perform such tests. In general, it is best to have the test done where they are most familiar with doing it.

The mail-in option for post-vasectomy testing has been used in England for over 10 years with great success. They receive samples from as far away as Indonesia! In some cases the sample has been in the postal system for 2 weeks without a problem. If you follow our instructions, the sample will be fine.

What do you think? If the wound was closed with glue, you may shower but not bathe. I’d say swimming is closer to a bath than a shower… 7 days!

You bet it does.

You’ve got to be kidding! If your worst problem is itching, I’d say you have little to worry about. Just don’t apply any creams or ointments to the skin until the little wound is completely healed and closed (usually a few days).

Most complications will occur in the first week. This is the really critical period. But you don’t want to traumatize the area (like horseback riding) for the first 14 days. Most other activities that don’t involve an impact to the scrotum are unlikely to cause problems after the first week. Rarely problems can arise after the first week.

In a word…no.

You really have to go back and read the “After the Vasectomy” section on this website or in your pamphlet.

That would be terrible! If the testicular artery were cut, it might result in loss of the testicle. Fortunately, this is not a common problem and has never occurred in Dr. Bercier’ career. The vas deferens has a characteristic feel to the surgeon who performs lots of vasectomies and it would be very difficult to mix it up with something else.

You’ll have to take my word for it, ease back into your exercise after one week. Of course, you’ll know if you can’t start exercising if you continue to have pain or discomfort. Otherwise, if you are feeling okay, consider that a sign that you can go ahead.

No. Have all the fun you want before…just don’t ejaculate for one week after.

Some say it is better to give than to receive. In the first seven days you may give, but you cannot receive. No ejaculation for 7 days.

That’s one of those Bill Clinton questions again. Ejaculation is ejaculation, no matter which bus gets you to the station.

Yes, if your partner says that it’s okay with them.

Oh, let me think a little. Oh, yes, it’s seven days!

I hope not! Vasectomy does not cause the testicles to change in size.

Do it if you have to. I think it’s pretty clear that you want to be off your feet as much as possible for a week. Climbing a few stairs from time to time and within reason should not be an issue.

Before should not be a problem. After…you have to ask Canadian Blood Services what their policy is.

Not unless you’re having the baby. Secondly, did you ask her if she wanted to? Third, unlike a birth, everything is sterile…so, sorry, but no.

There’s no bruising, no swelling, no pain…maybe nothing was done. A. I only put this in because I have actually received a number of these calls. I could not believe that some patients are angry at not experiencing pain! I don’t guarantee a totally pain-free experience, but if it does happen, please be thankful and don’t be angry!