To have a vasectomy you need to:
- Book the procedure date by phone (tel. +48 607 776 777)
- Fill in the health questionnaire
Contact with the doctor
- A conversation and medical interview (a series of questions about your health, past illnesses and life situation)
- Review and discussion of any medication you take.
- Discussion of the consequences and effects of vasectomy.
- A thorough examination of the genitals.
All this is aimed at assessing the indications and any contraindications for the vasectomy procedure.
Vasectomy – what to do in the days before the procedure:
- Do not regularly take large doses of Aspirin, Polopiryna, Acard or other medicines containing acetylsalicylic acid (acidum acetylosalicilum) or salicylates for two weeks before the procedure. Please discuss any other medication with the doctor before your vasectomy.
- Fill in the patient questionnaire
- Shave the scrotum thoroughly – ideally 4-5 days before the procedure – so that you do not feel unpleasant stinging when the disinfectant is applied.
- Plan your transport home after the vasectomy (ideally a taxi or a companion as driver). You can drive yourself after the procedure. In that case, however, wait at least 45 minutes after the procedure before starting the engine.
- Take a shower and wash your whole body thoroughly twice with soap (preferably antibacterial), especially the genitals, immediately before leaving home for your vasectomy (including the glans under the foreskin).
- Do not eat or drink anything for 3 hours before the procedure, and your last meal should be light, i.e. without meat, vegetables or fruit. For example scrambled eggs in butter, cheese, white bread.
- Come to your vasectomy in comfortable loose trousers.
Vasectomy – what to expect after the procedure – recommendations:
- Sometimes (if the doctor advises it) an ice-cube compress wrapped in a towel is applied for about 1 hour.
- For the rest of the day after your vasectomy, limit physical activity. Ideally, adopt an “armchair lifestyle”. Likewise, over the next 1-2 days activity should be increased gradually. Patients doing heavy physical work may receive a sick note.
- You may shower only the next day.
- Avoid heavy physical work and exercise for a week.
- Keep the site of the no-scalpel opening clean and dry by changing the gauze once a day for three to five days – or as advised by the doctor.
- A small amount of blood on the gauze is normal. A bruise on the scrotal skin and around the base of the penis is also normal.
- In case of excessive bleeding, severe swelling or pain, you must see a doctor.
- The doctor may prescribe antibiotics for a few days after the procedure.
- Before stopping your current contraception, you must obtain the desired semen analysis result.
- The semen analysis is best done 8-12 weeks after the procedure and after 30 ejaculations.
- For extra certainty, it is worth repeating the semen analysis after a further 2-4 months.
Vasectomy – what to expect after the procedure – returning to activity?
Most men feel well enough after a vasectomy to return to work the next day, or within a few days if they do physical work. Sexual activity can be resumed after about 2-3 days, but very gently, slowly and in the so-called spooning position. Initially, ejaculation may cause some discomfort in the groin and testicles until the tissues have fully healed. Some men may notice trace amounts of blood in their semen.
Avoid lifting very heavy objects or playing sport for 2-3 weeks, or be prepared for possible discomfort or even pain.
Until a semen analysis shows that there are no sperm in the ejaculate, you must use an additional method of contraception.
When to see a doctor immediately:
- If symptoms of infection appear, including fever and chills
- Redness, swelling, intense pain, excessive bleeding or discharge of pus from the opening through which the procedure was performed
Possible complications
Possible early complications after vasectomy – my own statistics
- a bruise (discolouration) on the scrotal skin (about 20% in my practice)
- a small amount of blood in the ejaculate (about 3% in my practice – if semen was emitted earlier than 7 days after the procedure)
- slight discomfort or aching of a testicle, the scrotum, the groin or above the pubic bone, which usually resolves on its own within 2-4 days and does not require painkillers (about 30% in my practice)
- Aching of the scrotum, testicle, groin or above the pubic bone requiring mild painkillers (e.g. ibuprofen), felt for several days or even weeks (about 3% in my practice)
- bleeding and a haematoma in the scrotum – a complication seen in about 0.2% of cases in my practice; a haematoma may take several weeks to be absorbed or require surgical removal (it usually resolves on its own)
- inflammation and infection at the procedure site – under 1% in my practice
- infection (inflammation) of the testicle or epididymis (described in the literature) – 0% in my practice so far
- transient swelling at the vasectomy site – under 1% in my practice
- Complications related to the anaesthesia (allergy to the drug) – described in the literature (not a single case in my practice so far)
- Failed vasectomy or early recanalisation = live sperm present 3 months after the procedure. 0.1% in my practice.
- Pregnancy after vasectomy – 1 reported case (not confirmed by genetic paternity testing or by establishing the time of conception).
Possible late complications after vasectomy
- Chronic pain around the testicles – so-called Post-Vasectomy Pain Syndrome – very rare with the “Canadian” method (described in the literature – not a single case in my practice so far). Chronic testicular pain is very often reported in men who have never had any procedure in the scrotal area. It is most often related to past mechanical injuries, e.g. from intensive regular cycling training.
- Late recanalisation – (described in the literature – not a single case in my practice so far).
- Sperm granuloma. This is a vascularised lump, palpable and visible on ultrasound; it requires excision because it cannot be distinguished from a tumour. In my practice there has been one case so far.
- Swelling and testicular pain occurring within a year of the vasectomy – very rare. Described in the literature – not a single case in my practice so far.
- Reduced libido and psychological problems related to infertility. Described in the literature – not a single case in my practice so far.
- Production of anti-sperm antibodies in response to secondary sperm resorption – these can be a problem when trying for a pregnancy again after a successful vasectomy reversal.
What increases the risk of complications during a vasectomy
- Local infection
- Blood clotting disorders (e.g. congenital or related to taking aspirin and similar drugs)