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ARE NO-SCALPEL VASECTOMIES BETTER?
Studies show a significant decrease in the risk of hematomas (blood pooling in your scrotum), pain during surgery, post-operation pain and infection rates with the no-scalpel technique compared to the traditional method. Because sutures are not used to close the skin, you will not be required to make another appointment to have them removed. The minimally invasive no-scalpel technique is the approach recommended by the Canadian Urology Association. [Can Urol Assoc J 2016;10(7-8):E274-8. http://dx.doi.org/10.5489/cuaj.4017]
HOW MUCH TIME DO I NEED TO TAKE OFF WORK?
Most men need between 2 and 5 days off depending on how demanding and/or flexible their work is. If you have an office job, you can usually return to work after 2-3 days. However, if you have a job that requires heavy lifting and you can't easily delegate tasks then you may need to wait 5-6 days before returning to work. Returning to work too soon after your procedure increases your risk of bleeding, pain and swelling.
WHAT ARE YOUR WAIT TIMES?
We strive to ensure patients can get their vasectomy done within 3-4 weeks depending on fluctuating demand and availability.
HOW MUCH DO VASECTOMIES COST IN ALBERTA?
Most clinics in Alberta charge $250-300 for the portion of the vasectomy that is not covered by Alberta Health. Vasectomy Central charges $200 for what is not covered by Alberta Health. If you've had a reversal and this is your second vasectomy, it is not covered by Alberta Health and the fee is $550.
WILL IT NEGATIVELY AFFECT MY SEX LIFE?
The vast majority of patients see no change in their sex drive, desire, erections or semen volume (sperm makes up only 5% of the total semen volume). Many even describe improvements in their overall sex life due to the piece of mind it provides.
WILL IT HURT?
Most men say they feel minimal pain. You can expect to feel some pressure and a pulling sensation during the procedure, but it is typically very well tolerated. If you are very anxious about the procedure, be sure to discuss this with your family doctor or Dr. Filion ahead of time as they can prescribe you medication to help put you at ease. We don't recommend self-medicating with alcohol on the day of the procedure as it can increase the risk of complications and bleeding.
On the day of your procedure, most men feel discomfort that radiates to the lower abdomen. This feeling typically lasts about two or three days, and comes and goes over the next week when you’re moving around. After a week or two, this feeling often fades, though in some men the soreness can last awhile longer. How men feel after a vasectomy is highly variable and discomfort may linger from 7 days to 3 months.
IS IT REVERSIBLE?
A vasectomy should be considered a permanent form of contraception as there are no guarantees of a successful pregnancy after reversal. The reversal itself is not covered by Alberta Health and can be quite costly (>$6000). Some men choose to store their sperm in case they decide to change their mind down the road and reversal is not successful. The cost for sperm storage can be significant.
AM I IMMEDIATELY STERILE AFTERWARDS?
No, sperm can hide in the area for up to 12 weeks. You NEED to use back-up contraception until the lab can prove that there is no more sperm in your semen. Click here for more info.
WHAT FOLLOW-UP IS NEEDED?
All follow-ups are done over the phone so you don't have to come into the clinic. Dr. Filion usually follows up at around the 2 week mark to make sure you are doing well. You will also be contacted once your 3 month semen analysis results have been received. You will have access to Dr. Filion's personal cell phone number and he will be available 24/7 if you have any questions or concerns following your vasectomy.
HOW LONG WILL THE APPOINTMENT BE?
The procedure itself is not very long, although this can vary patient to patient. Plan to be with us for approximately 20-30min. Please arrive 15 min early to ensure adequate time to complete your registration. We recommend that someone drives you to and from the appointment but it is not mandatory. If you think you will need medication prior to your procedure (triazolam) to put you at ease, please let Dr. Filion know at the time of the consultation so he can give you a prescription. You will need a ride to and from our facility if you opt to take this medication (triazolam).
IS THERE A NO-SHOW OR CANCELLATION FEE?
Yes, there is a fee of $250 for no-shows and cancelations within 7 days of the procedure unless there are extenuating circumstances.
WHAT HAPPENS TO THE EJACULATED SPERM AFTER A VASECTOMY?
Because the portion of the vas deferens that is connected to the testicle is left open (i. e open ended, not cauterized or tied) the sperm spills into the scrotum. The body then simply reabsorbs it. This is the same process that occurs when you don't ejaculate for a while, the body just gets rid of unused sperm. Click here for video.
WHAT SHOULD I BRING TO THE APPOINTMENT?
Nothing in particular. We recommend that you get a ride to and from our facility. You WILL need someone to pick you up if you were given medication prior to the procedure.
DO I NEED TO FAST PRIOR TO THE PROCEDURE?
No, In fact we encourage you to eat a good breakfast before your vasectomy. We do not use general anaesthetic or put you to sleep so there is no need to fast. Click here for more preparation info.
ARE THERE ANY RISKS?
Every medical procedure has risks; arguably, so does an unwanted pregnancy. Specifically, the no-scalpel vasectomy has the following risks:
Bleeding: It is less common than with the traditional technique. Rarely, a small amount of blood can pool resulting in what we call a hematoma which may need to be drained. AVOIDING Aspirin, Advil and alcohol prior to your procedure will greatly reduce that risk. Taking it easy the first 3 days can make a difference as well.
Infection: This is relatively rare and occurs in approximately 1:4000 cases. Signs of infection include fever, chills, increasing redness, pain and worsening swelling (beyond what is typically expected). Most of the time, this can be treated with oral antibiotics prescribed by a physician. Rarely, an infection does not respond to oral antibiotics and can turn into an abscess requiring drainage.
Sperm Granuloma: Occasionally, a pea-sized lump can be found at the vasectomy site. This is variation of the normal healing process. It can cause mild intermittent pain which is typically treated with anti-inflammatory medications such as Advil or Motrin, Naproxen etc. In rare cases, some choose to have the lump removed years later.
Congestion: Some people experience tenderness and inflammation as the body reabsorbs the sperm. This can be treated with anti-inflammatories. Approximately 1-15% of men will have mild chronic discomfort that can affect quality of life, but is not severe enough to seek care. Although relatively uncommon, 1:2000 men will have Post-Vasectomy Pain Syndrome that is severe enough that they may seek vasectomy reversal or nerve type treatments.
Recanalization: Sometimes despite our best efforts, the body finds a way to reconnect the two ends of the vas deference allowing sperm to flow. This is why you must use another form of contraception until the lab can prove that there is no more sperm in your semen (usually after 12 weeks and 20-25 ejaculations).
Failure: Late failure, meaning an unwanted pregnancy after the man has been proven sperm free, is rare and much less frequent than other forms of birth control such as tubal ligation, the pill etc. (click here for alternatives). This depends on the technique, but the rate of failure is approximately 1:2500-1:3500.
WHEN CAN I GO BACK TO ...
This is the most common question we get.
Work: It depends on the work you do and how scrotal intensive it is. Most men with sedentary jobs can go back to work in 2-3 days after their procedure. If your job is very physical, you may need to wait 5-7 days. A sick note will be provided at the time of your procedure.
Working out: You can go for gentle walks and light upper body workouts on day 2 if pain allows. You can gradually return to full-body workouts after >7 days. Use pain as your guide.
Running: You can usually return to running on day 3-5, use pain as your guide.
Swimming: We recommend you wait at least 7 days before swimming to reduced the risk of infection.
Hot tub: it is not recommended for at least 2-3 weeks as it will increase your risk of testicular swelling, pain and bleeding.
Biking: We recommend you wait at least 7 days before biking.
Sex: Urologists generally recommend waiting 7 days before ejaculating.
DO YOU USE LASERS?
No, lasers are not used for vasectomies.
IF YOU CUT THE VAS, WHAT HOLDS THE TESTICLES IN THE SCROTUM?
There are multiple structures holding your testicles in place within your scrotum (click here for anatomy). The vas functions as a tube and does not provide structural stability to the testicle. You should not notice a difference in how they feel.