Vasectomy: everything you need to know about getting “the snip”

While having a vasectomy can be daunting, it’s a simple, routine procedure to prevent unwanted pregnancies. Here’s an overview to help you understand the essentials and make a decision.

Vasectomies are one of the most effective forms of birth control, but can be daunting for men. What does it involve? Does it hurt? Are there any risks?

Will I lose my sex drive? Will it affect my orgasms? Can it be reversed? These are valid questions, all with good answers.

The vasectomy procedure

A vasectomy is a simple procedure that takes less than 30 minutes. The operation prevents sperm from travelling from the testicles to the penis to avoid getting a woman pregnant.

Vasectomies were illegal until 1971 but now, the procedure is very common – about 25,000 Australian men have one every year and around one in four men over 40 have had one.

Dr Geoff Cashion performs about 30 no-scalpel vasectomies every week around Australia.

“We do it under local anaesthetic,” Dr Cashion explains, “so a couple of little stings in the scrotum just to numb everything up, much like you would experience when you go to the dentist.”

Then the doctor will cut the vas deferens tubes to prevent them from carrying sperm and mixing with seminal fluid. When ejaculating, the fluid will then contain no sperm.

No-scalpel vasectomies are the least invasive, don’t require stitches and produce minimal scarring. They are also the cheapest method of the procedure.

The more traditional method involves two small cuts in the skin either side of the scrotum to achieve the same outcome.

For further peace of mind, it’s recommended to have the procedure with a practitioner who specialises in vasectomies and performs them regularly.

How much does vasectomy cost?

After the Medicare rebate, Dr Cashion charges a $300 to $400 gap. It will cost more with a surgeon, which will vary depending on their costs and your private health cover.

What to consider

Most men who get a vasectomy are fathers who’ve had children and don’t want any more. A small proportion of young men might have decided they never want children or have a genetic condition they don’t want to pass on.

If they haven’t had children, Dr Cashion encourages men to explore their reasons for having a vasectomy more deeply. With older men who have partners in their 50s or 60s he will often discuss whether it’s really necessary. Other considerations include what they’re currently using as contraception and their medical history.

Vasectomy risks and recovery

Some men may choose to have a vasectomy under sedation instead of anaesthetic. Possible complications immediately after surgery include infection and internal bleeding but these are 1–2%, and even lower with the no-scalpel method.

After the anaesthetic wears off there may be bruising and a low-grade soreness and ache. Dr Cashion again compares this with a dental procedure. In his experience, at least half of men won’t need pain relief. Others will be fine with ibroprufen or paracetemol, and the pain should ease within a few days with full recovery by day seven.

“My advice to guys is you can get back to sex, running, gym, that sort of activity, after a week,” he says. “I just want them to take a little bit longer if they’re doing, say, cycling or contact sports.”

But he warns against unprotected sex straight afterwards.

“When we cut the tubes, they’re full of sperm, so there are millions of sperm that need to be cleared out.” Men are advised to do 20 ejaculations and wait three months before having a sperm test. “At that point usually we can clear them and they’re good to go.”

What about my sex drive?

There’s no reason the procedure will affect a man’s sex drive or ability to reach orgasm as it doesn’t involve the penis nor interfere with testosterone production.

“It’s essentially a diversion of a pipe [rather] than any change to hormone levels,” says Dr Cashion. “What we do find is, if anything, men’s sexual desire often goes up because they can have sex without worrying about unwanted pregnancy.”

A vasectomy does not prevent the risk of contracting or spreading sexually transmitted diseases (STIs) or HIV.

Although there’s no biological impact, in rare cases the procedure can impact men psychologically with concerns about identity and loss of masculinity because they can’t father children.

Is a vasectomy reversible?

Vasectomies may be reversed by reconnecting the vas deferens tubes – a procedure called vasovasostomy. Of men who have had a vasectomy, 3–6% will have a reversal.

In theory, successful pregnancy after reversing your vasectomy is possible and may be achieved in up to 80% of cases. Dr Cashion notes that men who have reversals – and their female partners – are often in an older age category, which could impact their fertility.

It’s also possible to extract sperm from the testicles for IVF.

While there’s a lot to consider, Dr Cashion says a vasectomy is a safe, common procedure with minimal risks.

Words by Natalie Parletta
First published April 2021