Vasectomy

Dr. Clavijo offers a no-scalpel vasectomy in our clinic. He is a urological surgeon extensively trained in scrotal surgery and dissection of the vas deferens and surrounding structures. Along with each performing at least 4 vasectomies per week in the clinic setting, we can also offer a vasectomy in the operating room under anesthesia when it is deemed necessary due to difficult anatomy or patient preference (e.g. severe anxiety or history of fainting with minor procedures/blood draws).

The following concerns about vasectomy are typically discussed with patients during a consultation:

• Vasectomy is intended to be a permanent form of contraception.

• Vasectomy does not produce immediate sterility.

• Following vasectomy, another form of contraception is required until vas occlusion is confirmed by post- vasectomy semen analysis (PVSA). This is typically done at the 3 month mark.

• Even after vas occlusion is confirmed with a negative semen analysis, vasectomy is not 100% reliable in preventing pregnancy - spontaneous reversal with pregnancy is an extremely rare but real possibility. 

• The risk of pregnancy after vasectomy is approximately 1 in 3,000 to 1 in 5,000 for men who have post-vasectomy azoospermia (no sperm seen) or PVSA showing rare non-motile sperm (RNMS). This is called a late-failure. Consider, however, that even an intrauterine device (IUD) has a failure rate of about 0.2%.

• Repeat vasectomy is necessary in ≤ 1% of vasectomies, provided that a technique for vas occlusion known to have a low occlusive failure rate has been used. Dr. Clavijo and Lurvey use different vas occlusion techniques and this can be described precisely during consultation.

• Patients should refrain from ejaculation for approximately one week after vasectomy.

• Options for fertility after vasectomy include vasectomy reversal and sperm retrieval with in vitro fertilization. These options are not always successful, and they may be expensive.

• The rates of surgical complications such as symptomatic hematoma (blood clot in scrotum) and infection are 1-2%.

• Chronic scrotal pain (pain beyond 3 months) associated with negative impact on quality of life occurs after vasectomy in about 0.5-2% of men. Few of these men require additional surgery. Other permanent and non-permanent alternatives to vasectomy are available (e.g. tubal ligation in partner). However, one should consider the types and rates of complications in those settings.