Long Term Risks of Vasectomy

Vasectomy is a one-time male contraception procedure that provides 99.9 percent efficacy in preventing pregnancies. It offers permanent contraception and, compared to the female procedure of tubal ligation, vasectomy is:

  • Simpler.
  • More effective.
  • Safer, with fewer complications to patients.
  • Much less expensive.
  • Conveniently performed on an outpatient basis.

Following a vasectomy, you will find sex with your partner more spontaneous and enjoyable. After all, you will no longer have to worry about a potential pregnancy or need to interrupt pleasure to apply contraception.

So what are the long-term benefits and risks of a vasectomy?

Vasectomy is typically performed on younger men in their thirties and forties. These men still have many years of their lives during which long-term health effects might appear.

Luckily, medical studies have examined the long-term health impact of vasectomy and the evidence suggests there are no significant risks. In fact, men who have undergone vasectomy have basically the same risk of developing heart disease, cancer, or other health problems as those who have not.

Let us now consider the specific issues.

1. Vasectomy and testosterone levels

Vasectomy does not affect the secretion and release of testosterone—the male hormone responsible for facial hair, sex drive, deep voice and other masculine traits. Hormonal tests in those who have had a vasectomy show that there is no significant change in both free and total testosterone. Hormone levels in the body remain within normal range. There is also no significant difference in testicular or epididymal size after a vasectomy.

2. Vasectomy and sexual function

Can a vasectomy affect your sexuality negatively? Studies indicate there is no such effect. Apart from changing your fertility, a vasectomy will not influence your sexual and reproductive physiology. The nerves that are critical for erectile function and ejaculation remain intact and you will still achieve normal erections, climax and produce the same amount of ejaculate—only that your semen will not have sperm.

The procedure will not diminish your libido, which is related to various hormones in the body that are not altered by the surgery. Even your sperm production remains normal except that they are reabsorbed in the body. So the only change you are likely to have is ability to enjoy yourself without the worry of pregnancy.

3. Pain, discomfort and abscesses

The cause of post-vasectomy pain syndrome is unclear, but on rare occasions when it occurs, it can be a challenging urological problem. An estimated 1-2 percent of men experience chronic scrotal pain after a vasectomy that ranges from a dull, aching sensation to a sharp, biting pain. There is no single treatment for the pain, but your urology will tailor a solution for you should it occur, and it will rarely require further surgery to reduce or correct.

Abscesses are quite rare after a vasectomy, but they may occur. In typical cases, they result from post-operation infection at the surgical site. Fortunately, most respond to treatment with antibiotics and eventually resolve. However, when left untreated, the abscesses can fill with fluid and may need to be drained. So if you suspect you have an abscess after a vasectomy, you should see your urologist immediately to stop the condition from getting worse.

4. Epididymitis

In 1-3 percent of men who undergo vasectomy, inflammation of the epididymis may occur—a condition called epididymitis. The epididymis is a duct found behind the testicles that allows flow of sperm to the vas deferens. It is highly coiled and very narrow; since sperm still flows through the epididymis to the vas deferens after a vasectomy, the duct may get inflamed when the sperm get backed up as the vas deferens is already severed.

Inflammation of the gland is rare, but is often characterized by tenderness, pain and swelling. Some urologists recommend anti-inflammatory drugs to help with epididymitis, though the swelling should be gone within a week or so after surgery. If it gets worse after the first week, speak with your urologist about it.

5. Sperm granulomas

Cutting the vas deferens during a vasectomy ensures sperm is stopped from reaching scrotal tissues. In some cases, however, the sperm may leak through the cut vas deferens into scrotal tissues. When this occurs, the sperm may form a hard, occasionally painful lump or mass, the size of a pea, called granuloma in the scrotal tissue.

Once formed, a lump can cause small bumps or cysts, which range in size from 1 millimeter to 1 centimeter. Lumps may also produce multiple lesions that tend not to produce symptoms, though some men may experience pain at the granuloma areas. Studies estimate that 15-40 percent of men undergoing vasectomy have sperm granulomas.

While sperm granulomas are not usually dangerous and often gets absorbed by the body, some cause pain and swelling in the genital region. Actually, the entire area may become sensitive to temperature and pressure changes. Most granulomas respond to anti-inflammatory drugs and the sensitivity and swelling subsides within a week after treatment. But in some extremely rare cases, reverse vasectomy may be necessary if the leakage does not stop and the swelling becomes increasingly worse.

6. Vasovenous fistula

This is another rare risk of vasectomy. It occurs when several blood vessels adhere to the vas deferens injured when vasectomy is done. It can cause pooling of blood vessels leading to development of a fistula, or abnormal association between the vas deferens and close by blood vessels. The symptoms of vasovenous fistula may include blood in ejaculate or urine. Although the risk is quite rare, you need to seek immediate medical attention should these symptoms occur.

7. Immune based illnesses

Some men may have immune reactions to the sperm that gets absorbed in their bodies after a vasectomy. The effect is the possibility of immune reactions that may lead to heart disease and other immune-based illnesses. However, many extensive studies have concluded that a vasectomy does not lead to immune-based illnesses or heart disease later in life. In fact, studies show that the risk of immune-based illnesses is so insignificant that it should not concern either the urologist or the patient.

8. Vasectomy and cancer

One serious concern has been the possibility of a vasectomy increasing the risk of having prostate or testicular cancer. A study published in the Journal of the American Medical Association in 1993 suggested that 20 years or more after a vasectomy, men who have undergone the procedure are twice as likely to develop prostate cancer compared to men of the same age group who have not undergone the procedure.

However, reviews of the study by the medical community have since demonstrated that the study did not include enough participants and the findings are therefore not statistically significant. In fact, compared to other studies that have used PSA tests to establish the possible risk of prostate cancer, the general consensus is that vasectomy comes with no increased risk of the cancer.

The risk of prostate cancer among men who have and those who have not undergone the procedure is the same when PSA tests are combined with digital rectal exam, ultrasound or prostate biopsy. Therefore, as a rule, men should undergo prostate cancer screening whether or not they have had a vasectomy. Likewise, there have been no reports of increased risk of testicular cancer after a vasectomy.

At St Pete Urology, we have offered vasectomy services for decades and we are proud of the results. The procedure has minimal long-term risks compared to other surgical procedures and provides men the freedom to enjoy sex without having to worry about a possible pregnancy. And the risk of prostate cancer, testicular cancer, heart disease, immune-based illnesses and other conditions are too insignificant to stop you from having a vasectomy.

We are ready to answer all your vasectomy related questions and concerns during your consultation. For more information, schedule a consultation or visit the St Pete Urology website.

5 Things You Need to Know About Men’s Sexual Health

5 Things You Need To Know About Men's Sexual Health Image

Sex is a critical part of life. It helps in the perpetuation of species and provides an amazing source of pleasure. It ensures intimacy between partners while making bonds stronger and unions enduring. It is also a wonderful form of exercise that releases stress, gets rid of anxiety, boosts prostate health and improves overall health.

What is sexual health?

It is the state of wellbeing that enables a man to engage in and derive pleasure from sexual activity. You are sexually healthy if you have sexual desire (libido), can get and sustain an erection, and can participate in satisfactory sexual intercourse. Sex is a hormone-driven activity that begins at puberty and lasts your entire life.

On average, couples have sex once a week. Each sexual encounter typically lasts 15-30 minutes, though the actual penetration time averages 2 minutes. If you are in a relationship, you may be having less sex than you want due to a lack of intimacy or time. But by working on communication and spending quality time together, you and your partner can improve your intimacy and have a more gratifying sex life.

What should you know about men’s sexual health?

Sexual health in men is affected by a number of physical, psychological, social and interpersonal factors. For example, physiological changes can impact both the desire and the ability to have sex, while emotional and mental factors can determine the satisfaction achieved during sexual intercourse.

As a man, the knowledge of the following male sexual health issues can enable you to achieve better sexual and overall health.

Aging and sexual health

With increasing age, changes are bound to occur in your sexual function, most of which are normal. But even in your 80’s, you should still be able to enjoy sex and intimacy in your relationship. Nevertheless, one frequent effect of aging on sexual health is loss of libido (sex drive)—often due to decreasing testosterone levels. Loss of libido means you have reduced interest in sexual activity or diminished sexual thoughts. You can also lose your libido because of stress, anxiety, relationship issues, side effects of medication or some medical conditions.

If you are experiencing a reduced drive for sex, look out for the symptoms so you can describe them correctly when you speak with your urologist. One way to deal with reduced sexual urge is to take more time in direct stimulation or foreplay. For changes that occur drastically or refuse to go away after sex therapy, work with your urologist to differentiate normal from abnormal changes and receive proper treatment.

As a rule, do not assume that every change that occurs in your sexual function is because you are growing older. After age 40, make sure you are aware of the following health indicators:

  • Cholesterol levels
  • Blood pressure
  • Blood sugar levels
  • Testosterone levels
  • PSA (Prostate-specific antigen) levels

Erectile dysfunction (Impotence)

Erectile dysfunction (ED) means you are not able to get and maintain an erection that is firm enough for satisfactory sexual intercourse. It is a common sexual health issue affecting up to 50% of men above the age of 40. You may experience erectile dysfunction because of blood flow problems such as vascular disease or blood pressure, which are quite common among aging men. But other factors such as certain medications, use of alcohol and drugs, smoking and surgeries involving prostate cancer may also cause impotence.

Fortunately, medications treat 50-70% of ED cases effectively. However, if your condition does not improve with medication, your urologist can apply various non-surgical techniques to promote blood flow. There are also surgical options such as penile prostheses or implants. Surgery is not advisable as initial treatment; but when done as a last resort it usually delivers satisfactory results.

In some cases, erectile dysfunction is not due to a detectable physiological problem. Your urologist will evaluate your condition in terms of emotional or mental well-being and may recommend you work with a sex therapist. Stress, anxiety, depression or other emotional or psychological problems can often be alleviated by therapist who encourages a comfortable, honest and confidential discussion of the problem.

Peyronie’s disease

Peyronie’s disease develops when scar tissue or plaque occurs inside the erectile tissue of the penis. Though the actual cause of scar tissue formation is unknown, many men have suffered the condition following a minor trauma that elicited bleeding inside the penis. The resulting plaque is usually benign and noncancerous, but it tends to cause the bending of the penis downward or upward depending on its location.

Men with Peyronie’s disease usually experience pain during an erection and find it difficult to have sex. If you have this problem, you need to see a urologist for a timely diagnosis and treatment. The condition is diagnosed using an ultrasound exam which gives a clear picture of the erectile anatomy and function. Most cases of the disease are mild and the initial pain disappears within 6-12 months, allowing patients to return to normal sexual activity. Urologists treat remaining plaques using personalized treatment plans.

Ejaculation disorders

Ejaculation issues in men include premature ejaculation, inhibited (delayed) ejaculation and retrograde ejaculation. When you have premature ejaculation it means you are not able to delay ejaculation until the point when it is mutually desirable for you and your sex partner. It is the most frequent ejaculation issue, particularly among younger men.

Inhibited ejaculation means your ejaculation occurs slowly or never happens at all. Both premature and inhibited ejaculations have psychological causes, such as anxiety about sex, performance or trauma. But there are techniques that can be used to overcome these issues and a qualified therapist can help you. Speak with your urologist for treatment and referral to a sex therapist when necessary.
Retrograde ejaculation means the ejaculate is forced back into your bladder instead of through the urethra and out of the end of the penis at orgasm. It can be due to nerve damage, side effects of medication or surgery for bladder or prostate.

When you experience retrograde ejaculation, your urologist will change your existing medications or prescribe new ones to treat the issue. However, if the problem is caused by surgery, it might not be correctable. But that should not worry you as treatment is not usually medically necessary with retrograde ejaculation unless pregnancy is your goal.

Vasectomy is permanent contraception

Vasectomy is a simple, effective and minimally invasive surgical procedure offered as a permanent method of birth control. The 30-minute procedure involves cutting tubes that transport sperm within the male reproductive system.

The procedure does not affect the sexual health of a man and is very effective in preventing pregnancy. While vasectomy can be undone, the reversal is quite complex and comes with a lower chance of success. The time to undergo a vasectomy is when you are sure you no longer need to make your partner pregnant, for whatever reason, and consider it as a permanent method of birth control.

At St Pete Urology, we offer timely help to men with sexual health issues. We believe that speaking about these issues with a skilled and experienced urologist will help you resolve them. We also remind our clients that any sexual health issue that lasts several months may be an indicator of a more serious underlying medical issue that needs to be treated.

For instance, premature ejaculation may be due to nerve damage, medication or underlying urinary conditions. Problems with libido or erection may be the first indicator of diabetes or hormonal imbalance; while problems with erection may be due to underlying prostate cancer or cardiovascular issues. Hence, seeing a urologist for your sexual health may help uncover a potentially life-threatening condition.

Of course, there is also a connection between your overall health and your sexual health. In fact, hormonal, cardiovascular, neurological and psychological systems all contribute to your sexual performance. A healthy lifestyle that includes a good diet, healthy weight and regular exercise will promote your overall health while enhancing your sexual health and performance. For more information on men’s sexual health issues, visit the St Pete Urology website.

How soon can I have sex after a vasectomy?

Men have a vasectomy in order to not have to worry about conception when they are making love. A vasectomy is one of the few ways men can have control over their reproductive capacity. It’s also one of the most reliable ways to prevent an unwanted pregnancy.You may have questions before or right after having a vasectomy. Here are some answers to the most frequent questions.

What is a Vasectomy?

Considered a minor surgery, a vasectomy is when the vas deferens is cut and the two ends are seal and tied together. Depending on factors that your urologist can discuss with you, you will either have a conventional vasectomy or a “no-scalpel” vasectomy.

During a conventional vasectomy, the surgeon will make one or two small incisions in the skin of the scrotum to access the vas deferens. The surgeon may remove a small piece of the vas deferens before searing the ends and tying them off with a suture. The procedure is repeated on both sides. The small cuts in the scrotum may be closed with dissolvable stitches or simply left to close on their own.

For a no-scalpel vasectomy, your urologist will locate the vas deferens by feeling for it under the skin of your scrotum and place a small clamp on the vas. A minute hole is made in the skin, which is stretched open so the vas deferens can be lifted out to cut, and then the ends are tied or seared, and replaced.

What will sex be like?

A vasectomy is a fairly simple procedure without long-term effects on sexual activity. Your surgeon may recommend abstaining from sex for a short time afterward. This is to allow the incisions and sutures time to heal.

Normally the recommendation is to wait for any pain or swelling to resolve before having sex. The reason you should wait to have sex is because if it is too soon, you could reopen the site of the incisions and infection-causing bacteria might enter the incision.

Most men can resume sexual activity within a week or two. During the time shortly after your vasectomy you should use an alternative form of birth control because it takes a little while before all the sperm is cleared from your ejaculate. Your doctor will test your semen sometime after surgery, usually around six to twelve weeks.

Having a vasectomy rarely changes anything about ejaculation or orgasm. There are a few cases of post-vasectomy pain syndrome. But most patients have only the following post-surgical inconveniences which generally go away on their own:

  • mild to moderate pain or discomfort
  • bruising or soreness of the scrotum
  • blood clots in the scrotum
  • swelling in your genital area or scrotum
  • blood in the semen

Having the peace of mind that a vasectomy delivers sometimes can enhance sex life, with better arousal and erections. About three months after your surgery, you can have unprotected sex without fear a possible pregnancy. However, it is always wise to use protection with a new partner.
To find out more about the vasectomy procedure, visit St Pete Urology’s websit.

Can a vasectomy fail?

A vasectomy is a form of male contraception that is administered through a minor surgical procedure. During a vasectomy, the patient’s vas deferens are cut and the ends are tied up or seared so they are blocked. The vas deferens is made up of two narrow tubes that transport sperm to the ejaculatory duct during ejaculation. A vasectomy inhibits the transportation of the sperm to the duct, so only seminal fluid is discharged when a man ejaculates. The absence of sperm removes the possibility of conception. A vasectomy is considered to be the most efficient form of birth control. However, there are instances, though very rare, in which pregnancy occurs even after the man has had a vasectomy.

Reasons why a vasectomy may fail

1. Recanalization

This is a medical term for when the cut vas deferens reconnect and revert to something like what they were before the vasectomy. This process happens naturally when tissue from the cut ends gradually grows until the two ends reach one another and reconnect.

Tiny channels also can form in the healing scar tissue of the snipped vas deferens and provide a passageway for sperm from one end of the vas deferens to the other.

2. Surgical error

In very rare cases, surgeons have been known to make an error during the procedure. This might mean either that the vasectomy was not done at all or that it was done in a manner that might cause it to fail.

Such errors could be:

a. Cutting one vas deferens and leaving the other;

b. The surgeon cuts completely different tubes that are not the vas deferens; and

c. In the very rare cases where the patient has duplicated vas deferens, that is to say two vas deferens on each side rather than one on each side as is the normal case, and the urologist cuts only one of the two .

d. Having intercourse too soon

Men who have had vasectomies are always advised to avoid having sex too soon, and if they do, to use another form of contraception. This is because semen does not become clear of sperm immediately after the vasectomy. The standard practice is to wait for three months after the procedure. After the three months, a urologist should conduct a semen analysis and advise accordingly.

Vasectomies are largely successful. Any man considering it has absolutely no reason to fear that it will fail because they rarely do. However, after undergoing the procedure, the patient must take care to observe all guidelines given by the urologist. A little anxiety before the procedure might be expected but the advice of a trained urologist, such as those available at St Pete Urology should dispel the worry. The team of specialists at St. Pete Urology can help with questions, consultation, surgery and follow up steps for a vasectomy. For more information, visit the St Pete Urology website.

5 Facts Men Need to Know About Vasectomy Reversal

Vasectomy is a form of male contraception. It is achieved through surgically cutting or sealing the vas deferens, which transport sperm from the epididymis to the ejaculatory duct during ejaculation. The result is that during ejaculation, the semen ejaculated does not contain sperm. Vasectomies are so efficient in preventing conception that for a long time they have been considered as a form of sterilization. The reality, however, is that with modern medicine, a vasectomy does not have to equal sterilization. It can be reversed through a procedure called a Vasectomy Reversal.

Facts about Vasectomy Reversal

A vasectomy reversal aims at rejoining the cut ends of the epididymis or unblocking them if they had been sealed. Important facts include:

1. It is a precise but outpatient procedure. A vasectomy takes about two hours. The patient can go home the same day. The fact that it is an outpatient procedure, however, should not take away from the fact that vasectomy reversal is a very precise operation that makes use of micro surgical techniques. The sutures made are extremely fine.

2. High success rate. Vasectomy reversal procedures are reported to have a success rate of over 90 percent. Even so, patients should appreciate that the rate of conception will be influenced by factors beyond themselves, such as the fertility of their partner. As such, conception may not happen immediately.

3. The procedure. A vasectomy reversal involves making two incisions on the side of the scrotum through which the vas deferens can be accessed. The surgeon then cuts open the tied or sealed ends and sutures them together.

4. Age of the vasectomy may affect success rate. Reports indicate that vasectomies done not more than ten years ago have the highest success rates. The success rate starts to decline when the vasectomy was performed more than fifteen years ago.

5. Short recovery period. Due to its relatively minor nature, a vasectomy reversal heals quickly and requires little after care. Patients, however, are advised to wait at least six weeks before they return to having sex.

The success of a vasectomy reversal requires almost pinpoint accuracy. A patient, therefore, should place a great deal of weight on the experience and training of the urological specialist or surgeon who does the procedure. St. Pete Urology has a strong track record of experienced specialists who can work with the individual in determining what is the best plan for him and answer questions or concerns. For more information, visit the St Pete Urology website.

What are the risks of vasectomy?

You have all the children you want and have decided not to have any more. You can now enjoy a sex life with your partner without worrying about pregnancy if you opt for an effective method of contraception. There is no form of male contraception more reliable than a vasectomy, so is it the right decision for you?

Choosing a competent, experienced surgeon for your vasectomy procedure

If you’ve made the decision, what must you do to improve the success of your vasectomy and minimize the risk of complications? You must make sure it’s done by a qualified and experienced surgeon. When a vasectomy is performed correctly by a skilled and experienced physician, only about 1 in 1,000 vasectomies may fail to prevent sperm reaching the semen. But when done by a doctor who performs less than 50 vasectomies a year, the likelihood of failure is as high as 10-17 percent or more.

How are vasectomies done?

Your sperm is generated in the testes then stored in the epididymis, a sac adjacent to the testes. The sperm is driven through the shoestring-sized tube known as the vas deferens, about 15 inches long, by a whip-like motion of a tail. Because the vas deferens is connected to the prostate gland that produces semen and also with the seminal vesicles located near the bladder, sperm is able to find its way into the semen to reach the ova after an ejaculation, causing a pregnancy. Failure of sperm to reach the semen means a pregnancy won’t occur.

To conduct a vasectomy, a surgeon kneads the scrotum tenderly until the vas deferens are located — a process similar to a guy looking for a tie-string that has withdrawn into his sweatpants’ waistband. Once the doctor finds the vas, a needle is used to poke a hole in the scrotum before tiny clamps are applied to draw out a small portion of the vas. Then the surgeon cuts, closes or inactivates the two clipped ends of the tubes so sperm won’t get out of them.

There are a number of techniques for achieving this, but the best method currently is the intraluminal cauterization and fascial interposition, That is a technique involving the slicing of the vas in two, scarring the inside (lumina) of the vas using a heated needle, then pulling up the fascia (tissue that surrounds the tube) and clamping or suturing it over the vas end. With the procedure completed, you are ready to return home the same day and take a few days off work to recover.

Fascial interposition improves vasectomy success

During the vasectomy procedure, the doctor sews up the tubes to prevent “recanalization,” which may occur if microscopic channels develop between the tubes’ cut ends. And when recanalization happens, sperm may pass through micro-channels and get into semen, leading to a failure of vasectomy.

When the ends are only clipped but not cauterized up to 1-in-300 men can still get their mates pregnant after a vasectomy. In fact, according to one study of 14,000 men who had undergone a vasectomy, there were six pregnancies and up to 10 percent of men had significant numbers of sperm in semen months after their vasectomy.

However, with the fascial interposition technique, the surgeon puts tissue between the cut ends, which acts as a double zip and lock. The result is that pregnancy rates drop to 1-in-7,000 and only about one vasectomy may be redone per year. Nevertheless, the skill and experience of the urologist conducting the vasectomy still remains the most critical factor for success and minimal complications.

Improving vasectomy success

Three months following a vasectomy there will still be sperm swimming around “downstream” beyond the cut area. It is crucial to use another birth control method such as condoms to prevent pregnancy. At 12 weeks after the procedure, a follow-up test for the presence of sperm in semen is necessary — with a negative result confirming that the procedure was successful.

But even with the negative result, there is still a 1-in-2,000 chance that you can later regain your fertility. If a pregnancy does occur, you should assume that the body has healed and you’re again capable of making your mate pregnant.

Vasectomy pain

A significant number of men fear getting a vasectomy because of pain. But how bad is the vasectomy pain? While the procedure is almost painless when properly performed, it’s common to feel some soreness afterward. Studies show that somewhere between 1-50 percent of men have chronic testicular soreness, including epididymitis (blue balls) for up to a year after the procedure. And as many as 15 percent of men may experience a seriously aggravating pain after the procedure. The pain, however, is managed with painkillers and would rarely hamper your ability to engage in routine tasks.

Sexual intercourse should be postponed for at least a week after a vasectomy. Some men who have tried sex a day or two after the procedure have reported terrible pain and swelling of the scrotum. Again, it’s important to remember that the surgeon’s experience and technique will determine how much pain you experience after a vasectomy.

What of the link between prostate cancer and a vasectomy?

A few studies were published in early to middle 1990s that reported that prostate cancer is linked to a vasectomy. However, a more conclusive survey conducted in New Zealand disproved such a link. Another study by researchers from the University of Toronto and Mayo Clinic in Rochester examined results of 40 different studies with over 12 million participants and concluded that a vasectomy does not enhance the risk of a man developing prostate cancer. So as we now know it, there is no link between prostate cancer and a vasectomy.

Vasectomy and dementia

A 2006 study by researchers from Northwestern University appeared to relate vasectomy with dementia, causing some concern by highlighting a plausible, even if unlikely, mechanism through which vasectomy can result in brain damage. Triggered by a patient at an Alzheimer’s clinic complaining that his aphasia (speech problems) started soon after a vasectomy, the researchers surveyed 47 clinic patients with early-stage aphasia and found that 19 of them had undergone a vasectomy.

According to the study, sperm can leak into the body’s normal tissue after the vas deferens is cut resulting in the development of antibodies to sperm in the blood. This was observed in about two-thirds of vasectomized men (sperm doesn’t normally get into the bloodstream). From the observation, the Northwestern study theorized that if antibodies to sperm — which contain some proteins also found in brain cells — appear in blood, they may lead to an autoimmune attack of the brain cells resulting in dementia. Nevertheless, being a small study that hasn’t been replicated, it’s still quite early to draw much from it. And for now, dementia still remains only hypothetically linked to a vasectomy — though the association requires further research.

Effectiveness of vasectomy reversals

Vasectomies are reversible. That’s true. But when making the decision to undergo the procedure, it’s important to approach it as a permanent method of sterilization and not by expecting it to be undone. In fact, when done well, it can only be reversed successfully about 50 percent of the time and with no guarantees that you’ll have children. Only go for a vasectomy if you are sure you have had enough children or don’t want any children. Also make sure to ask all the questions and go for the procedure only when you are truly ready for it.

At St Pete Urology, we offer both vasectomy and vasectomy reversals using procedures that ensure maximum comfort and the least pain for our patients. We have assembled a team of skilled, knowledgeable and experienced urologists who perform hundreds of vasectomies every year. So you can be sure that your procedure will follow the right technique and have the highest chance of success. For more information on vasectomy and vasectomy reversals and their risks and benefits, visit the “St Pete Urology” site.

Vasectomy Reversal – Does it REALLY work?

A vasectomy reversal is the procedure to reconnect the tubes (vas deferens) that are cut and sealed off during a vasectomy. Though still considered a permanent method of birth control, advances in microsurgery have ensured that it can be reversed even after 15 years or more. Men can choose to undergo a vasectomy reversal after a remarriage, a change of heart, loss of a child, or to treat testicular pain associated with a vasectomy. The reversal is typically an outpatient procedure performed under general or local anesthesia, taking around 3 hours and followed by a short recovery period. Nevertheless, only about 6 percent of men who undergo a vasectomy choose to have it reversed later.

Success rate of vasectomy reversal

The success rate of reconnecting the tubes severed during vasectomy is quite high, about 90 percent. After a successful reconnection of each tube, sperm is again able to pass from the testicles through the tubes and reach semen, and a man may again be able to get his partner pregnant. But the success of a vasectomy depends on a number of factors, such as the state of the tubes during the reversal and how many years have elapsed since the vasectomy was done.

If you undergo a vasectomy reversal within seven years of the vasectomy, the reversal is a simple procedure of putting the vas deferens back together. But if the tubes are too short to reconnect, if there is scarring or it’s been more than seven years since you had the vasectomy, the reversal process may be more complex. However, even with the more complex procedure, the success rate is still around 50-60 percent with no much difference in pregnancy rates — the average being 50-60 percent likelihood of pregnancy, which drops to 44 percent if time since a vasectomy is greater than 15 years.

If the time since vasectomy is less than 15 years, the reversal provides a pregnancy rate that’s higher than in vitro fertilization (IVF) and sperm aspiration with intra-cytoplasmic sperm injection (ICSI). And even after intervals greater than 15 years since a vasectomy, the reversal still gives outcomes equal or greater than IVF with ICSI.

Vasectomy reversal techniques

Vasectomy reversal is usually performed in two ways. The first technique is vasovasostomy (VV), which is basically the piecing back together of the two sides of the tubes (vas deferens) — that is vas deferens to vas deferens. The other technique is vasoepididymostomy (VE), which involves reconnecting the vas deferens to epididymis, the duct that transports sperm to the vas deferens. Generally vasovasostomy (VV) is done if sperm is present in the vas fluid. If sperm isn’t present in the fluid, vasoepididymostomy (VE) is the go-to procedure. In some cases, a combination of both techniques may be necessary, with a vasoepididymostomy done on one side and a vasovasostomy on the other.

A vasoepididymostomy is slightly more complicated and therefore chosen only when a vasovasostomy is impossible or can’t work. You won’t know the technique that the surgeon will use until the operation begins and that usually depends on whether sperm is present in the fluid found in the vas deferens at the time of surgery. Both are outpatient procedures that take less than 3 hours. A man has a successful vasectomy reversal if sperm evaluations performed several months later indicate he has the normal sperm count necessary for conception.

How should you prepare for a vasectomy reversal?

A vasectomy reversal is a complex and expensive procedure that’s often not covered by insurance. So you should find out what you’ll need and all the costs well ahead of time. The procedure is generally more successful when performed by surgeons who are trained and experienced in microsurgical techniques and who have done the procedure several times. So when choosing a doctor for the procedure, find out how many reversals the surgeon has performed, the techniques used, how often pregnancy has occurred after surgery, and the risks and complications involved.

Similarly, you’ll need to buy tight-fitting undergarments (like an athletic supporter) that you will wear after the procedure to hold bandages in place and support your scrotum. You also will need to stop taking medications that increase the risk of bleeding, including pain relievers (like ibuprofen or aspirin) and blood-thinning drugs. You should make arrangements for your travel to and from the hospital and for the length of time you will need to recover after surgery.

What should you know before a vasectomy reversal?

Vasectomy reversal is performed as an outpatient procedure that doesn’t require an overnight stay in a hospital. Before the procedure, the surgeon will take your medical history and conduct a physical examination to make sure you’re not having any health problems that may lead to complications after or during surgery. If your physical exam shows abnormal results or you’ve got sexual function issues, the doctor may consider running some blood tests. Likewise, a review of your surgical history is done to assess whether you had any previous surgeries other than the vasectomy or prior injuries that can hinder the vasectomy reversal. The doctor also will confirm whether you can produce healthy sperm. While evidence of fathering a child before is usually sufficient proof of the health of your sperm, additional testing may be necessary if there is uncertainty.

What happens during a vasectomy reversal?

Once you’re in the operating room, anesthesia is applied to minimize discomfort during the procedure. That may either be general anesthesia to keep you unconscious throughout the procedure or a local, spinal or epidural anesthesia to minimize pain but without putting you to sleep. The surgeon then makes a small incision on the underside of your scrotum to expose the tubes (vas deferens) and free them from surrounding tissues. Cutting open the vas deferens, the surgeon examines the fluid inside the tubes to establish whether sperm is present. If it’s found that sperm is present, the doctor simply reconnects the ends of the tubes to enable sperm passage. If the fluid inside the vas deferens is pasty, thick or contains partial or no sperm, that’s usually an indication that there’s a blockage of sperm flow and that vasovasostomy may not work. In that case, vasoepididymostomy is the more appropriate procedure.

What happens after the procedure?

After the procedure, the doctor applies bandages to cover the incisions. Make sure to ask your doctor when it will be OK to take the bandages off. The stitches applied should dissolve in 7-10 days. You will be required to wear tight-fitting undergarments (like athletic supporter) and apply ice to minimize swelling. The area may feel sore for many days, but the pain shouldn’t be severe and should improve within a few days to one week.

Once back at home, make sure to take it easy and avoid any activities that may move the testicles excessively or pull on the scrotum or testicles, such as heavy lifting, biking, jogging or sporting activities. For the next several weeks, wear an athletic supporter at all times, removing it only when showering. Avoid activities such as swimming and bathing for the first two days following surgery because they can make the surgery site wet. If your job requires much driving, walking or physical exertion, seek your doctor’s advice on when it’s safe to return to work. But for a desk job, you can return to work within a few days after surgery — only making sure that nothing harms the surgery site. Do not ejaculate or engage in sexual intercourse until your doctor gives you a go ahead — that is often 2-3 weeks after surgery.

What results should you expect?

To assess the success of a vasectomy reversal, the doctor will examine your semen 6-8 weeks after surgery. If the procedure is successful, sperm will be present in the semen. The appearance of sperm in semen should happen within a few months, but may take a year or more in some cases. So the doctor may have to conduct periodic semen analysis to evaluate the success of the procedure, unless your partner gets pregnant soon after the reversal. The prospect of achieving pregnancy usually depends on a number of factors, including the age of your female partner and the duration of time that has elapsed since the vasectomy.

Can the reversal fail to work?

If a blockage develops in the tubes after surgery or there is an underlying issue with your testicles that wasn’t recognized during surgery, a vasectomy reversal can fail to work and you may need a second-attempt reversal procedure. Doctors often opt to collect and freeze some sperm during a vasectomy reversal, which can then be used if the procedure doesn’t work. But if sperm isn’t frozen during the procedure or you completely lack sperm in your ejaculate, sperm can still be retrieved directly from your epididymis or testicle to help you have children via assisted reproductive techniques, like in vitro fertilization.

At St Pete Urology, we have a huge pool of urologists trained in andrology and experienced in microsurgical techniques. We conduct the procedure under very high-level magnification using incredibly small sutures. We perform several vasectomy reversals every year and boast significantly high success rates. So if you are looking for specially trained and skilled doctors to reverse a vasectomy in a way that will maximize your chances of having children, come and see one of our urologists. For more information on vasectomy and vasectomy reversal procedures, visit the “St Pete Urology” site.

Addressing 7 Vasectomy Myths

Alright guys, it’s time now to talk about the big V! When you hear about different birth control methods, whether through word-of-mouth, billboards, newspapers, TV or radio, you seldom hear anything about vasectomy. We want to talk to you about vasectomy now, explain away the myths and fears around it and shift the birth control discourse from the most common approach of what women should do to what men can do.

So what’s a vasectomy?

It is a simple, 15-minute non-drug permanent sterilization procedure for men. It’s performed under localized anesthesia and involves sealing off or cutting a portion of the sperm-conveying tubes (called vas deferens) in order to stop sperm from reaching the ovum when ejaculation occurs. If you are a man who has had all the children you wanted to have or are sure that you will never want to have any children in the future, vasectomy is a safe and cost-effective way to sterilize yourself.

Lots of questions

Yet, if you are like most men, you have probably heard the horror stories associated with vasectomy and you are worried that things may go wrong for you. Will it reduce my sexual pleasure? Will it turn me into a “eunuch” — a sad miserable man looking back constantly to his youthful years with nostalgia? And what if disaster strikes late in my life, or my life plans change, and I decide to have children? Can I reverse it? These and many more questions can make you have doubts about having a vasectomy. But it turns out these fears are baseless myths that shouldn’t stop you from a vasectomy.

What are the most frequent myths about vasectomy?

1. It will be intolerably painful

Honestly, for most men, the idea of the whole procedure can seem quite awkward. And since most of us have the habit of protecting our testicles from any type of direct assaults, a vasectomy seems like a real intrusion into a protected zone. But the truth is doctors who conduct vasectomies have gone through many years of study and training. They know what they are doing. They use the latest minimally invasive techniques to perform the procedure, ensuring that you feel no pain. The procedure is done under local anesthetic, so you will probably only have to worry about the needle going in. After that, you will remain aware of the procedure as it goes on but you will feel no pain or uncomfortable sensations.

2. Your penis won’t work

That’s wrong, mate. In reality, the procedure isn’t done anywhere near your penis — except of course if it’s causing an obstruction and the urologist has to move it out of the way. The snip is entirely about your balls and affects only those little tubes inside your balls that are called the vas deferens. Remember too that when you have sex and reach orgasm, the fluid that comes out, called ejaculate, is 97 percent semen and only 3 percent sperm. After vasectomy, you will still achieve orgasm and produce this ejaculate, except it won’t contain sperm and you won’t be able make your partner pregnant. That means your erections will remain exactly the same and your penis will stay as sensitive during sex as it was before the vasectomy. Likewise, your ability to enjoy sex and achieve orgasm will remain unchanged, though now you’ll be able to do so without having to worry about making anyone pregnant.

3. You will no longer ejaculate

That’s wrong, too. If you ejaculated before the snip, you’ll continue to do so after. Semen, the main component of ejaculatory fluid, is produced in the seminal vesicles and the prostate, which aren’t cut or blocked off during a vasectomy. And since only a small portion of fluid comes from the testicles with sperm, the overall volume of your ejaculate will reduce only slightly after a vasectomy — you won’t even notice it. Likewise, because the muscle contractions that propel fluid out during ejaculation typically come from the pelvis, your ejaculations won’t be affected by a vasectomy.

4. Your sperm production will shut down

Not true. Vasectomy doesn’t block sperm production and you’ll continue to make sperm after the snip. The only difference is that sperm will no longer reach semen and form part of the ejaculate. Because the sperm will go nowhere after a vasectomy, it will live for 3-5 days and decay naturally in the body. This is the same thing that happens naturally in men if they don’t ejaculate every 5 days or so. They produce sperm continuously but the sperm goes nowhere and is reabsorbed naturally in the body.

5. You can’t reverse it once it’s done

No, you can if you want. Vasectomy can be reversed through a surgical procedure called vasovasostomy (vasectomy reversal). During the procedure, the vas deferens (tubes) are reconnected, with each tube re-joined as it was before the snip in order to create a passageway for sperm, allowing sperm to again be present in semen. A successful reversal procedure restores your fertility and you can again make your partner pregnant. But when considering a vasectomy reversal, you need to consult an experienced urologist. That will ensure that no tissues are irreparably damaged during the reversal procedure.

6. Even if it’s reversed, you’ll remain impotent

Not really. With microsurgical advances currently used in vasectomy and vasovasostomy, the reversal has become more precise and more successful. So while vasectomy reversal is still technically expensive and demanding, doctors can now successfully restore a man to his pre-vasectomy condition. Although many men think that vasectomy can make them impotent, they should know that the procedure has no effect on blood flow to the spongy veins of the penis. These veins cause an erection. A vasectomy tends to make love-making more pleasurable and fun through the exhilarating feeling accompanying the ejaculation of spermless semen and also by erasing the fear of pregnancy.

7. It’s harder than a woman getting her tubes tied

A nice try indeed, but still wrong. Tubal ligation is performed under epidural or general anesthesia and typically takes longer than the 10-20 minutes required for a vasectomy. Tying a woman’s tubes also comes with a much more serious complication rate than a vasectomy. So why not just take the simpler route to contraception and block the source of sperm in order to remove the burden of birth control from women instead of looking for excuses to pressure women with contraception? After all, vasectomy is more effective than tubal ligation, costs much less and guarantees better results. In fact, for partners and couples considering family planning, vasectomy is a great cost-saving and effective solution to consider.

What if you are just one of those men who want to have multiple sexual partners without any additional responsibilities? Well, vasectomy works for that too. If you get a vasectomy, you can enjoy your lifestyle without having to worry about the possibility of fatherhood.

Want to know more about vasectomy? Speak with your partner and assess whether you have had all the children you want. Once you are sure of your decision, visit your doctor to discuss this birth control method. For more information on vasectomy and vasectomy reversal, visit the “St Pete Urology” site.

What It Actually Feels Like To Get A Vasectomy

You are married and got the number of kids you always wanted. You also have decided that your family is now complete, right? So, a vasectomy it is, then. For you know that three months after a vasectomy, you will be almost 100 percent sure of no pregnancy. And that it is reversible, with 40-90 percent success rate. That’s great. Now you can go for it and enjoy wonderful times together thereafter with your spouse — no more kids to worry about.

Ready to go?

Well, yes. But there is a problem. You don’t know what it feels like to have a vasectomy and that worries you. Will it hurt? What if something goes awfully wrong down there? How long will it take to get back to 100 percent? The Internet provides answers, but you can’t tell which answers are correct. You find several men saying the experience was so easy that they were able to run a marathon the day after. But others are complaining that their experience made them feel less of a man.

Learning from others

Both sound too extreme. You want to clear the gray areas; you want true, non-medical real-talk. You want to hear from a man who has had a vasectomy and can understand your concerns. Let’s talk about what you will experience, or rather what I experienced.

What is a vasectomy?

A vasectomy is a method of birth control that prevents pregnancy by stopping the supply of sperm to your semen. The tubes (vas deferens) carrying sperm from the epididymis to your ejaculatory ducts are sealed to prevent sperm from moving and getting into the semen. So you continue to ejaculate semen that doesn’t contain sperm and can’t cause pregnancy.

How is a vasectomy done?

Your doctor cuts open your scrotum to access the testicles (two balls inside your scrotum) and locate the tubes (vas deferens). Starting with one testicle, the urologist removes a tube, cuts a chunk out of it, closes the cut ends, puts the now-two tubes back into the testicle and stitches it shut. After that, the doctor turns to the other testicle and repeats the process. The entire procedure takes 10-30 minutes and you are free to go home. While you remain awake throughout the procedure, a local anesthetic applied to your scrotum makes sure you are numb down there. So you can engage in a chat with your doctor as the procedure goes on.

Does it hurt?

Yes, but not as much as you imagine. Initially, pain occurs when the anesthetic is applied. As the anesthetic is applied, you will feel as if someone is whacking your balls with a rubber band many times, resulting in deep, nauseating discomfort. But after that, everything down there becomes numb, though you may still feel the tugging, pulling and pressure during the procedure.

Can it go wrong down there?

Like any surgical procedure, a vasectomy comes with risks, such as infection and hematoma (bleeding in your balls). But overall, it is a safe and effective procedure. Your doctor will discuss with you all the risks of the procedure before you agree to it. And you will sign a waiver document for risks such as impotence, heart attack, bleed out, stroke and death. If you are worried that a vasectomy will trigger prostate cancer, this is the time to chat about it with your urologist. Of course studies have shown that there is no link between prostate cancer and vasectomy.

What about anxiety?

Anxiety can be a terrible part of a vasectomy. But many urologists prescribe medications to relieve anxiety, commonly a single Xanax prescription. If your doctor gives you this, don’t hesitate to take it. It will help you drift away mentally and relax, ensuring you are free from anxiety during the procedure. My urologist did not give me any such medication and I must confess that anxiety was the worst part of my experience.

What of post-op pain?

For a few days after the procedure, you have a dull, generalized soreness down there, accompanied by some low-grade stomachaches. With prescribed pain medication, you feel okay. I took Tylenol regularly plus rest and a couple of beers and felt fine. But the most serious post-op pain occurs when you catch one of the stitches with your underwear. It really hurts. I fell down like a potato sack, and believe you will too. Make sure you don’t catch one of these stitches.

How long will it take for you to recover 100 percent?

It’s different for each person. The doctor will tell you something like 10-14 days, but it may be longer or shorter for you. You definitely should keep off your feet for the first 24-48 hours and keep yourself on ice. You can start to shower after 48 hours, but that won’t be fun. I was able to walk around with slight problems after a couple of days, and started running again after a week with little soreness. I was able to resume my normal activities by day three, but that was because I felt pain-free and was quite bored after two days. Monitor your body well for pain and other complications before you get back to normal activities.

When can you begin to have sex?

The invasive stitches on your balls will remain tender and physically strange for a couple of days. This will make you quite anxious and less prepared for sex. My doctor said, “Go for sex when you are ready.” For me that was around 10 days after the procedure. Your case could be different. So don’t worry too much about it because you will get back to your old self pretty quickly once you and your spouse begin to ignite the flames of passion in the bedroom.

Where can you undergo the procedure?

Depends on which city you live in. But you should go for a doctor with years of experience performing the procedure. A place offering no-scalpel, open-ended vasectomy is great. Mine was done at St Pete Urology and it was great. The urologist was frank and friendly, and we explored a lot of questions before the procedure. Want more information on safe vasectomy? Visit the “St Pete Urology” site.

Is It Ok to Work Out After Getting A Vasectomy?

So you are thinking of having a vasectomy? And you fear it could disrupt your imminent project, work plan, business venture or regular workout routine? You really enjoy what you do and you can’t stand several days away from it. Your fears may be justified considering how long it often takes to recover from various medical procedures. But when it comes to a vasectomy, you really don’t need to worry. A vasectomy will keep you out for a far shorter time than you imagine. And in no time you will be back doing what you like.

Scalpel-Free Open Ended Vasectomy

Previously, vasectomy involved an incision in the scrotum using a scalpel, followed by blocking both ends of the tubes (vas deferens) with a clip, suture or diathermy. This closed-ended technique required stitching of the incision, which increased the risk of infection and complications, like congestive epididymitis (tenderness due to pressure build-up). However, things have since changed and the no-scalpel, open-ended procedure is now the norm. This technique only requires a tiny puncture in your skin using special forceps, followed by closing the upper part of your vas with a suture while leaving open the end of the tube connected to the testicle. In only 15-20 minutes, the procedure is done and you are out to begin your recovery.

Less Strenuous Activities

If all goes well, you can be back to your desk job soon after the procedure. But for a fitness routine or a more physically demanding job, you may require a few days off to recover before returning. Typically, the number of days you need depends on the type of activity you intend to undertake. For instance, you should not engage in activities requiring standing and walking all day or carrying loads greater than 10-15 kg until after one week. Likewise, for non-contact sports such as swimming, golf and tennis, you need 2 weeks before you can return. For cycling, you should take 2 weeks off before engaging in stationary cycling, at least 3 weeks before getting back to road cycling, and at least 4 weeks before you can engage in mountain biking.

More Strenuous Activities

Before you can engage in more strenuous activities, you need more time off to recover. For instance, contact sports such as soccer, rugby, martial arts, hockey or powerlifting will require at least a month off. If you fall in the powerlifting category, you may be tempted to use these four weeks off to build your one-rep max, but you must resist such temptations. In fact, you must avoid all sorts of heavy weights that come with low repetition sets, such as squats, leg press and heavy deadlifts. Such exercises can cause a massive build-up of internal pressure, which may lead to internal bleeding at the operation site and potentially result in a scrotal hematoma. A scrotal hematoma is a nasty lump that can be as big as a grapefruit in your scrotum and may take up to 2 months to resolve.

Sexual Intercourse

You can resume normal sexual intercourse one week after a vasectomy. But you should use contraception such as condoms for at least 3 months and until after your semen has been double-checked and found to be completely sperm-free. Ever heard of pregnancies after a vasectomy? Sex within 3 months after a vasectomy may still result in pregnancy because your semen may still contain sperm. So use contraceptives until your doctor confirms that your semen is sperm-free.

Work With Your Urologist

To prevent any problems and reduce the time you need to be off before resuming normal work, follow post-care instructions strictly and pay attention to your doctor’s guidance. By using a cold pack during the first 3-4 days after the procedure and avoiding strenuous activities until your body has healed properly, you will prevent potential complications (such wound reopening, pressure build-up and infection) and speed up your recovery. Fortunately, the most likely issue after a vasectomy is often just a mild ache that goes away in a few days and can be contained with Paracetamol.The other complications, such as hematoma, infection and sperm granuloma (a pea-sized lump on the cut end of your vas deferens) are quite rare.

At St Pete Urology, we offer the painless, no-scalpel open-ended vasectomy procedure. And we guarantee that you recover swiftly and get back to your most cherished activities very quickly. Have questions still? Find out more about safe, painless vasectomy by visiting the “St Pete Urology” site.