All You Need to Know About Vasectomy

A vasectomy is a form of contraception whereby the vasa (vas deferens) or the tube for sperm delivery is segmentally excised and ligated.

There are 2 types of vasectomy, which are a conventional vasectomy using a scalpel (surgical knife) and a no-scalpel vasectomy. The only intention for vasectomy is to prevent pregnancy. The thought of having a vasectomy can be daunting and involve many unknowns.

In this article, Gleneagles Hospital Kuala Lumpur's Resident Consultant Urologist explains the intricacies of what you need to know before having a vasectomy.

Are There Any Impacts to a Man’s Health After Undergoing a Vasectomy?

With vasectomy, the occlusion of sperm delivery will have absolutely no impact on a man’s health. The libido of the man will not be affected, as the level of testosterone, remains unchanged.

Adding to this, the blood supply to the penis is also unaffected after vasectomy, resulting in no changes to the quality of erection post procedure.

Lastly, even the volume and texture of semen remain the same. This is because the production and delivery of semen are predominantly determined by the prostate and seminal vesicle, therefore the ligation of vas deferens will not visibly alter the semen production.

In conclusion, the overall health and sexual health of a man including his libido, erection, orgasm, and ejaculation is completely unchanged after vasectomy.

Can a Vasectomy Be Reversible?

Vasectomy reversal is a common operation carried out if couples change their minds about family planning. This is also a common surgical procedure carried out when a man with a vasectomy decided to start a new family with a new partner.

Although the procedure for the reversal of vasectomy is not as straightforward as the vasectomy, this procedure can be successfully carried out with the advancement of microsurgery.

Most vasectomies are performed under local anaesthesia with minimal post-operative care. However, the reversal can only be carried out under general anaesthesia with much longer post-operative precautions. Occasionally men can also choose to store their sperm with sperm-banking services. This can avoid the reversal with the change of mind.

Will a Vasectomy Impact Sperm Count and Quality?

The quality of sperm will certainly be impacted by a vasectomy. The longer the interval after vasectomy, the poorer the quality of sperm would be after the reversal. The prolonged pressure in the sperm-delivering systems seems to harm the number, motility, and morphology of the sperm, following vasectomy.

Usually, the quality remains reasonable after ten years of vasectomy. However, the quality of sperm drops significantly beyond twenty years of vasectomy. On many occasions, the sperm quality may be unsuitable for natural conception following the reversal. This will support the use of in-vitro fertilisation (IVF).

What Are the Important Facts or Details Patients Need to Know Before Going Through Vasectomy?

Firstly, the patients need to be certain this is the form of contraception they are willing to take on. The advantages of vasectomy over tubal ligation in women are enormous. The procedure is not as risky, with less pain and complications in vasectomy; especially as this procedure can easily be done under local anaesthesia. Men who undergo vasectomy need to know the complication rate of the operation is as low as 2%.

The short-term complications may include mild pain and bleeding and complications are usually short-lived. Men who undergo vasectomy also need to know they need to produce semen to confirm the success of the operation through a semen analysis.

On rare occasions, which happens in one in two thousand men, the cut vasa will somehow rejoin itself. This can cause the operation to fail. Hence, until it is shown that the semen does not carry sperm cells, men who undergo vasectomy should continue using their present method of contraception if they have sexual intercourse (sexual intercourse can usually be resumed in about a week post vasectomy procedure).