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Many men who wish to have a vasectomy have probably heard of frightening myths surrounding this procedure. Not being able to have an erection or ejaculate are common misconceptions that could have reached your ears. If that’s what’s stopping you, we got you covered! Read on as Dr. Vikramjit Singh Saren, consultant urologist at KPJ Sentosa KL Specialist Hospital, offers an in-depth explanation of the male contraception method.

What is a vasectomy?

Dr. Vikramjit Singh Saren: A part of the male reproductive system is the vas deferens, which are tubes that carry sperm from the testicles to the penis. A vasectomy is a surgical procedure that involves cutting or blocking the vas deferens. This procedure is designed to prevent sperm from reaching the semen that is ejaculated during sexual intercourse.

During the procedure, a doctor will make a small incision in the scrotum and cut or block the vas deferens, either by tying or sealing them. This can be done using a variety of methods, including traditional surgical techniques or minimally invasive procedures that use lasers or other tools.

A vasectomy is a highly effective form of permanent contraception for men who do not wish to have children. It does not affect a man’s ability to have an erection or to ejaculate, but it does make him sterile.

Are there different kinds of vasectomies?

Dr. Vikramjit: Yes, there are different kinds of male vasectomies. The two main types of vasectomies are:

TRADITIONAL VASECTOMY

This procedure involves making one or two small incisions in the scrotum to access the vas deferens. The vas deferens are cut or blocked using sutures, clips, or cauterisation.

NO-SCALPEL VASECTOMY

This procedure is less invasive than the traditional vasectomy and involves using a special tool to make a small puncture in the skin of the scrotum instead of an incision. The vas deferens are then accessed and cut or blocked as in the traditional vasectomy.

Both types of vasectomy are effective at preventing pregnancy, and the choice between them will depend on factors such as a man’s preference, the doctor’s expertise, and the availability of the procedure in a particular area.

Who can get a vasectomy?

Dr. Vikramjit: In general, most men who have decided that they do not want to father children or do not want to have any more children can get a vasectomy. However, it is important to note that a vasectomy is considered a permanent form of contraception, and it may not be appropriate for everyone.

Men who are considering a vasectomy should discuss their options with a healthcare provider who can provide information about the risks and benefits of the procedure and help them make an informed decision. In addition, some healthcare providers may require men to undergo counselling or other forms of evaluation before undergoing the procedure to ensure that they fully understand the implications of the procedure and are making a fully informed decision. 

In general, men who are considering a vasectomy should be in good overall health, and should not have any medical conditions that would make the procedure riskier.

What should one know before having a vasectomy?

Dr. Vikramjit: Before having a vasectomy, there are several important things you should know:

A vasectomy is intended to be a permanent form of birth control. It is important to understand that it is not always possible to reverse a vasectomy, and even if it is possible, the success rates of reversal are not guaranteed.

A vasectomy is a minor surgical procedure that can be done under local anaesthesia. The procedure typically is done on an outpatient basis, which means you can go home the same day.

After the procedure, you will need to take a few days off work to rest and recover. You may experience some discomfort, swelling, and bruising in the area for a few days to a week after the procedure.

You will need to use an alternative form of birth control until the procedure is effective. It can take several months for the remaining sperm in the vas deferens to be cleared out. So, it is important to use an alternative form of birth control until a semen analysis confirms that there is no longer any sperm present in your semen. A confirmatory semen analysis is usually done at 3 months post vasectomy.

There are potential risks and complications. As with any surgical procedure, there are potential risks and complications associated with a vasectomy. These can include bleeding, infection, swelling, and pain.

Before deciding to have a vasectomy, it is important to consider all your options for birth control.

After the procedure, it takes a few weeks or months for all the remaining sperm to be cleared from the vas deferens, so it is important to use another form of birth control until a sperm test confirms that there are no more sperm in the semen.

How does a vasectomy work?

Dr. Vikramjit: A vasectomy is a surgical procedure that is performed to sterilise a man and prevent him from being able to father children. During the procedure, the vas deferens, the tubes that carry sperm from the testicles to the urethra, are cut, tied, or sealed so that sperm cannot be released during ejaculation.

The procedure is usually performed in a minor surgical theatre and typically takes about 30 minutes. A local anaesthetic is used to numb the area, and the doctor makes one or two small incisions in the scrotum to access the vas deferens. The tubes are then cut, tied, or sealed, and the incisions are closed with stitches or adhesive strips. After the procedure, it takes a few weeks or months for all the remaining sperm to be cleared from the vas deferens, so it is important to use another form of birth control until a sperm test confirms that there are no more sperm in the semen.

It is important to note that a vasectomy does not provide immediate protection against pregnancy, and it does not protect against sexually transmitted infections (STIs).

Where can one get a vasectomy?

Dr. Vikramjit: A vasectomy is a surgical procedure performed by a urologist, a specialised doctor who deals with the male reproductive and urinary systems. You can typically get a vasectomy at a urology clinic or hospital. You could start by consulting your primary care physician or healthcare provider to get a referral to a qualified urologist who can perform the procedure.

It is important to research and choose a qualified and experienced urologist who has performed vasectomies before. You should also have a consultation with the urologist beforehand to discuss the procedure, potential risks and to clear any doubts pertaining to the vasectomy.

Is a vasectomy reversible? How effective is a vasectomy?

Dr. Vikramjit: While vasectomy is considered a permanent form of birth control, it is possible to attempt a reversal procedure called a vasovasostomy or vasoepididymostomy. However, it is important to note that a vasectomy reversal does not guarantee that fertility will be restored.

The success of the reversal depends on a variety of factors, including the length of time since the vasectomy, the location of the blockage, and the amount of scar tissue that has developed. Generally ranging from 30 percent to 90 percent, with higher success rates seen in men who have had the reversal done within 10 years of their vasectomy.

As for the effectiveness of a vasectomy, it is considered a highly effective form of birth control. According to the American Urological Association, the failure rate for vasectomy is about 1 in 2,000. However, it is important to note that there is still a small risk of pregnancy. So it is recommended that couples use another form of birth control for the first few months after the procedure until a semen analysis confirms that there are no more sperm in the semen.

While vasectomy is considered a permanent form of birth control, it is possible to attempt a reversal procedure called a vasovasostomy or vasoepididymostomy.

Are there any side effects of a vasectomy?

Dr. Vikramjit: Like any surgical procedure, a vasectomy can have some potential side effects and risks. Some of the most common side effects include:

Pain and discomfort in the scrotum or groin area, which can last for several days or weeks after the procedure.

Swelling or bruising in the scrotum or groin area.

Bleeding inside the scrotum, which can cause a lump or swelling.

Sperm granuloma, which is a small, hard lump that can form at the site where the vas deferens were cut.

Infection, although this is rare.

Chronic testicular pain, although this is rare.

Vasectomy failure, which can result in pregnancy.

It is important to note that many of these side effects are temporary and can be managed with pain medication and other treatments. Most men are able to return to normal activities within a few days or weeks after the procedure.

If you experience any persistent or severe side effects after a vasectomy, you should contact your doctor right away.

Does a vasectomy increase the likelihood of getting prostate cancer?

Dr. Vikramjit: The link between vasectomy and prostate cancer is a topic of ongoing research and debate. While some studies have suggested a possible association between vasectomy and an increased risk of prostate cancer, other studies have not found a significant association. The American Urological Association and the National Institutes of Health have both stated that there is no clear evidence that vasectomy increases the risk of prostate cancer.

It is important to note that any potential increased risk is small, and the overall risk of developing prostate cancer is relatively low. Men who are concerned about their risk of prostate cancer should talk to their doctor about the best screening and prevention strategies based on their risk factors.

Men who are concerned about their risk of prostate cancer should talk to their doctor about the best screening and prevention strategies based on their risk factors.

What to expect post-vasectomy?

Dr. Vikramjit: After a vasectomy, you can expect to experience some mild to moderate pain and discomfort as mentioned. These symptoms usually peak within 2-3 days after the procedure and then gradually improve over of a week or two. Your doctor will provide you with pain medication and instructions on how to care for the incision sites. You may need to wear a supportive garment, such as an athletic supporter or snug underwear, to help reduce swelling and support the scrotum.

It is important to avoid any strenuous activity or heavy lifting for at least a week after the procedure to allow the incision sites to heal properly. You should also avoid sexual activity for at least a week after the procedure and until your doctor confirms that there are no more sperm in your semen.

Your doctor will likely schedule a follow-up appointment 3 months after the procedure to check your semen for the presence of sperm and confirm that the vasectomy was successful. It is important to continue using another form of birth control until then. Overall, most men are able to return to their normal activities within a few days or weeks after a vasectomy, and any discomfort or side effects usually resolve within a few weeks.

Vasectomy still a taboo topic in Malaysia. What are your thoughts on this?

Dr. Vikramjit: It is unfortunate if in fact vasectomy is still considered a taboo topic. This can make it more difficult for men to make informed decisions about their reproductive health and access safe and effective forms of birth control. One reason for the taboo surrounding vasectomy may be cultural or religious beliefs that view family planning or contraception as unacceptable. There may also be a lack of awareness about the benefits and safety of vasectomy.

Ultimately, the decision to undergo a vasectomy is a personal one that should be based on individual circumstances and preferences. In countries where vasectomy is not widely accepted, it may be helpful to promote awareness and education about the procedure through public health campaigns or other initiatives.

Are there requirements or restrictions to getting a vasectomy in Malaysia?

Dr. Vikramjit: In general, there are no strict requirements or restrictions to getting a vasectomy, but there may be some factors that can impact whether the procedure is a good option for a particular individual. Some of these factors may include:

AGE

Some doctors may recommend waiting until a man is at least 30 years old or has completed his family before undergoing a vasectomy.

HEALTH

Individuals who have certain medical conditions or take certain medications may not be good candidates for vasectomy. Your doctor will discuss your medical history and any medications you are taking to determine if a vasectomy is safe for you.

CONSENT

In most cases, men must give informed consent before undergoing a vasectomy. This means that they must fully understand the risks and benefits of the procedure and freely choose to undergo it.

It is important to talk to your doctor about your individual circumstances and any concerns you may have before deciding whether to undergo a vasectomy. Your doctor can provide you with information about the procedure, discuss any potential risks or complications, and help you determine if it is the right choice for you.