Vasectomy

• We recommend that you be accompanied on the return trip by someone who can drive you home.
• We suggest that you do not take aspirin or anti-inflammatories in the week before the procedure, as this may increase bleeding. If you need pain medication during this time, opt for acetaminophen (Tylenol).
• The day before or the same day, you will need to shave the scrotum and the base of the penis. It is not necessary to shave the thighs or above the penis.
• We advise you to avoid an electric razor, as it is more irritating to the skin, as well as depilatory cream.
• Take a shower the morning of the procedure as we suggest waiting until the next day for the next one.
• To promote your comfort after the procedure and to keep the dressing in place, we recommend that you wear tight underwear on the day of the appointment.

There are approximately 15,000 vasectomies per year in Quebec. Since the beginning of the 1990s, it is mainly the “no scalpel” technique that has been practiced. This technique from China allows a minimally invasive procedure.

Sperm are produced in the testicles. They then travel through the vas deferens (left and right), ascend to the seminal vesicles, which produce the majority of the fluid present in semen, and finally exit via the urethra when ejaculation occurs.

The “no scalpel” technique consists of releasing the vas deferens through a small incision on the central line of the scrotum and proceeding to cut them, their cauterization and the installation of a small titanium forceps to block the passage of sperm. You won’t feel these pliers and it won’t ring the metal detector!

This is done under local anesthesia, which is administered with a microneedle (the size of a hair). It is normal to feel pressure afterward, but there should be no pain.

Vasectomy is not effective immediately! The procedure does not stop sperm production, but it does block their path and therefore their fertilization potential. They will then be reabsorbed by the body.

During the procedure, there are already sperm in circulation (in the seminal vesicles), which explains why you must then use an alternative method of contraception and wait until you have eliminated them. This may take around 3 months, or around 20 to 30 ejaculations. The success of the procedure must then be confirmed with a spermogram.

For the majority of men, confirmation of sterility is done with the first sperm test. However, it may happen that the channels reconnect (early recanalization) (very rare 0.3%) or that your reserve takes more time to decrease. We can then repeat the test 2-3 months later. If there are still sperm remaining, we can repeat the procedure. Late recanalization (years after vasectomy) can occur in very rare cases (0.1%). We can therefore consider this procedure 99.9% effective.

When you arrive at the clinic, you will be asked to read the consent for vasectomy. This document will be signed with the doctor.

You will then meet with the doctor and nurse to review your medical questionnaire.

The procedure will take place in a normal medical office, you will lie on the examination table. We will ask you to pull your underwear and pants down to your knees, pull your sweater up under your torso and cross your hands at this height.

The nurse will place a sterile field over the pelvis and will disinfect it. The doctor will do an examination of the scrotum and testicles. The next step will be local anesthesia, administered with a microneedle for minimal discomfort around the vas deferens and scrotum. The rest of the procedure should be painless.

During the procedure, it is normal to see some smoke because we are using an instrument to cauterize.

After the operation, there is no need for stitches, the small incision will close by itself. The doctor will still leave a dressing on to optimize healing and limit complications.

We will give you the prescription for the spermogram and you can then return to the room for a waiting period of approximately 10-15 minutes to ensure that everything is okay before leaving with your companion.

It is normal for the scrotum to swell a little, turn bluish and be uncomfortable, this is the normal process. The coloring should return to normal in 7-14 days and the pain should fade after 3-4 days (but it is normal for you to feel it all the way down to your lower abdomen). However, it is advisable to consult if you feel like you have a third testicle, if the pain is not relieved by the advice below or if you have a temperature.

Ice

• Apply ice (“Ice pack”, bag of frozen peas, etc.) for 20-30 minutes at 1 hour intervals, three times.
• ** So, if you live more than 20-30 minutes from the clinic, plan to bring some along the way.

Medication

• We suggest you take acetaminophen (Tylenol), 500mg (extra strength), 2 tabs every 6 hours if you have no contraindications.
• It is wise to wait a few days after the procedure before starting anti-inflammatories (Advil, Motrin, Naproxen) or aspirin again.

Dressing / underwear

• You can remove the dressing in approximately 24 hours, at the same time as your shower.
• You can continue to wear tight underwear, day and night, for the next 5 days: the more supported the testicles, the easier the healing.

Shower/bath/pool

• It is possible to take a shower the next day. However, avoid rubbing the scrotal area, you can only let the water run.
  • You can apply a diachylon to the incision
• It is suggested to wait at least 48 hours before taking a bath or swimming.

Physical activity/work

• Avoid heavy physical exertion for 5 to 7 days after the vasectomy.
  • This involves avoiding lifting loads of more than 25kg and sporting activities (hockey, skiing, gym, jogging, etc.).
  • If you have young children, be careful when lifting and kicking or head-butting them.
• You can do manual work, remaining careful, within 3-4 days following the procedure.
• If you need a medical document, do not hesitate to ask us.

Sexual activity

• You can resume sexual relations 4-5 days after the vasectomy. Go at your own pace.
• It is normal for the first ejaculations to be tinged with blood (red, pinkish or brownish).
  • If this persists, do not hesitate to consult again.

Alcohol

• There is no contraindication to consuming alcohol after the procedure.

Complications are rare, but not impossible. The main ones are:

• Bleeding (hematoma) and infection (1%).
• Discomfort in the testicles (congestive epididymitis) in the following days 1%
• Granuloma (scar nodule) (1%)
• Chronic pain (0.1%)

For these reasons, it is suggested to avoid outside travel for the first two weeks after the vasectomy.

The medical literature does not support a link between vasectomy and cardiovascular disease or between vasectomy and prostate cancer.

In addition, this procedure has no impact on erectile function and libido, your testosterone level remains the same.

When you leave, you will leave with a container and a prescription for a spermogram. We suggest doing this 3 months after the vasectomy. It is important to continue a contraceptive method until you receive the result. If you have not heard from us 2-3 weeks after taking the test, do not hesitate to call us back.

You can make an appointment via Clicsanté (https://portal3.clicsante.ca/).

Procedure: this consists of collecting a semen sample, which you will obtain by masturbation and which you will keep in the jar provided at the start (only once is necessary). You can then bring your sample, within one hour, to the collection center. It is important to keep it at body temperature.

Abstinence period before: 48-72 hours

To Montreal :

● CHUM – possible even if the prescription comes from a doctor outside the CHUM
● Verdun Hospital
● MUHC
● Maisonneuve-Rosemont Hospital

North Shore:

● Cité-de-la-Santé Hospital

South Shore :

● Charles-Lemoyne Hospital

As mentioned in the “Effectiveness” section, vasectomy is a very reliable method, but not infallible. If in the years to come, your partner has symptoms of pregnancy (menstrual delay, nausea, vomiting, fatigue, breast tenderness, etc.), do not forget to take a pregnancy test. However, it is not indicated to repeat the spermogram during your life.