Curious about a Vasectomy? Our expert doctor cuts to the chase!

Our expert doctor fills you in on everything you and your partner want to know about vasectomy in Singapore!

Love your kids, but done having them? One of the safest, most effective, and economical ways to prevent future pregnancy is via vasectomy. While many men might wince at the mere mention of the word, recent advancements have made this surgery quick, virtually painless, and minimally invasive. We spoke with Dr Christopher Eldridge of International Medical Clinic (IMC) to get the lowdown; he answers all the questions you and your partner may have been too shy to ask, mama!

What is a vasectomy and should I consider it?
Vasectomy is the technique of interrupting the vas deferens with an intention to provide permanent contraception. It is a safer, cheaper procedure that causes fewer complications than tubal ligation in women. The cost of other methods, such as birth control pills or condoms and spermicide, is likely to be greater over time.

A development since 2004 has been the widespread adoption of minimally invasive vasectomy techniques, as opposed to traditional invasive techniques, as well as an increase in the proportion of vasectomies undertaken in non-hospital settings

What does the procedure involve?
A relatively newer technique to expose the vas, the no-scalpel Vasectomy, involves a puncture wound in the scrotal skin where the skin opening is ≤10 mm to access and occlude the vas. The dissection area surrounding the vas deferens is minimised and skin sutures are not required. Once this heals you will have a very small scar on the scrotum which will become invisible over time.

Vasectomies are usually performed under local anesthetic. The consultation and procedure take place on the same day and the procedure usually takes around 15-30 minutes

How Well Does It Work?
Vasectomy is a very effective (99.85%) birth control method. Only 1 to 2 women out of 1,000 will have an unplanned pregnancy in the first year after their partners have had a vasectomy. A vasectomy does not protect against sexually transmitted infections (STIs), including infection with the human immunodeficiency virus (HIV).

There is a slight chance of failure that can occur at any time due to the sperm-carrying tubes rejoining naturally. The vast majority of failures occur within two months of the procedure, so if the semen test suggests the vasectomy has failed, the procedure can be repeated.

What aftercare is involved?
It usually takes several months after a vasectomy for all remaining sperm to be ejaculated or reabsorbed. A man must use another method of birth control until he has a semen sample tested and it shows a zero sperm count. Otherwise, he can still get his partner pregnant. He will need to submit a semen sample three months after the procedure to ensure his semen is sperm-free.

He will need to abstain from sexual activity for between 2 and 7 days post-procedure. Tight underpants/athletic support for the first few days following the procedure are worn, including at night for the initial 48 hours or longer, depending on symptoms.

How does a vasectomy affect sexual function?
A vasectomy will not interfere with a man’s sex drive, ability to have erections, or sensation of orgasm. Because the tubes are blocked before the seminal vesicles and prostate, he still ejaculates about the same amount of fluid.

Vasectomy only interrupts the vas deferens that carry sperm from the testes to where they are added to semen. The penis and testes are not altered in any way. The operation has no noticeable impact on the man’s ability to perform sexually, nor does it affect the balance of male hormones, or male sex characteristics. As always, testosterone continues to be produced in the testes and delivered into the blood stream. As before, the body naturally absorbs unused sperm. The patient will not feel any different physically from the way he felt before. Vasectomy is simply a sterilisation procedure; once it has been performed, a man’s semen will no longer contain sperm and he cannot father a child.

What are the complications?
A man may have some swelling and minor pain in his scrotum for several days after the surgery. Unless his work is strenuous, he will be able to return to work in 1 or 2 days. Avoid heavy lifting for a week.

Vasectomy is associated with a risk of postoperative testicular, scrotal, penile or lower abdominal pain that is rarely severe and chronic in some men. Non-steroidal anti-inflammatory drugs (NSAIDs) and treatment to alleviate neuropathic pain are common first-line treatment options for chronic post-vasectomy pain (CPVP) and are preferable to surgery which involves the reversal of vasectomy.

There is no evidence of an increase in testicular cancers associated with vasectomy. The weak association observed in some studies between vasectomy and prostatic cancer is unlikely to be causal bleeding (hematoma) and infections are the most common (although rare) complications of vasectomy. These occur in 3.1% of men undergoing a conventional vasectomy and less than 0.4% of men undergoing a No-Scalpel Vasectomy. The no-scalpel method is associated with a much lower rate of hematoma because the skin and vas sheath are punctured and the opening is then dilated, so blood vessels are more likely to be pushed aside rather than cut. The risk of a severe complication occurring (one that would require admission to the hospital) is less than one in a thousand (0.01%).

Can a vasectomy be reversed?
An estimated 2% to 6% of men undergoing vasectomy may request a reversal at a later date. In many cases, the cut ends of the vas deferens can be surgically reattached. However, this operation, a microsurgical vasovasostomy, is expensive and, for a variety of reasons, does not guarantee a return to fertility. Vasectomy reversal appears to be more successful if performed within 10 years of the vasectomy, but again, there is no guarantee that fertility will be restored.

Vasectomy should therefore be considered a permanent procedure. Before you choose to have a vasectomy, make quite sure that you and your partner do not want any more children. If you are thinking about a reversal now, perhaps take more time to decide whether vasectomy is right for you.

Thanks, Dr Eldridge! For more information, you and your partner can visit IMC and their friendly team of international doctors at one of two convenient locations.

International Medical Clinic (IMC)

Camden Medical Centre, 1 Orchard Boulevard, #14-06, Singapore 248649, Tel: (+65) 6733 4440
293 Holland Road, #02-04 Jelita Shopping Centre, Singapore 278628, Tel: (+65) 6465 4440, www.imc-healthcare.com