Sterility and Spermogram

YOU ARE NOT STERILE IMMEDIATELY AFTER THE PROCEDURE.

In fact, the seminal vesicles form a reservoir that can contain about 3 months of living spermatozoa. It therefore takes 3 months to empty it. There is no point in trying to break records by trying to empty your tank in 20 days. The more frequent your ejaculations, the less sperm they contain.

Schéma des différents éléments de l'organe sexuel masculin dont les vésicules séminales, la prostate et le canaux déférent

After the vasectomy, the doctor will give you a jar and a form to take your spermogram 3 months later.

The spermogram is a test to see if there are any sperm left in your semen. You will do it at home, by masturbation in the little pot, once. Afterwards, you will have 1 hour to bring it to one of the laboratories that they will indicate to you. During transportation, it is important to keep the sample at body temperature, in a shirt or pants pocket.

The doctor will receive the results of your test 1 to 2 weeks later, and will call you with them.

You must continue your contraception until you receive the results of your spermogram.

Efficiency

Although vasectomy is one of the most effective methods of contraception, nothing is infallible. In fact, in rare cases (about 1 in a thousand patients, 0.1%), nature manages to reconnect the ducts despite being cut, clipped and burned.

Most of these cases reconnect shortly after the procedure (this is called early recanalization). At this point, the spermogram 3 months after the procedure will still show the presence of live sperm in the semen. The doctor will then do a second spermogram two months later, because some men take longer than others to empty their reservoir. If the second spermogram shows a large amount of sperm, the procedure did not work and the vasectomy must be repeated.

An even rarer phenomenon is late recanalization. This is the reconnection of the tubes long after the spermogram has indicated that everything had worked well. We have seen cases that reconnect several years after their vasectomy. Since this phenomenon is very rare, if your spermogram result is satisfactory, consider yourself sterile and you do not need to use any other method of contraception.

If, in the months or years after your vasectomy, your partner has a late period or other symptoms of pregnancy, it is important that she take a pregnancy test.

Complications

Vasectomy, especially no-screw vasectomy, is a procedure that is considered to have a very low risk of complications. Complications are rare and usually mild, but it is important to be aware that they can occur.

In about one in one hundred patients (1%), a small ball of blood may form near a testicle. This is called a hematoma. It will cause some pain for a few days and does not require any particular treatment.

Infection, on the other hand, also occurs in 1% of patients and brings redness on the skin, pain and swelling. It is usually easily treated with an oral antibiotic (pill).

An accumulation of sperm in the testicle one week after vasectomy is called congestive epididymitis. This complication rarely occurs (0.5%). It creates pressure in the testicle that usually lasts less than a week and is easily treated with anti-inflammatories and ice.

Painful scarring of the duct or a small ball filled with sperm (granuloma) occurs in less than 1% of patients. Sensitivity will then persist for a few weeks.

Approximately 1 in 1000 patients (0.1%) will experience chronic pain following vasectomy. Certain treatments can be proposed to reduce or completely eliminate this pain. Unfortunately, some patients will remain with their pain for a long time.

No change in sexual function is reported. The vasectomy will not affect libido, erection, pleasure, sensitivity or ejaculation (remember that spermatozoa make up only 2% of what you ejaculate).

A small controversy arose after the publication in 1996 of a study reporting a possible increase in the risk of prostate cancer following vasectomy. Further analysis of these results, as well as the publication of several other analyses, have not, to date, demonstrated a link between vasectomy and the risk of prostate cancer. These studies have proven that vasectomy does not cause cancer, heart disease or any other disease.

Efforts

The most important thing after the vasectomy is to avoid exertion for 5 days. It is recommended that you do not exert yourself more than 20 pounds.

It doesn’t matter if you are straining your arms or your legs. When you exert yourself, your blood pressure rises and can burst small blood vessels that the doctor has blocked during the vasectomy. You may end up with a lot of inflammation and pain for 1-2 weeks. So it’s better to take things easy for 5 days than to have problems for 2 weeks.

Work

Getting back to work depends on what you are doing. If you have a job that does not require physical exertion, you can return to work the next day. You will be able to walk, climb stairs, stand and drive your car normally.

However, if your work requires effort, you will have to stop working or do light work for 5 days. The doctor will be able to make a “doctor’s note” for your employer if you need it.

Truck driving is not a problem as long as you do not have to exert yourself (example: unloading merchandise, forcing to tighten fasteners or canvas, etc.). On the other hand, driving forklifts is not recommended for at least a week. Since they do not have shock absorbers, they transmit blows and vibrations directly to the driver’s testicles.

Sports

For most sports, it is recommended to abstain for a period of one week (field hockey, golf, jogging, skiing, tennis, hiking, etc.).

As for walking, there are no restrictions as long as you are not carrying anything and you walk at a normal pace.

Certain sports that are more demanding or have a risk of impact on the testicles are not recommended for 2 weeks (e.g. cycling, motorcycle, snowmobile, all-terrain vehicle, horseback riding, squash, water skiing, martial arts, etc.).

As for weight training, it is strongly discouraged during the week following your vasectomy. For the first two days of your return to training, start with 50% (half) of the load you normally use. Then, if all goes well, you can resume your normal training.

Sex

You can begin sexual relations 5 days after your vasectomy if you feel well. Don’t be surprised if there is a little blood when you first ejaculate. The first ejaculations may be a little painful (this is normal).

Afterwards, your sexuality will be exactly the same as it was before your vasectomy. Erections, libido, pleasure and even ejaculations will be identical.

In fact, spermatozoa make up only 2% of what is ejaculated. The vast majority is a storage fluid made by the seminal vesicles (near the prostate in your belly). When your sperm reservoir is empty, you will continue to ejaculate normally, but a small drop that contained the living cells will be missing (you won’t know the difference).

Post-operative monitoring

After your vasectomy, the doctor will ask you to stay in our rest room for 15-20 minutes before leaving. This monitoring period is important to ensure that you do not have an adverse reaction to the anesthetic medication (e.g. allergy). Sometimes, nervousness causes some patients to feel a drop in pressure after surgery. The monitoring period ensures that you are ready to go back on your way.

Pad

As you complete the vasectomy, the doctor will place a small packet of cotton over the tiny incision below the penis. The cotton pads will be held in place with a little tape and your tight underwear. Dr. Nélisse will advise you to remove the bandage 5 hours later. Dr. Caouette prefers that you remove it the next morning. You can then throw it away and you won’t have to put anything else on the wound. The vasectomy doesn’t change anything for urinating.

Local anesthesia

You will begin to “thaw” about 1-2 hours after the procedure.

The pain

In most cases, you will feel a small tingling sensation on the skin once the anesthesia has worn off. Afterwards, a feeling of heaviness in the testicles will set in for 3-4 days (as if you had a rock in your sack!). Generally, this is more of a discomfort than a real pain.

If you have pain, you can take Tylenol, Motrin or Advil.

You can also apply ice to the scrotum about 10-15 minutes 3-4 times a day for 1-2 days. Wrap the ice with a damp washcloth (no ice directly on the skin). Frozen peas are also a practical solution, as they mold to your body shape (avoid, however, serving them to your friends at the next BBQ !!!!).

A Bruise ?

After the vasectomy, there may be some bruising in the scrotum (the sac) and even the thighs. This is a normal phenomenon that is not dangerous. The bruise is not painful and changes color and disappears in a few days (like any other bruise).

Tight underwear

Wear tight underwear day and night for 5 days. The less the testicles move, the easier it is to heal. A scrotal support found in pharmacies can be a good idea.

Bath and Shower

You can take your shower the morning after the operation, but wait 3 days for the bath, the pool or the Spa (so that the skin does not soak and “macerate” in the water).

Movements

Immediately after the procedure, you will be able to walk normally, take stairs and drive your car.