MSP-Funded Vasectomy

Vasectomy is intended to be a permanent form of contraception, therefore patients should be confident that they do not want any more children before proceeding.

Vasectomy does not produce immediate sterility and an alternate form of contraception must be used for the first few months until success of the procedure has been confirmed by post-vasectomy semen analysis.

How it works

Vasectomy is a minimally invasive procedure intended to provide permanent contraception. It involves blocking the tubes called vas deferens that carry sperm from the testes. This prevents sperm from entering into the semen that is ejaculated.

The no-scalpel vasectomy is a technique that was developed in China in the 1970s; in this approach, the doctor locates one of the vas deferens under the skin and holds it in place with a small clamp, then uses a special tool to create a small puncture in the skin through which the vas deferens can be accessed and blocked, and repeats the procedure on the opposite vas deferens through the same opening. No stitches are required and the opening typically seals on its own within a day, and compared to conventional vasectomy methods, the no-scalpel technique generally results in less discomfort, quicker recovery, and a lower risk of complications such as bleeding and infection.

No-needle vasectomy refers to the way the local anesthetic is delivered. Instead of using a traditional needle to “freeze” the skin and tissues around the vas deferens, the doctor uses an injector device to deliver anesthetic through the skin in a quick spray. This can reduce the sensation of a needle poke for some patients, although you may still feel a brief sting or pressure as the anesthetic is administered. In some cases, a small amount of additional anesthetic may still be required to ensure you are completely comfortable throughout the procedure.

    • Low-risk office-based procedure performed under local anesthetic

    • Reliable form of permanent contraception

    • Does not alter sexual performance, function, pleasure, sensation, sex drive, orgasm, ejaculation, or quality of semen

    • No increased risk of prostate cancer, testicular cancer, heart disease or other health conditions

    • Does not produce immediate sterility

    • An alternate form of contraception must be used until success of the procedure is confirmed with post-vasectomy semen analysis

    • Does not prevent sexually transmitted infections

    • Reversal procedure is not covered under MSP and is not always effective

What you can expect during the procedure

  1. After checking in you will be shown to an exam room and will sit with a heating pad on the scrotum for 10-15 minutes to allow the skin to relax.

  2. For the procedure you will pull down your underwear and lie flat on your back on the exam table.

  3. Your penis will be positioned out of the way and a colorless antiseptic solution will be used to clean the scrotum.

  4. Local anesthetic will be administered.

  5. The left vas is isolated and grasped with a small ring clamp, holding it to the skin. A tiny puncture is made over the vas with a fine tipped surgical instrument, then stretched open about 2-3 mm. The vas is grasped and a small segment gently pulled through the skin opening. The vas is divided. The upper end is cauterized. The fascial tissue overlying the vas is closed over the cauterized end with a clip in order to fully separate it from the lower end. This is called fascial interposition. The ends are placed back into the scrotum.

  6. The procedure is repeated for the right vas through the same opening.

  7. After the procedure is complete you will sit up and pull up your tight fitting underwear to provide support.

  8. If you feel well, you will be able to leave immediately.

Frequently Asked Questions

  • Having a vasectomy will not impact your sex drive or sexual function. Your testosterone levels will also be unaffected. Sexual sensation, erection, and ejaculation are the same except that the ejaculate will no longer contain sperm.

  • No, there should be no noticeable change in the quality or quantity of the semen you ejaculate. Most of the semen comes from the prostate gland and seminal vesicles that are located above the vas, with only 5% of the total volume being made in the testicles.

  • Our bodies are constantly recycling old or unused cells. You will continue to make sperm but they will have nowhere to go. Your body will absorb and recycle them.

  • Most patients feel sore for a night or two after the procedure. We recommend wearing tight fitting underwear for the first couple of days to decrease discomfort and risk of bleeding. You should avoid any vigorous activity, including sports and sex, for the first 3-7 days after your vasectomy.

  • Sperm can hide in the prostate gland and seminal vesicles for 2-3 months, so sperm counts can initially remain high even when the vas deferens were successfully sealed. Waiting allows the hidden sperm to be flushed out. There is a very rare chance that the separated ends rejoin after a vasectomy. After three months, the semen analysis should show if this has occurred. The semen analysis is a simple last step in the process to ensure a successful vasectomy and allow alternate forms of contraception to be discontinued.

  • If you have a valid BC Services Card (Medical Services Plan) there is no charge to you for the procedure.

    There is no fee for the procedure, and no patient comfort kit is required.

    If you have valid health insurance from another province, the procedure will also be covered.

    If you DO NOT have a valid BC Services Card, or your provincial coverage is from Quebec, the cost will be $1000.00.

  • Yes, you are welcome to bring a support person with you to the appointment. They can accompany you during the procedure or wait for you in the waiting room.

  • You can expect to be in the clinic for approximately 1 hour. The actual procedure takes about 20-30 minutes.

  • You will need to bring your valid BC medical card and a pair of tight fitting underwear.

  • Vasectomy is the most effective of all the methods of birth control, but even after confirmation of a successful procedure (no or rare non-motile sperm on post-vasectomy semen analysis), there remains a 1 in 2,000 chance of pregnancy or 0.05% failure rate.

  • Vasectomy should be considered a permanent procedure. If you decide to undergo vasectomy reversal, the cost is not covered by our provincial health insurance (MSP) and the reversal often needs to be performed in the hospital under general anesthetic. Even after a reversal surgery, as many as 50% of patients will not succeed in having children. Another option if you decide you want more children is to undergo sperm retrieval with in vitro fertilization.

  • Sperm storage should be considered by all patients undergoing vasectomy, as it offers the ability to parent more children in the future, should you change your mind. Patients less than 35 years old with fewer than 2 children, or those in an unstable relationship are more likely to desire vasectomy reversal. Sperm banking is offered through local fertility clinics. Olive Fertility and the Pacific Centre for Reproductive Medicine are the two options here in Victoria.

  • A painless bruise might appear around the scrotum and the base of the penis on the second or third day. It is harmless and will fade over several days. If you develop a large bluish lump inside the scrotum the size of a golf ball, in the first two days, it may be a hematoma (blood accumulation). It is important to treat this complication early, so call the clinic right away.

  • We recommend waiting one week. When you no longer have any pain or tenderness you may ejaculate. After 7 days there are no restrictions, however you must continue to use a reliable form of contraception until you are cleared with a negative semen analysis.

  • On each side of your scrotum, the lower end of the vas will develop a pea-size nodule where the vasectomy was done. This scar is normal and permanent. It can be tender initially. The tenderness should resolve within a few months.

Potential risks / complications

  • Syncope (< 1%). Caused by a vasovagal reaction which makes people feel faint for minutes to hours after the procedure.

  • Hematoma (1-2%). This results from bleeding into the scrotum. It can get large and painful, and turn the scrotum black and blue.

  • Infection (1-2%). Minor infections are generally managed with a short course of antibiotics. Serious infections, requiring intravenous antibiotics or drainage of an abscess occur in less than 0.1% of cases. Even these more serious infections usually resolve completely in a few weeks.

  • Vasitis or epididymitis (< 1%). Inflammation and swelling of the tissue surrounding the vas or extending down around the epididymis (where sperm are stored). It’s usually mild and transient, and causes swelling no bigger than the size of a grape. It typically resolves with a short course of NSAIDS such as ibuprofen.

  • Sperm granuloma (1-2%). This is a small inflammatory lump which can occur near the cut end of the vas or in the epididymis weeks or even months after surgery. It can be painful, but it’s not serious and usually resolves with a short course of an NSAID like ibuprofen.

  • Chronic post-vasectomy pain (1-2%). This is a rare complication where patients experience ongoing pain in the scrotum that can persist for months or years and can interfere with quality of life. Various treatments are available.

  • Recanalization. Where the separated ends of the vas reconnect and allow sperm to reenter the semen. It can occur early during the healing phase which would be detected on post-vasectomy semen analysis and requires a repeat vasectomy (< 1%). In very rare cases recanalization can occur months to years later following a vasectomy that had been determined successful based on post-vasectomy semen analysis testing (0.05%).