We want you to feel comfortable and at ease with your procedure, so we have created a list of frequently asked questions to assist you. If you find that after reading the FAQ, there are still questions you have, please feel welcome to call us. You may also be interested in our Myths and Facts page.
A vasectomy is partly covered by Medicare. Metrocentre is not a budget cut price vasectomy service and we do not offer a ‘quick snip’ like many other clinics. We have a dedicated theatre in which our open ended vasectomies are performed. We do not perform our procedures in doctors’ rooms. No additional inpatient fees are charged.
It is important to note that sperm storage is not covered by Medicare, and this factor should be taken into consideration before undertaking this surgical procedure.
There is now a Medicare rebate for vasectomy reversal, however, the procedure is still expensive and there is not a guaranteed 100% chance of success and as such the vasectomy should be considered permanent.
This procedure involves two tiny incisions to access the vas tubes. The tubes are then cut and the testicular end is left opened and unsealed, with both ends of the tubes separated by layers of tissue within the scrotal sac by fine suturing. Sperm continues to be produced after the vasectomy so this fluid travels from the testicle up the vas deferens where it then flows out of the vas and into the tissues. The body reabsorbs this naturally. The testicular vas and the vas that leads to the prostate reconstructed in separate compartment to minimise the risk of failure.
As a result of this technique:
It is highly important to use contraception for the first few months after surgery. This is done to allow the remaining sperm to be flushed out beyond the scrotal ties. It is important to note that sperm will continue to be produced in the testicles after surgery.
You will still continue to produce sperm and male hormones in the same way- the sperm is simply prevented from mixing with the semen before ejaculation.
At the Metrocentre we have an extremely low complication rate associated with our micro-surgical procedures
Serious side effects associated with these procedures are very rare. Most patients experience some minor discomfort and bruising around the site of the procedure. This can be managed effectively with ice after the procedure, simple pain medications and supportive underwear
As with all scrotal surgery, there are published risks and complications and these include:
Complications of vasectomy are not a feature in our high volume open – ended vasectomy and micro-surgical vasectomy reversal practice. There has never been a scrotal haemorrhage and an almost zero infection rate. The reasons are:
On the day of your procedure, we will give you everything required for your three month sperm test. This test can be performed by your local pathology lab and they will send the results through to us. We will then notify you of these results.
During the procedure some of the sperm will be flushed out ‘downstream’. After the procedure when you feel comfortable and up until you perform your three month sperm count, it is recommended that you have at least 30 ejaculations (sex with your partner will result in the most forceful muscular contractions at orgasm). This will completely flush out residual sperm and usually achieves a nil result on your sperm test.
Use contraception up until you have received your post vasectomy sperm count results.
Sometimes, we find that if you have not had enough sex, you may have a test result that indicates dead sperm present rather than no sperm present. If this is the case, the sperm are dead so you will not be able to get your partner pregnant, however you should still use contraception and have another test done in a month’s time to ensure a nil sperm count.
In short, have lots of sex post operatively to avoid the hassle of repeat testing.
80% of failures will be detected at the three month testing.
20% of the remaining 1 in 500 or 1 in 1000 (i.e. .04 % to 0.02 %) have a chance of failure after three months due to the ends joining back together.
At Metrocentre, the chance of failure of vasectomy would be rather surprising, as our Open-Ended reconstructive technique minimises scarring. Excessive scarring causes contraction of tissues at the procedure site and is usually the cause of the vas deferens ends re-joining.
Dr Lekich has noted with his ultrasound assessment of 4000 sides of men consulting him for vasectomy reversal that extensive scarring due to an aggressive vasectomy technique brought the two ends of the vas deferens extremely close together.
A reconnection was confirmed on ultrasound for the many failed vasectomies performed elsewhere that he has assessed and since redone successfully.
Although at Metrocentre open-ended vasectomies can be reversed in many cases, this is still considered a permanent procedure.
During your initial consultation, all aspects of the procedure will be discussed to ensure that you are an appropriate candidate. As for every patient, counselling is important.
For men that have not fathered children, it is advised that you have your consultation on a separate day to your procedure. This will allow you to discuss all issues in detail and have time to think about how you feel once you have spoken to the doctor. Dr Lekich has reversed vasectomies on many males that have never fathered children.
Men whose partners are pregnant should consider waiting until the baby is born in the event that the pregnancy or birth becomes complicated.
Young age is generally not considered a barrier, particularly when many children are fathered.
If you are considering storing sperm for the future before undergoing a vasectomy, we are more than happy to discuss this with you.
This procedure will not even hinder the production of sperm, as men will continue to produce over 20 million sperm per day as normal after a vasectomy procedure.
If you have any further questions or concerns the highly experienced team at Metrocentre are more than happy to share their knowledge and expertise.
We have a dedicated theatre where the vasectomies are performed rather than in a consultation room.
Metrocentre is not a budget cut price vasectomy service and we do not offer a ‘quick snip’ like many other clinics that do exist.
It is important to note that sperm storage is not covered by Medicare, and this factor should be taken into consideration before undertaking this surgical procedure.
There is now a Medicare rebate for vasectomy reversal, however the procedure is still expensive and there is not a guaranteed 100% chance of success and as such the vasectomy should be considered permanent.
A vasectomy is partly covered by Medicare and the Medicare safety net may reimburse up to 85% of the procedure cost. We have a dedicated theatre where the vasectomies are performed rather than in a consultation room. No additional inpatient fees are charged.
Metrocentre is not a budget cut price vasectomy service and we do not offer a ‘quick snip’ like many other clinics.
It is important to note that sperm storage is not covered by Medicare, and this factor should be taken into consideration before undertaking this surgical procedure.
There is now a Medicare rebate for vasectomy reversal, however the procedure is still expensive and there is not a guaranteed 100% chance of success and as such the vasectomy should be considered permanent.
That said, men may still be able to donate their genetic material via IVF. If you wish to undertake a vasectomy procedure you may wish to store some sperm beforehand. At Metrocentre we are more than happy to help organise this storage.
“No scalpel” vasectomies do not use a scalpel for a clean cut, but use a blunt instrument to rip, tear or pierce the scrotal skin which can lead to complications or compromised healing. Once the skin is opened, a traditional technique is generally used to perform the vasectomy.
At Metrocentre our advanced open-ended vasectomy procedures involve 2 tiny incisions.
These incisions are typically 1cm long or less, to promote swift and precise healing.
There are 12 microsurgical instruments on our Open Ended Vasectomy trays all used to reconstruct tissue, compared to two (2) instruments generally found on a No Scalpel Vasectomy tray.
We have found that the presence of sperm antibodies does not have an impact on the success of future reversal procedures because the antibodies are present in the bloodstream. Therefore, they do not impact on the healthy sperm stored in the testicles.
Overall a well performed vasectomy reversal is considered the most logical step for a vasectomised male to have more children after a vasectomy.
Dr Lekich was attached to Dr Silber’s clinic and theatre (St Lukes Hospital St Louis Missouri USA) in Jan 2013, He confirmed from his time with Dr Silber, a pioneer of vasectomy reversals and IVF (www.infertile.com), “that the best chance that a vasectomised male has to get his partner pregnant, irrespective of her age, was naturally with sex in bed after a well performed vasectomy reversal”.
Further the issues of sperm antibodies erroneously flagged as a limitation to reversals and only performing vasectomy reversals within 2- 5 years of a vasectomy was also confirmed by Dr Silber as absolute nonsense and without any scientific evidence. These points can be referenced in Dr Silber’s book “How to Get Pregnant” (2007 ed available online).
At Metrocentre, we use local anaesthetic to avoid the side effects associated with general anaesthetic. This means that most men can drive to and from the procedure. Many of our patients report that they experience little to no discomfort during and after the procedure.
In conjunction with local anaesthetic, we can additionally offer inhaled relaxant medication for men who are nervous about the procedure or more sensitive to pain. This can help you relax and feel more comfortable during the procedure. It is important to note that recovery time takes a little longer if this medication is used and you will not be able to drive for the rest of the day.
However this is not the most recent type of vasectomy. The Open-Ended Vasectomy was pioneered in the 1970’s by Dr Lekich’s mentor Dr Bruce Errey. It is said to be practiced by less than 5% of vasectomists’ however the true form of the procedure as pioneered by Dr Errey is practiced rarely. Dr Lekich often demonstrates this technique to those performing standard vasectomies.
The Open–Ended Vasectomy procedure reduces the inflammation and discomfort associated with traditional vasectomy procedures “that close the system”, and can also support the success of a potential future vasectomy reversal.
The most recent form of vasectomy is the “NON SCALPEL” vasectomy. Learn more on the No Scalpel Vasectomy
Often times we can even conduct our consultations & procedures within the same day! We will send you all of the information prior to your appointment, so you can understand all of the issues at hand. A separate consultation is recommended for those who have not had children, are not sure about the procedure or have significant past medical or surgical histories that are relevant to the scrotum.
Although we do still view a vasectomy as a permanent procedure, there are higher success rates for a reversal with an Open – Ended vasectomy procedure.
You may also wish to organise the storage of sperm before having your vasectomy procedure. At Metrocentre we are happy to help you organise this.
Our consultations take around 40 minutes and partners are more than welcome to attend also. The open-ended vasectomy procedure takes approximately 25 minutes with a short stay in recovery required afterwards.
We will send you home after the procedure with an ice pack on the area – the more ice you can keep on for the rest of the day after the procedure, the better you will feel the day after the procedure.
As many of our patients experience minimal discomfort after the procedure, we suggest that taking at least one dose of paracetamol before bed is beneficial. Don’t be brave – if you have any unrelieved pain – no matter how little, use paracetamol.
For men who do highly physical work involving heavy lifting, we recommend that they take at least seven days off from these activities. If you have taken inhaled medication you will need at least 12 hours off work to recover.
As the fear of accidental pregnancy is removed, many couples find that a vasectomy actually adds to their sexual pleasure. After surgery the sensations of sex will remain unchanged, although the volume of ejaculate will decrease only slightly (approx. 0.2ml – usually not detected by the naked eye) as the fluid contribution from the prostate and seminal vesicles is unchanged.
This surgery will not affect your sexual ability, although sex should be avoided for the first 3-5 days after surgery. After this time we recommend that you have as much protected sex as possible- this enables faster clearance of the remaining sperm from the vas above the vasectomy site.
When searching for a clinic to conduct your vasectomy reversal procedure, it is important to not only ask for success rates but also actual birth rates.
The successes at Metrocentre are attributed to the personal three years of training given to Dr Lekich by Professor Owen, who pioneered and perfected microsurgery and the Owen 3 Layer Vasectomy Reversal Procedure.
On the day of your procedure, we will give you everything required for your three month sperm test. This test can be performed by your local pathology lab and they will send the results through to us. We will then notify you of these results.
During the procedure some of the sperm will be flushed out ‘downstream’. After the procedure when you feel comfortable and up until you perform your three month sperm count, it is recommended that you have at least 30 ejaculations (sex with your partner will result in the most forceful muscular contractions at orgasm). This will completely flush out residual sperm and usually achieves a nil result on your sperm test.
Use contraception up until you have received your post vasectomy sperm count results.
Sometimes, we find that if you have not had enough sex, you may have a test result that indicates dead sperm present rather than no sperm present. If this is the case, the sperm are dead so you will not be able to get your partner pregnant, however you should still use contraception and have another test done in a month’s time to ensure a nil sperm count.
In short, have lots of sex post operatively to avoid the hassle of repeat testing.
When searching for a clinic to conduct your vasectomy reversal procedure, it is important to not only ask for success rates but also actual birth rates.
The successes at Metrocentre are attributed to the personal three years of training given to Dr Lekich by Professor Owen, who pioneered and perfected microsurgery and the Owen 3 Layer Vasectomy Reversal Procedure.
These are procedures where there has been a vasectomy, then a reversal, another vasectomy and then another reversal. These procedures were not only successful but have resulted in the birth of many children.
This means that our patients can experience a rapid recovery and discharge from our facility, and avoid the risk of vomiting. Twilight sedation is especially advantageous for our fly in/fly out patients as they can return to their accommodation with their partners after this procedure. It is important to inform us of your medical history and any drug allergies you have experienced before undertaking this procedure.
Semen is produced by glands located in the pelvis called the seminal vesicles and the prostate, and this is added to the sperm to create normal ejaculate. This seminal fluid makes up about 95% of the ejaculate and so men who have undergone a vasectomy may not notice any difference in the volume of ejaculate.
The testicles will continue to produce sperm after a vasectomy, so if both vas deferens have been tied off, the stream of sperm is simply blocked in the vas tube.
This procedure re-connects the vas tube to allow the sperm to mix with the semen once more to create fertile seminal fluid. There are few viable alternatives to this procedure apart from IVF.
When selecting a clinic to perform this procedure it is highly important that you examine the success rates (not simply the pregnancies) that each clinic experiences.
We perform high volume Owen 3 Layer Micro-Surgical Vasectomy Reversals – up to 28 cases (56 sides) in a month, making us one of the largest clinics in Australia.
Metrocentre’s Dr Chris Lekich is one of the most experienced microsurgeons in the world and has been able to perform many successful re-do vasectomy reversals! See our Re-Do Vasectomy Reversal page for more information.
Ultrasound allows visualisation of the structures in detail, and from this he is then able to map and plan the surgery, reducing my need for “exploration” during the procedure. His high resolution scanning of over 2000 sides since 2008 has enabled me to see diverse pathology and details of the micro-tubules deep within the body of the testicle, epididymis and scrotum, NOT visible with the naked eye or with the microscope. This is particularly useful for past IVF extractions and past failed vasectomy reversal attempts. The ultrasound has allowed Dr Lekich to advise patients regarding the likelihood of surgical success – particularly patients who have had previous scrotal procedures and previous failed vasectomy reversals.
For example: one patient had his vasectomy 23 years ago, had two failed reversal attempts elsewhere and then had three sperm extractions through IVF. Several clinics had told him that reversal was now impossible. After careful ultrasound assessment and planning, we successfully reversed this patient – achieving a 35 million sperm per ml count nine months after our procedure, with a wound that was one (1) cm in length on both sides. His wife is currently pregnant with their baby.
The use of the ultrasound in has facilitated the delivery of safe and minimally invasive Owen Three Layer Micro-surgical Vasectomy Reversals, difficult vasectomies and the management of post vasectomy congestion syndrome. Coupled with Dr Lekich’s micro-surgical training, the ultrasound has helped our team assess and plan what often becomes relatively straightforward surgery once there is a clear map. This is particularly important in the following challenging cases;
There has been open criticism with regards to the use of ultrasound by competing surgeons, with suggestions that this is a waste of time. At Metrocentre we respect these opinions as all surgeons try their best – open exploration has been common place during vasectomy reversal procedures for many years. With the benefit of ultrasound, Dr Lekich has almost completely eliminated the need to explore the scrotum during the procedure, which preserves the precious vas deferens. This subsequently reduces the risk of bleeding. To date we have never had a patient experience a scrotal haematoma after surgery. We do not routinely use drains which are often used in other practices.
If you do experience some mild discomfort in the first few days after this procedure, paracetamol can be used to offer relief. A comprehensive summary of the postoperative instructions will be provided well before your procedure.
At Metrocentre we recommend the following for the first four weeks after surgery:
With good care you should experience a swift and successful recovery from your Owen 3 Layer Micro-Surgical Vasectomy Reversal procedure.
Every man who has had a vasectomy is virtually guaranteed to have sperm antibodies develop as a natural response to the presence of a new protein within the body.
When the sperm protein is detected in the body after a vasectomy procedure, this triggers the immune system to produce antibodies (or white blood cells) which attack the sperm cells present outside of the reproductive tract.
This process is not a cause for concern for men who have developed sperm antibodies in response to a vasectomy procedure as these antibodies only attack sperm cells in the blood stream. With more than 18,000 immature sperm cells developed every minute by mature males, these lost sperm cells are easily replaced. Contrary to myths, these sperm antibodies do not cause any health related problems or prevent a vasectomy reversal from working.
It has long been shown that sperm antibodies are not significant after a vasectomy reversal. This has been disproved over 40 years in the practices of the pioneers of microsurgical vasectomy reversals Professor Earl Owen (Australia) and Dr Sherman Siber (USA). This has been confirmed scientifically and has also been noted not to be significant in the practice of Dr Lekich. This issue is made interesting by numerous patients in Dr Lekich’s practice testing up to almost 100% positive for sperm antibodies by IVF labs yet they still fathered children naturally after their reversals with us.
Some of our patients who have had a reversal with us (and then had a baby) have chosen to have a sperm antibody test for their own information. Two of these patients, both having had multiple rounds of IVF without success before they had the reversal (and subsequent baby) with us, were happy to share their results with us. These two results came back with 100% agglutination and comments by the pathology company that this indicated that they were infertile and that IVF was the only option to achieve a pregnancy. Yet, they had both just fathered children after our reversal.
It is generally stated in IVF circles that sperm antibodies will render a vasectomy reversal a failure. This very controversial issue of sperm antibodies has been long criticised by Professor Owen and is explored in further detail by Dr Sherman Silber both a pioneer in IVF and Vasectomy Reversal in USA at (https://www.infertile.com/). A failure of vasectomy reversal would rarely be from sperm antibodies.
Some women may develop sperm antibodies which can result in permanent infertility, but this unfortunate and rare condition is not connected with a vasectomy procedure whatsoever.
Dr Lekich uses the advanced Owen Three-Layer Close technique, pioneered and perfected by Professor Owen since 1971, in his specially designed facility located on the Gold Coast. This technique has been used in over 6000 procedures, and draws on over 40 years of microsurgical research and experience. Our procedure has been optimised to reach the very highest success rates.
The success rate of the Owen Three-Layer closure technique has enabled the following success rates:
Years since vasectomy: |
Success Rate: |
---|---|
0-5 years | 80-90% |
6-10 years | 70-80% |
11-15 years | 65-75% |
16-20 years | 50-65% |
Several factors can influence the success of this reversal procedure, and these include:
At Metrocentre, we currently perform around 25 Owen 3 Layer Micro-Surgical Vasectomy Reversal each month, making us one of the largest and most experienced clinics in Australia.