Vasectomy-PatientInformation

From Wiki Surgery
Jump to navigation Jump to search


VASECTOMY

MICHAEL EDWARDS

Author's note

This information describes what a patient may expect when having the described operation.

The information is specific to the author's practice.

Other surgeons will doubtless differ in their preferences.

The script can be down loaded and edited to suit other surgeons.

Click here for the PDF version of the leaflet

You will need Abobe Acrobat Reader which can be downloaded from http://www.adobe.com/uk/products/acrobat/readermain.html


Your Vasectomy - Some Information

These notes give a guide to your stay in hospital. They also give an idea about what it will be like afterwards. They do not cover everything. If you want to know more, please ask.

What exactly is a Vasectomy?

First of all, the vas is the name of the tube that carries the sperm from each testicle, up into the groin and then deep inside the body to the base of the penis.

A vasectomy means that a piece of the vas on each side is taken out just above each testicle and the ends are tied off. The sperm cannot pass into the penis, so you will no longer be fertile. But you will still make fluid at intercourse.

Is it reliable?

Yes, once the vas tubing has cleared itself of sperms (which may take several weeks) the operation is very reliable. However, in spite of all surgical efforts, pregnancies do occur in about 1 in 2000 men after vasectomy.

This is a very low chance and is lower than the chance of pregnancy when the contraceptive pill is used, lower than the 1 in 500 chance of pregnancy after female sterilisation, and much lower than when the sheath, coil or diaphragm are used.

Can it be reversed?

Yes, the cut ends can be joined up again but the rate of success in producing further pregnancies is only about 1 in 3.

It is best to have a vasectomy on the understanding that it is not reversible.

YOU NEED TO DECIDE THAT COME WHAT MAY YOU DO NOT WANT MORE CHILDREN.

Bear in mind that 1 in 3 marriages break up nowadays.

Also, if you now have children that are under 1 year old, they do not have such a strong hold on life as older children. There are about 1000 cot deaths per year in the United Kingdom.

Do not make a hasty decision about vasectomy, it is very permanent.

Are there any alternatives?

Most of the other ways of contraception are not permanent. For instance, a condom, coil, the pill and the long term female injection treatment. Less proven ways include the day after contraceptive pill and the contraceptive pill for men.

Clipping the tubes in the female is worth thinking about. It is not as reliable as a vasectomy and needs a general anaesthetic.

Removal of the womb in the female is clearly a permanent solution. You should think about this if your partner has, for instance, fibroids and heavy periods.

Are there any side effects?

After vasectomy, the testicles still make sperm, but these sperm are melted away by the body as quickly as they are made. The testicles do not swell or feel heavier or tense afterwards.

The testicles still make sex hormones, so that you still grow a beard, have the same abilities at sex, remain just as aggressive, do not put on weight and will not change your voice.

You will still make fluid at intercourse after vasectomy because this fluid is made further down the tubing than the tied off part of the vas.

The operation appears free from long term side effects.

What is the operation like?

EITHER

You have the skin of the scrotum numbed with an injection of local anaesthetic just as a dentist numbs a tooth.

A 1/2" cut is made in the front of the scrotum and the operation is done in 20 minutes. There are 3 stitches in the cut which drop out themselves in a week or so.

You can expect to feel some pushing and pulling, but it is less uncomfortable than having a tooth filled.

You do not need to shave or starve beforehand and you can drive home straight away afterwards.

You should wear Y front or slip underpants, but not boxer shorts.

OR

You can have a general anaesthetic when you would be asleep during the operation. While you are asleep, we numb the wound with an injection so that it does not hurt when you wake up.

You would need to starve beforehand, but you would be able to go home the same day.

You would not be fit to drive, use machinery or make big decisions for 24 hours.

After the operation

After local anaesthetic injection last for an hour or two. Take aspirins or paracetamol tablets within one hour. This will let the tablets kick in and control any discomfort before the injection wears off. The discomfort is not severe. Take things quietly for the rest of the day.

After a general anaesthetic you will feel sleepy for 2 to 4 hours. Aspirins or Paracetamols will control discomfort from the wound.

On the next day you may feel sore, perhaps as bad as after a black eye. You can take off the dressings and wash, bathe or shower. You will have spare dressings to cover the wound. Use underpants to hold them on.

On the third day you may notice black bruising in the skin. This fades away in a day or two.

After a week the wound has settled almost completely and the stitches will have dissolved out.

What about the sperm tests?

You need to have sperm counts done 12 and 14 weeks after your operation to test that the tubing is clear of sperms.

Straight after your vasectomy you will be given dated specimen pots and forms.

On each appointed day you should produce a specimen by masturbation and put it in the appropriate pot.

Bring the pot, plus the form, within 2 hours to Woodlands Hospital reception desk or the Pathology Department at South Cleveland Hospital. Please arrange to bring the pot between 8.45 a.m. and 11.00a.m.

If the dates turn out to be unsuitable you can do the test on a later date, but make sure that you alter the dates on the forms and the containers to match.

If the tests are not clear then we will write to you with further pots and forms.

When the tests are finally clear I shall write to you. Only then should you stop using a contraceptive.

What about passing urine?

The operation does not upset passing urine. The urine will not sting or get bloody.

What about work?

You can work the next day, but you would find it more comfortable to take a day off after the operation.

What about sport?

It is sensible to avoid mild sports for 3 or 4 days and violent sports for a week or so.

What about sex?

You can start again as soon as the wound is comfortable. That is after about a week.

Remember, you are still fertile until the sperm tests are clear. Carry on with a contraceptive until you get the go ahead from me.

Are there any risks?

There is always a swelling about the size of a marble on each side due to the internal stitches and minor bleeding. This settles down in a week or two.

Perhaps 1 in 1000 men notice bleeding which causes swelling bigger than marble size or which comes through the dressings. If this happens (it will be in the first 12 hours), get surgical help immediately. Go to your nearest accident and emergency department.

Sometimes the stitches do not drop out in 2 weeks. If this happens they can be nipped out easily. Ask your General Practitioner’s surgery if they will take them out.

Very rarely there is some pain and discharge due to infection 4 or 5 days after operation. This responds to antibiotics. Ask your General Practitioner or call Woodlands Hospital.

Even more rarely swellings appear 4 to 6 weeks after operation on each side where the internal stitches have been. These can be removed if necessary. Call Woodlands Hospital.

Minor twinges may be felt for several weeks.

Rarely the tests do not clear. We will contact you if this happens. Very rarely a redo operation is needed.

General advice

Your main decision is that you do not want to have any more children. After that, the operation is straightforward.

You can always get help if you have queries or problems. Overall the operation is most satisfactory.

Any Questions?

If you have any questions, jot them down here and ask the doctors or nurses for answers.

Any complaints?

If you have any complaints, please contact the doctors or nurses straight away. If this does not solve the problem, please write to your surgeon