Vasectomy and Links

Referral is not always necessary for this operation.
Mr Knight has had extensive experience with this operation. He has safely been performing vasectomies for 30 years.

Vasectomy is a simple, effective and safe means of sterility or permanent birth control. It is an important step to take because it is potentially irreversible [11].

Therefore it is important that you when you decide to have a vasectomy that you do not want to have any more children. It is a decision that is best make with your partner. If you are young, your current relationship is not permanent, you are under a lot of stress, you are counting on it being reversed at a later date, or you are having a vasectomy to please your partner a vasectomy may not be right for you

The operation of vasectomy is designed to exclude sperm from the semen and thereby make you sterile. However there are storage organs containing sperm which have to be emptied before other forms of contraception are abandoned. It usually takes about 20 ejaculates for all sperm to be eliminated and a test of the semen is then necessary and will be explained to you at the time of the operation.

The only complications of the operation are local ones [4]. Bruising of the scrotum is not unusual and some swelling and soreness of one or both sides is not uncommon [1]. A highly regarded study looking at the risk of prostate cancer and vasectomy found that vasectomy does not increase the risk of prostate cancer, even after 25 years or more. (click here to read the study)

The testes suffer no ill effects from having the outlet blocked [1]. Sperm production is still normal although slower than usual and the sperms disintegrate and are absorbed without causing any ill effects. Competently performed, the operation does not damage the blood supply of the testis and therefore male hormones are not affected since they enter the bloodstream directly from the testis. There are no changes to your maleness and in particular no depression of your sexual appetite or your ability.

Although 1.000 per 1,000 certainty of sterility can not be guaranteed, there are double safety steps taken, and we have the final check of semen as an indicator of sterility.

Initial Appointment
A short initial appointment is necessary prior to the procedure. At this time any questions can be answered, risks explained, the consent process is covered and your vasectomy time is arranged.

Consent

Consent form (to come)
.pdf format click here
Data you need to provide (to come) .pdf format click here

Before the operation
It is advisable to bathe some hours before the operation and carefully shave the scrotum since the incisions will be made near the upper portion of the scrotum. It is also helpful if you wear brief underwear of the support type when you come for operation.

The Vasectomy Procedure
Vasectomy is performed in the Clive Square Napier operating theatre. The procedure will take about 30 minutes.
The operation can be performed under local anesthetic and most men prefer the operation this way as they find it quite tolerable, if somewhat uncomfortable and much more convenient than a general anesthetic since they can come and go on their own, (not on a ten speed mountain bike or motor bike), and there is no need to starve and none of the occasional complications of a general anesthetic.

After the Operation
After surgery you are advised to go home and place an ice pack over the area. It is preferable to stay off your feet that evening and take it easy, to minimize swelling.
Change the dressings for the next day or two. Some slight oozing and discoloration of the scrotum is normal. You may take a shower the following day but avoid baths for 4 days. Do not undertake any strenuous activity for the following week. Delay intercourse for 7 days after the operation.
For pain relief you will have been given a prescription for an appropriate mild analgesic. Brief preventative antibiotic cover is given.

Testing of Semen
Continuing contraception is necessary until two consecutive tests of the semen show zero sperm count. Follow the directions given at the time of operation. You will be notified of the results.

Cost
The cost of a vasectomy is $366.00 including GST. This price includes:

Pre-operative consultation
Vasectomy procedure
Post-operative medication
Follow up of semen results

Payment by cheque, cash, EFTPOS (debit card or major credit card) is accepted.
Private Medical Insurance
Some medical insurance companies will fully fund the cost of the vasectomy under a surgical cover policy.
Low Income Patients
Patients who hold a Community Services Card may apply for assistance through Work and Income New Zealand. A letter supporting this application can be requested at the initial appointment. If funding is granted, it is usually up to $300. The shortfall must still be met by the patient.

Risks and Complications
Vasectomy is a very safe procedure. Even with a minor procedure, there are risks [1] [8] [10]
Swelling [1]
Some swelling and bruising is normal. Occasionally there will be a lot of swelling [1]. If there is increased pain, swelling, redness and tenderness of the scrotum, call Mr Knight.
Sperm Granuloma [5]
Occasionally a small hard lump at the site of vasectomy can be felt. This is usually of no significance if there are no symptoms. If it is associated with discomfort this normally resolves and no treatment is necessary[5].
Auto-reversal
The spontaneous return of fertility is very rare but possible [3].

Vasectomy Links

UpToDate Patient information
National Institute for Health (UK) Patient information
Risk of recanalization after vasectomy Medical article
Complications of vasectomy A medical article abstract from Pubmed
MyDr (Australian site) Your questions answered
Andrology Australia Men's reproductive health
Pubmed search for medical articles Use key words in the search field

Basic Anatomy

References

1. Awsare, N.S., et al., Complications of vasectomy. Ann R Coll Surg Engl, 2005. 87(6): p. 406-10. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16263006


2. Cook, L.A., et al., Scalpel versus no-scalpel incision for vasectomy. Cochrane Database Syst Rev, 2007(2): p. CD004112. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17443540

3. Cook, L.A., et al., Vasectomy occlusion techniques for male sterilization. Cochrane Database Syst Rev, 2007(2): p. CD003991. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17443535


4. Dassow, P. and J.M. Bennett, Vasectomy: an update. Am Fam Physician, 2006. 74(12): p. 2069-74. Access date: 10 December 2008, Available from: 3http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17186713


5. Gade, J. and K. Brasso, Sperm granulomata. Ugeskr Laeger, 1990. 152(32): p. 2282-4. Access date: 10 December 2008, Available from: 5http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2205035


6. Heath, C.B., Helping patients choose appropriate contraception. Am Fam Physician, 1993. 48(6): p. 1115-24. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8237732

7. Hepp, S.M. and E.J. Meuleman, Vasectomy: indications and implementation in historic perspective. Ned Tijdschr Geneeskd, 2006. 150(11): p. 611-4. Access date: 10 December 2008, Available from: 1http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16610501

8. Holt, S.K., C.A. Salinas, and J.L. Stanford, Vasectomy and the risk of prostate cancer. J Urol, 2008. 180(6): p. 2565-7; discussion 2567-8. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18930503

9. Labrecque, M., et al., Vasectomy surgical techniques: a systematic review. BMC Med, 2004. 2: p. 21. Access date: 10 December 2008, Available from: 2http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15157272


10. McDonald, S.W., Is vasectomy harmful to health? Br J Gen Pract, 1997. 47(419): p. 381-6. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9231476


11. Murtagh, J., Patient education. Vasectomy. Aust Fam Physician, 1993. 22(5): p. 806. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8517823

12. Peterson, H.B., Sterilization. Obstet Gynecol, 2008. 111(1): p. 189-203. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18165410

13. Schwingl, P.J. and H.A. Guess, Safety and effectiveness of vasectomy. Fertil Steril, 2000. 73(5): p. 923-36. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10785217


14. Trussell, J., et al., Cost effectiveness of contraceptives in the United States. Contraception, 2009. 79(1): p. 5-14. Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19041435

Page reviewed on 1st November 2013

 
   
Copyright © 2007 Douglas H Knight. All Rights Reserved.