Vasectomy

What is vasectomy?

Vasectomy is a permanent method of contraception in men that achieves sterilisation. It should be regarded as irreversible although it is possible to have a vasectomy reversal procedure.

The operation

The procedure may be performed using a local anaesthetic only, however for patient comfort and safety most surgeons recommend the use of a light general anaesthetic and a day surgery hospital admission. A small opening is made on the scrotal skin to allow the vas, the sperm-carrying tube on each side of the scrotum, to be accessed. A small section of the vas is removed and the ends are tied and cauterised. One end of the vas is buried under a layer of tissue in the scrotum so that the two ends are separated from each other. Local anaesthetic is used and the skin is closed with dissolving sutures or stitches.

Preparation for surgery

Blood thinners such as Plavix (Clopidogrel), Assasantin and Warfarin need to be ceased prior to surgery. It is usually acceptable to continue Aspirin. Inform your surgeon if you have a cardiac stent. All herbal preparations (eg Gingko biloba), glucosamine or fish oil should be ceased two weeks prior to surgery.

Bring two pairs of tight fitting underpants with you to hospital to support the scrotum after surgery. Because you are having a general anaesthetic, the hospital will contact you the afternoon before the day of your procedure with fasting instructions. This usually means nothing to eat or drink for at least six hours prior to surgery. You will need to arrange a friend or relative to take you home as you will not be permitted to drive after the procedure.

Post surgery instructions

The scrotum is supported with a dressing and underpants should be pulled up firmly. Paracetamol tablets should be taken every six hours on the first day, even if the pain is not troubling you. Showering is permitted from the morning after the procedure. The dressing should be gently soaked off in the shower, the area dried carefully and, if required, a new dressing applied. Continue applying the dressings after showering until the wounds stop oozing. All the stitches are dissolvable, and take about ten days to dissolve in most cases.

It is best to rest on the day of surgery, and as much as possible for the next few days. You may return to work within two to three days or when you feel comfortable to do so. Avoid contact sport, heavy exercise and swimming for at least three weeks and avoid any sexual activity for the first two weeks.

You should contact your surgeon if there is a marked increase in pain, bruising or if the wound is discharging pus or becoming inflamed.

A sperm count should be performed after at least twenty ejaculations and not before three months after the date of the procedure. Contraceptive methods should not be ceased until the sperm count is zero and you have been notified by your surgeon to this effect. You will be given a pathology request form to take to the laboratory for the sperm count, and further instructions about the testing will be provided at that time.

There is usually no need to attend the consulting rooms for a follow up appointment after the procedure.