Vasectomy Clinic
HIGHCLIFFE MEDICAL CENTRE has been appointed as the centre for vasectomy by the South East Dorset Primary Care Trust. It set up a team of doctor and nurses who have carried out a busy weekly vasectomy clinic since August 2004. Facilities are quiet and comfortable, with the surgical area and waiting rooms separate from the main practice. A well-equipped operating area has been set up, with surgical theatre facilities.
Dr Naveed Sami with a background and experience in general surgery has been appointed by the South East Dorset PCT and approved by urologists from the Royal Bournemouth General Hospital and the Primary Care Trust as a GPSI (GP with special interest) in this area.
Who should have it?
Vasectomy is the most popular form of PERMANENT birth control world wide. It is ideal for couples who have finished their families and do not want any more children. If you or your partner are unsure on this point, this procedure is NOT for you.
What is involved?
The operation itself is quite straightforward. To help you relax, you can bring a tape or a CD to listen to during the procedure.
A small amount of local anaesthetic will be injected into the skin of the scrotum to numb the area so you should not feel any pain. We might have to shave away some of the hair but this does not cause discomfort.
The 'No-Scalpel Technique' is used to make a small opening in the skin; a small piece of the vas deferens (the tube that takes the sperm from the testes) is removed and the ends tied and sealed. The procedure is repeated on the other side and usually a single self-absorbing stitch is required to close the skin opening. This technique has the benefit of less pain, early healing and very little bleeding.
The operation takes about 20 minutes. However, you will probably spend an hour at the Centre, allowing for preparation and rest time afterwards.
What to expect afterwards
It is best if you have someone to drive you home as the local anaesthesia starts to wear off after an hour. You will feel uncomfortable for a few days but there are a few things you can do to help:
- Take some painkillers such as a Paracetamol or Ibuprofen on a regular basis for at least the first 2 days.
- Rest in bed for the remainder of the day and use an ice pack on the scrotum for the first few hours after the operation.
- Wear tight underwear or an athletic support. This helps support the testicles and prevents bleeding and discomfort.
The following day you can have a shower but hot baths are not recommended for the first week. You should take things easy and no heavy lifting or cycling should be done for the first week. By the second or third day, most men should be able to go back to work but those with a heavy manual job might have to wait a bit longer depending on their symptoms.
Expect to have some yellow coloured fluid from the wound for the first few days and a bit of bruising. Over the next few weeks, you might develop a small lump up to 1cm across at the site of the operation. Again, this is normal and is just the body's own healing process. It should go away by 2 months.
Sexual activity can be commenced once you feel comfortable but not in the first few days. There is usually no change in sex drive and no obvious reduction in the amount of semen produced.
Post Operation Sperm Count
You are normally requested to provide two semen specimens in containers provided for the 12th and 16th weeks after surgery.
To provide these specimens:
- There should be no sexual intercourse for 4 days prior to the test.
- A fresh specimen should be collected by masturbation directly into the container.
- Condoms should not be used to collect a specimen as they contain a spermicide.
- The specimen should be kept warm (room temperature) and taken within the hour to the microbiology laboratory.
Results
You must continue to use contraception until you are contacted by your doctor, informing you that both specimens are clear of all spermatozoa.`
Complications
No serious complications have been shown to be associated with vasectomy.
Whilst all care is taken to ensure that you have a safe and uneventful recovery following your operation, there is always an element of risk following surgery.
- The most common problem is bleeding. If it occurs from the skin edge, it can be stopped by resting, gently squeezing for 5 minutes and using the ice packs more often. Large haematomas (blood clots) are unusual and your doctor will need to see you if this occurs.
- Infection is uncommon but if there is worsening pain in the scrotum with fever and generally unwell, you will need to see your doctor who may prescribe some antibiotics.
- A very small number of men (less than 0.5%) develop chronic testicular pain, but in many cases this is resolved.
- Even after a successful operation, 1 in 2000 men become fertile again at some point in the future. This is because, rarely, the two ends of the cut vas deferens re-unite in time.
Although vasectomy is a very effective form of sterilisation it must be noted that
- There is no guarantee that the operation will be 100% successful.
- If there is any doubt about having the operation you must be aware that this procedure is not easily reversible.