The Vasectomy Doctor

The no-scalpel technique was developed in 1974. Conventional vasectomy involves a scalpel incision to both sides of the scrotum and sharp dissection to gain access the vas deferens tubes. The no scalpel technique involves puncturing the scrotal skin with one entry into the middle of the scrotum. No scalpel is used to puncture the skin or importantly in the dissection to isolate the vas deferens. This technique has been proven to reduce complication risk by upto 10 times. In addition, the procedure itself has been shown to better tolerated.

No-scalpel vasectomy is regarded as a low-risk office procedure.

Vasectomy carries a complication rate of less than 2 in 100 ¹.

1. Bleeding may range from minor bruising to a collection of blood accumulating in the scrotum called a scrotal haematoma. Small haematomas usually resolve safely by themselves. Very rarely do haematomas need to be drained surgically.

2. Infection risks are reduced with vigilant sterile preparation and technique. No antibiotics are usually required before the procedure. Infections are rare but can be serious requiring antibiotics or surgery.

3. Allergic/adverse reactions may occur to skin preparation, latex, anaesthetic or other equipment may occur rarely but can be easily managed. Please inform us of any allergies you may have including to latex.

4. Sperm granuloma is an internal lump thought to be caused by a leakage of sperm from the vas. It usually requires not treatment but can cause discomfort rarely resulting in surgical removal.

5. Post-Vasectomy Pain Syndrome is a rare syndrome is characterized by chronic (that is long-term) pain in the scrotum or testicle. This may occur for a number of reasons including pressure in the structures draining into the vas (for example the epididymis or testicle), scarring or nerves being disrupted from the procedure. One of the more robust studies showed less than 1 in 100 men will have pain that noticeably affects their quality of life at 7 months after vasectomy².

6. Recanalisation is where the two ends of the vas may rejoin and sperm are again free to pass through. This is known as a failure. Again this is rare. Failure may be early (acceptable risk about 1/350) or delayed (which maybe years down the track). Vasectomy stacks up as a superior form of contraception compared to the alternatives. Semen is checked to determine success of a vasectomy.

Misconceptions about the risks of vasectomy

There have been some questions about risks of vasectomy for men in terms of sexual health and overall health.

• There is no physical reason why vasectomy would lead to decreased sex drive. In fact, evidence shows that half or more of men who undergo vasectomy reported and increase in frequency of sex or sexual satisfaction. Only 5% of men reported a decrease in frequency of sexual habits.

• There is no evidence vasectomy leads to long-term health risks such as cardiovascular disease or cancer.

• There is no link between vasectomy and prostate cancer.

Sources

1. Sharlip ID, Belker AM, Honig S et al: Vasectomy: AUA guideline. J Urol 2012; 188: 2482.

2. Leslie TA, Illing RO, Cranston DW, Guillebaud J. The incidence of chronic scrotal pain after vasectomy: a prospective audit. BJU Int. 2007 Dec;100(6):1330-3. Epub 2007 Sep 10.

Men need to at least be above age 18. However, if you are under the age of 30 and have fewer than 2 children, we ask that you book in for a consult to discuss your situation before committing to vasectomy. Life circumstances do change and younger patients may experience regret in the futurs. We like to know that you have thought about the ramifications of vasectomy and the options available for you prior to undergoing a potentially irreversible procedure.

Generally, the procedure itself takes 10-20 minutes.

1. Read the Instructions and information sheet.

2. Print and fill out Registration form.

3. Make sure you do not take any blood thinning medications for 7 days before the procedure. These include anti-inflammatory medications (eg ibuprofen, nurofen, advil, voltaren) and fish oil. If you are on aspirin for a medical condition, then this can be continued. Please call if you are unsure.

4. Bring or invest in some tight underwear (briefs not boxers) to wear immediately after the procedure and for 7 days into recovery.

5. Shower on the morning of the procedure - no shaving is required. The next time you are advised to shower is the day following the procedure.

6. Arrive 10-15 minutes before your procedure

This depends on the type of work you do. If you work in an office environment which does not involve heavy lifting or intense labouring then you may return to work the following day. This is also if you are relatively comfortable. If your work involves heavy lifting or more intensive physical labour, then we suggest that you do not go back to work for at least 48 hours. If you are pain and tenderness free after this time, we suggest a gradual return to work duties. When you do return to work, please wear supportive underwear for at least 7 days post procedure.

Pain is very subjective and each man will experience a different level of discomfort. Local anaesthetic is used to make the procedure as comfortable as possible. This usually wears off a few hours after the procedure. Following this, most men are surprised at how little pain they have. In general, pain can be controlled with paracetamol and wearing supportive underwear. Sometimes anti-inflammatory medications (such as Nurofen or Advil) are required. It is unusual to escalate pain relief, however, it is advisable that you speak with Dr Ranaweera or seek medical attention if you feel your level of pain is severe or increasing.

Some men use ice packs which is optional.

The day after the procedure you should be able to walk and drive. From day 2, more physical activity is allowable provided you.

1. Wear tight fitting underwear for compression

2. Avoid actiivits that place direct pressure onto the operated area such as bike riding, surfing, horse riding or harness work.

3. Use common sense (if it is too sore, don't do it)

Usually men have recovered substantially enough by day 7 to go about their usual activities.

Sexual intercourse is not recommended for 1 week after the procedure.

To prove success, a semen sample is required. This is an important step to completing your Vasectomy.

Please ensure that 12 weeks have elapsed from your procedure and you have ejaculated at least 20 times since your procedure before sumitting your sample. The sample can be submitted in our supplied pathology container to a pathology company of your choosing. Please note that pathology companies may charge for analysing post vasectomy samples.

The results come back to us and we contact you.