Vasectomy is now the most chosen form of birth control with vast numbers of men undergoing the procedure and few problems being reported. It is preferential to female sterilisation, due to the simplicity and ease of the operation and the greatly reduced recovery time.
When a couple decide that they have completed their family the only reliable and permanent option is sterilisation. This can take the form of tubal ligation for the female partner or a vasectomy for the male.
In the best cases tubal ligation generally involves a half-day hospital operation under a general anaesthetic and has an extended recovery time which may be up to five days.
Vasectomy can be carried out at a local clinic under a local anaesthetic during a procedure which probably lasts less than 20 minutes. The failure rate is generally very low and normally patients can be back at work the following day.
Due to the many possible complications and extended recovery time necessary after a tubal ligation the vasectomy option is more preferable. With great improvements in medical techniques the No-Scalpel Vasectomy (NSV) allied with the No-Needle technique and No-Stitch procedure turn this operation almost into the category of a very simple procedure.
Vasectomy should be regarded as a permanent procedure. Vasectomy reversal operations, it must be understood, cannot be guaranteed as being successful and are usually more expensive than the vasectomy itself.
Prior to the procedure commencing the patient will be counselled to ensure that this is completely understood.
On the day before the opertation takes place the patient is asked to shave the scrotum and the sides of the groin.
On the day of the operation the patient is asked to have a light breakfast and take two paracetamol tablets TWO HOURS before the operation is scheduled. This will reduce the amount of discomfort during the operation.
Traditional anaesthetic was one of the primary sources of discomfort and possibly some pain upon the introduction of the needle to the scrotum. Now with the use of the No-Needle anaesthetic the vasectomy procedure is as near to pain free as possible.
Due to advances in technology the anaesthetic is now delivered using a pressure jet injection instrument which uses a nozzle to pass the anaesthetic through the scrotum directly to the vas. This eliminates the necessity for two anaesthetic injections, one for each vas. Another advantage of this method is the more rapid onset of the effect of the anaesthetic, 10 - 20 seconds as opposed to 2 - 3 minutes using a needle.
Once the anaesthetic has taken effect the operation can begin. In conventional procedures the scrotum would be cut using a scalpel. Using the NSV technique the surgeon will first locate the vas under the skin of the scrotum. When this is done it is held in place using the Li Brand™ ringed forceps. A small incision is made using a pair of dissecting forceps and the vas is delivered through this. The vas is then separated using the dissecting forceps and sealed using an electro-cautery device. The diagram shows how the vas is separated and a larger, labelled image can be seen by clicking the diagram itself.
The procedure is repeated for the second vas through the same incision thus only one incision is made in the scrotum as opposed to two using the conventional method. This results in less discomfort after the procedure is complete.
The final stage of the operation is to cover the small incision with antibiotic spray and a sterile dressing is held in place with a scrotal support. No stitches are necessary to close the puncture hole which is usually very small.
In total the process normally takes fifteen to twenty minutes to complete.
SuiteWhen the vasectomy procedure is completed the patient is given such time as is needed to rest in our recovery suite.
We recommend that the patient rests at home for approximately twenty-four hours after the procedure and that analgesia such as paracetamol or ibuprofen is used reduce any discomfort during that period.
If paracetamol is taken after the procedure the patient should bear in mind that not more than 8 paracetamol should be taken in one 24 hour period.
The patient should also use a scrotal support for five to seven days following the vasectomy procedure and if there is any cause for concern should contact the Vasectomy Clinic for guidance.
It has been known for men to return to work as soon as the day following a vasectomy operation. Whilst this may be acceptable for anyone employed in a less physical type of occupation those with strenuous occupations are advised to undergo two to three days of rest.
Sexually patients should not be affected in any way after the vasectomy operation and the male genetalia will work in exactly the same way as it did prior to the procedure except you will not be able to make your partner pregnant.
After undergoing a vasectomy you will NOT be sterile straight away and some form of contraception MUST be used until a minimum of two semen samples have been tested and proven to be negative for sperm.
You may resume sex as soon as you feel comfortable but we would normally advise that you wait until you are pain free.
No invasive surgery can be deemed to be one hundred per cent safe although many procedures have a very low incidence of complications. There are four main complications associated with vasectomy operations as follows;
- Haematoma (bleeding) - is the most common complication of vasectomy but this is extremely rare. This occurs in just over three per cent of men who have a conventional vasectomy and less than half of one per cent of men who opt for the No-Scalpel method. The no-scalpel method is associated with a much lower rate of haematoma because as the scrotum and sheath covering the vas are punctured rather than cut with a scalpel and the opening dilated, blood vessels are more likely to be moved aside and not cut. The risk of any severe complications with the No-Scalpel method which would require hospital admission is less than one in a thousand (0.01%).
- Recanalization - Vasectomy is not guaranteed to be 100% effective. Even when the procedure is performed perfectly sperm can travel past the cauterised ends of the vas deferens. Although this is very rare (less than 0.2% of the time), it can occur months or even years later. This illustrates the importance of performing tests on the patient's semen samples up to eighteen weeks after the operation to ensure a nil sperm count. This complication will usually occur within two or three months of the vasectomy, but in exceptional cases has been known to happen a number of years later.
- Granuloma - This is a hard and sometimes painful pea-sized lump,which may form as a result of sperm leaking from the dissected vas. It is not dangerous and almost always rectified by the body's natural healing processes over a period of time. Normally the use of pain relief and a scrotal support are all that is necessary to relieve the symptoms. Although the doctor may suggest other treatments such as trimming off the affected end of the vas in a further minor procedure.
- Congestion - or more accurately a sense of fullness or pressure caused by sperm in the testes, epididymis, and lower vas. This may cause discomfort some 2 to 12 weeks after vasectomy. Again this is not serious and is usually resolved in the passage of time.
Although the No-Scalpel Vasectomy is one of the safest invasive surgery procedures available it is only proper that we point out the possible complications listed above to provide proper care and guidance to our patients.
Should you have any further questions regarding the procedure or the facilities at our clinic please use our contact form so that we may assess your question and provide a full answer via your preferred option.
A full explanation of the No-Scalpel Vasectomy together with explanations of the terminology involved and history and detail of the procedure are available at the website of Weill Medical College at Cornell University.
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