Vasectomy is a well tried and tested technique of family planning for men.
It frees the female partner of the need to use other forms of contraception. It is a simple surgical technique.
It does not reduce the risk of sexually transmitted diseases, for which barrier contraceptive techniques should still be used.
It involves the division of the two vasa deferentia, cutting off the flow of sperm from the testis. Sperm production then falls off.
The operation is intended to be permanent. There are reports of the cut ends rejoining spontaneously, restoring fertility. This is known as recanalisation. A number of strategies are thus employed to reduce the risk of this happening to an absolute minimum. The details of the technique may vary slightly from one surgeon to another.
In our practice, approximately one centimetre of each vas is removed and the cut ends are turned back on each other and tied back. The segment of vas is sent to the pathology laboratory for further confirmation of the technical accuracy of the procedure. The operation is usually undertaken through a small cut of a few mms on each side of the scrotum, and usually takes around 15 minutes.
Most procedures can be undertaken under local anaesthetic as a day case procedure. Men’s scrotal anatomy varies considerably, and it is occasionally advantageous and more comfortable for the patient to have a general anaesthetic.
It can take several months for viable, fertile sperm to be cleared from the reproductive system. We thus arrange for two semen samples produced at approximately 12 and 14 weeks post operatively to be analysed for viability. Contraception should continue until you have received the “all clear” from the hospital.
Some surgeons offer an operation which can rejoin the vasa, known as a Reversal of Vasectomy.
This has a very unpredictable outcome, and no-one should opt for a vasectomy as a temporary form of contraception on the assumption of successful later reversal.
The decision to undergo vasectomy
Vasectomy is best embarked upon as a rational contraceptive strategy by couples in stable long term relationships, who have both freely agreed that they have completed a family or would not want any or more children under any circumstances.
Marriages and partnerships dissolve, and men do seek a reversal procedure from time to time, having changed partners. If you have any doubts about the operation in the context of your personal relationships, it is probably better to adopt an alternative strategy until time has clarified matters.
Consent for Vasectomy
This is ultimately a personal and private decision which no other adult, partner or spouse can deny to you. However, in the best interests of happiness and harmony for all, we strongly encourage vasectomy to be a joint and agreed decision between partners. Your consent form may reflect this aspiration.
The key issues are consent are:
1. Understanding of the irreversibility of intent of the procedure
2. Recognition of the remote possibility of spontaneous reversal, of the vasectomy at a later date despite properly conducted primary surgery
3. The need for continued contraception until sperm counts are clear.
A successful day case vasectomy does little to inhibit rapid and full recovery to normal activities, including sexual activities, and an immediate return to work and sport
Rarely, a blood clot can form around the operation and delay recovery.
Some men are troubled by persisting discomfort, and a small knot of scar tissue, a stitch granuloma, can occasionally be felt at the cut ends of the vasa.
Text provided by Mr David Rew, Copyright 2003