Vasectomy and Links
Referral is not always necessary
for this operation.
Mr Knight has had extensive experience with this
operation. He has safely been performing vasectomies
for 30 years.
Vasectomy is a simple, effective
and safe means of sterility or permanent birth control.
It is an important step to take because it is potentially
irreversible [11].
Therefore it is important that
you when you decide to have a vasectomy that you
do not want to have any more children. It is a decision
that is best make with your partner. If you are
young, your current relationship is not permanent,
you are under a lot of stress, you are counting
on it being reversed at a later date, or you are
having a vasectomy to please your partner a vasectomy
may not be right for you
The operation of vasectomy is designed
to exclude sperm from the semen and thereby make
you sterile. However there are storage organs containing
sperm which have to be emptied before other forms
of contraception are abandoned. It usually takes
about 20 ejaculates for all sperm to be eliminated
and a test of the semen is then necessary and will
be explained to you at the time of the operation.
The only complications of the operation
are local ones [4]. Bruising
of the scrotum is not unusual and some swelling
and soreness of one or both sides is not uncommon
[1]. A highly regarded study looking at the
risk of prostate cancer and vasectomy found that
vasectomy does not increase the risk of prostate
cancer, even after 25 years or more. (click
here to read the study)
The testes suffer no ill effects
from having the outlet blocked [1].
Sperm production is still normal although slower
than usual and the sperms disintegrate and are absorbed
without causing any ill effects. Competently performed,
the operation does not damage the blood supply of
the testis and therefore male hormones are not affected
since they enter the bloodstream directly form the
testis. There are no changes to your maleness and
in particular no depression of your sexual appetite
or your ability.
Although 1.000 per 1,000 certainty of sterility
can not be guaranteed, there are double safety steps
taken, and we have the final check of semen as an
indicator of sterility.
Initial
Appointment
A short initial appointment is necessary prior to
the procedure. At this time any questions can be
answered, risks explained, the consent process is
covered and your vasectomy time is arranged.
Consent
Consent form (to come) |
.pdf format click here |
| Data you need to provide (to come) |
.pdf format click here |
Before
the operation
It is advisable to bathe some hours before the operation
and carefully shave the scrotum since the incisions
will be made near the upper portion of the scrotum.
It is also helpful if you wear brief underwear of
the support type when you come for operation.
The Vasectomy Procedure
Vasectomy is performed in the Clive Square Napier
operating theatre. The procedure will take about
30 minutes.
The operation can be performed under local anesthetic
and most men prefer the operation this way as they
find it quite tolerable, if somewhat uncomfortable
and much more convenient than a general anesthetic
since they can come and go on their own, (not on
a ten speed mountain bike or motor bike), and there
is no need to starve and none of the occasional
complications of a general anesthetic.
After
the Operation
After surgery you are advised to go home and place
an ice pack over the area. It is preferable to stay
off your feet that evening and take it easy, to
minimize swelling.
Change the dressings for the next day or two. Some
slight oozing and discoloration of the scrotum is
normal. You may take a shower the following day
but avoid baths for 4 days. Do not undertake any
strenuous activity for the following week. Delay
intercourse for 7 days after the operation.
For pain relief you will have been given a prescription
for an appropriate mild analgesic. Brief preventative
antibiotic cover is given.
Testing
of Semen
Continuing contraception is necessary until two
consecutive tests of the semen show zero sperm count.
Follow the directions given at the time of operation.
You will be notified of the results.
Cost
The cost of a vasectomy is $333.00 including GST.
This price includes:
| Pre-operative consultation |
| Vasectomy procedure |
| Post-operative medication |
| Follow up of semen results |
Payment by cheque, cash, EFTPOS (debit card or
major credit card) is accepted.
Private Medical Insurance
Some medical insurance companies will fully fund
the cost of the vasectomy under a surgical cover
policy.
Low Income Patients
Patients who hold a Community Services Card may
apply for assistance through Work
and Income New Zealand. A letter supporting
this application can be requested at the initial
appointment. If funding is granted, it is usually
up to $300. The shortfall must still be met by the
patient.
Risks
and Complications
Vasectomy is a very safe procedure. Even with a
minor procedure, there are risks [1]
[8] [10]
Swelling [1]
Some swelling and bruising is normal. Occasionally
there will be a lot of swelling [1].
If there is increased pain, swelling, redness and
tenderness of the scrotum, call Mr Knight.
Sperm Granuloma [5]
Occasionally a small hard lump at the site of vasectomy
can be felt. This is usually of no significance
if there are no symptoms. If it is associated with
discomfort this normally resolves and no treatment
is necessary[5].
Auto-reversal
The spontaneous return of fertility is very rare
but possible [3].
Vasectomy
Links
Basic
Anatomy
References
1. Awsare, N.S., et
al., Complications of vasectomy. Ann R Coll Surg
Engl, 2005. 87(6): p. 406-10. Access date: 10 December
2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16263006
2. Cook, L.A., et al.,
Scalpel versus no-scalpel incision for vasectomy.
Cochrane Database Syst Rev, 2007(2): p. CD004112.
Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17443540
3. Cook, L.A., et
al., Vasectomy occlusion techniques for male sterilization.
Cochrane Database Syst Rev, 2007(2): p. CD003991.
Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17443535
4. Dassow, P. and J.M.
Bennett, Vasectomy: an update. Am Fam Physician,
2006. 74(12): p. 2069-74. Access date: 10 December
2008, Available from: 3http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17186713
5. Gade, J. and K.
Brasso, Sperm granulomata. Ugeskr Laeger, 1990.
152(32): p. 2282-4. Access date: 10 December 2008,
Available from: 5http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=2205035
6. Heath, C.B., Helping
patients choose appropriate contraception. Am Fam
Physician, 1993. 48(6): p. 1115-24. Access date:
10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8237732
7. Hepp, S.M. and
E.J. Meuleman, Vasectomy: indications and implementation
in historic perspective. Ned Tijdschr Geneeskd,
2006. 150(11): p. 611-4. Access date: 10 December
2008, Available from: 1http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16610501
8. Holt, S.K., C.A.
Salinas, and J.L. Stanford, Vasectomy and the risk
of prostate cancer. J Urol, 2008. 180(6): p. 2565-7;
discussion 2567-8. Access date: 10 December 2008,
Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18930503
9. Labrecque, M.,
et al., Vasectomy surgical techniques: a systematic
review. BMC Med, 2004. 2: p. 21. Access date: 10
December 2008, Available from: 2http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15157272
10. McDonald, S.W., Is
vasectomy harmful to health? Br J Gen Pract, 1997.
47(419): p. 381-6. Access date: 10 December 2008,
Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=9231476
11. Murtagh, J.,
Patient education. Vasectomy. Aust Fam Physician,
1993. 22(5): p. 806. Access date: 10 December 2008,
Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8517823
12. Peterson,
H.B., Sterilization. Obstet Gynecol, 2008. 111(1):
p. 189-203. Access date: 10 December 2008, Available
from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18165410
13. Schwingl,
P.J. and H.A. Guess, Safety and effectiveness of
vasectomy. Fertil Steril, 2000. 73(5): p. 923-36.
Access date: 10 December 2008, Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10785217
14. Trussell,
J., et al., Cost effectiveness of contraceptives
in the United States. Contraception, 2009. 79(1):
p. 5-14. Access date: 10 December 2008, Available
from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19041435
Page constructed in September 2007 and last modified
December 10 2008
