Vasectomy Counselling

Vasectomies are one of the most reliable and safest forms of contraception available and is becoming increasingly popular. The operation is simple to perform and causes only a couple of days discomfort as a rule.

Unlike the sterilization operation for women which needs a general anaesthetic, a vasectomy can be carried out under local anaesthetic within General Practice. 

The operation has to be considered as permanent and so a couple considering this procedure should be fully informed before going ahead.

Counselling with Dr Syed Akhter

Dr Syed Akhter qualified from Dow Medical College, Karachi, and trained as a surgeon in Ireland before joining Somerset Bridge Medical Centre in 2002. He obtained a fellowship in surgery in 1996 from the Royal College of Surgeons.  His main interest includes Extended Minor Surgery in which he holds the specialist qualification (FRCS).

 

Post-operative Care and Advice

After approximately 2-3 hours the anaesthetic will begin to wear off. Over the counter analgesia may be taken e.g., Paracetamol, Ibuprofen or Co-codamol as per pack instructions. Use of an icepack on the scrotum for 10-15 minutes at a time every 1-2 hours may help reduce swelling and discomfort. 

To minimise discomfort or swelling it is advised that you wear some tight-fitting underwear, swimming trunks, or jockstrap. You should arrange for someone to be with you for the rest of the day. It is sensible to plan to relax at home for a few days, and should avoid any strenuous exercise, heavy lifting, or driving long (>1 hour) distances for 1-2 weeks.

After the procedure care should be taken with bathing for about 7 days, even though the scrotum may be bloodstained, it is best not to wash for the first 24 hours. It is advisable not to soak in the bath, but to have showers. Do not use excessive gels, shampoos, or tale.

 

Sexual intercourse can be resumed when comfortable. It is essential to continue to use contraception until there are no more live sperm in the ejaculation. Vasectomy has no known effect on masculinity, or on sexual arousal, performance, or orgasm.

Where the tubes have been cauterised and cut, some scar tissues will form. This may be felt as a slightly lumpy, sometimes tender area just above the testicle. This is quite normal, but if you do become concerned about any unusual lumps, see your GP.

There are no stitches to remove, there is only a small that will heal itself although may gape open a little and cause a slight blood-stained discharge. You only need to seek medical advise if it is persistent, excessively smelly or inflamed. You may also see slight blood-staining the first few times you ejaculate. 

Some swelling and bruising on the scrotum and testicles are normal but if it severe during the first few hours after operation you should contact the surgeon immediately. If you are unable to contact them, please contact a doctor through your own surgery.

Post-Vasectomy Semen Analysis

You will be required to give at least 1 specimen after about 4 months. Up to 4 months is the time when the risk of the tubes re-joining is the greatest. Sperm can live up to 70 days or longer and will be released for a variable length of time after the operation when you ejaculate.

To empty the reservoir of live sperm, it is recommended that you have intercourse or ejaculate on average 3 times a week. Sometimes it is found that even with this frequency of intercourse, some men take longer to clear the 'reservoir' of live sperm, you should not worry if you are asked for further specimens.

Traditional advice has been to obtain two completely clear semen tests before stating that a person is infertile, but this is no longer necessary. Your surgeon will confirm if you need to repeat the tests, and when you're 'clear' and 'infertile'.

No assurance that you have become infertile can be given without these tests and no responsibility will be accepted for failure of the operation if the required semen specimens are not submitted for analysis at the appropriate. 

Until you have written confirmation you should continue to take contraception precautions.

Consent to Treat

I hereby consent to undergo the operation of 'Vasectomy' under local anaesthetic, the nature and effect of which has been explained to me by Dr Syed Akhter. I have been counselled regarding alternative forms of long-term reversible contraception, e.g., coils/implants and have read and understood the information leaflet.

I also consent to such further alternative measures as may be found necessary or advisable during the operation and to the administration of a local anaesthetic for any of these purposes. I have been told that the object of the operation is to render me sterile and incapable of further parenthood, and I understand that the effect of the operation may be irreversible. Further, I confirm that I acknowledge there is a rare but accepted failure rate associated with non-scalpel vasectomy reported, to be in the order of 0.04% (1 in 2000), and therefore a small risk of pregnancy in the future even after being given the 'all clear'.

I understand that no guarantees can be given that the operation will be successful and that I can fail (1 in 300) risk of tubes joining together in the first 3 months, which means pregnancy can still occur or that it will be free from side effects.

I acknowledge that there is a small risk of significant complications such as infection and excessive bleeding/bruising/swelling (common to any surgical procedure - for non-scalpel vasectomy scrotal pain 1-2% and, extremely rarely, testicular atrophy (loss of the testicle due to interruption of the blood supply). Any complication may require further medical treatment, hospitalisation, further surgery, or can affect quality of life.

I understand that I should not abandon other methods of contraception prior to receipt of notification that at least one sperm count at least 4 months after my vasectomy has proved clear, or special clearance has been given, which may take up to 7 months.

I understand that I can change my mind at any time and decide not to proceed with the vasectomy.

A copy of this form will be given to you on the day of the operation. You will have a chance to raise any questions with Dr Syed Akhter prior to the operation.

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