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[ Vasectomy: Procedure ]
[ The Decision ]
[ How it works ]
[ The Operation ]
[ Afterwards ]
[ Collection of Semen ]
 
 
 

 

The Decision
Don't be surprised if it takes a couple of years to phone for an appointment after making the logical decision 'to get it done'.  Sometimes a 'near miss' or another pregnancy will accelerate things, but often the logic has to be filtered through a whole heap of emotional "what ifs".  Then there is also the very natural apprehension about having the job done.

It is almost impossible to make the decision 100% certain.  Eventually you may decide it's better than the other options that are available in your situation.

It is good to talk to your GP because he/she will have an impartial view of all the choices and may know something that would influence your decision (e.g. the possibility that your wife or partner will need a hysterectomy etc. ).

How it works
Men produce 1000 sperm a second.  Normally 95% of these go nowhere and get recycled in the testes.  The remaining 5% travel up the vas, get stored in the seminal vesicles near the prostrate (which supplies the juicy bit) and get fired out through the ejaculatory ducts during ridiculous acts of bizarre behaviour on Friday nights and Sunday mornings.

Removing a little (3 mm) portion of vas and sealing both ends of the tubes just above the testicle cuts off the supply line but from then on it will take one to three months (or even longer) to completely empty the dying residual sperm in the seminal vesicles.  The prostate keeps on supplying seminal fluid so all that stays the same.

Hormones are made in the testes but produce their effects by getting into the blood stream and are, therefore, not affected by vasectomy.

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The Operation
No special preparation is needed.

We will give you some antibiotics when you arrive and some anti-inflammatories and panadeine for afterwards (if needed)

Most people register surprise at the ease of the 'no scalpel' operation.  After shaving a little area on each side of the scrotum and using a small amount of local anaesthetic, a small loop of vas is brought to the surface, a small section is removed, both ends are sealed with fine nylon ties and cautery, both ends are buckled back on themselves, checking for any oozing they are replaced and the skin is sealed with glue, NOT stitches.

The complete time involved is about 1 hour although only about 20 minutes is needed for the real work.

You'll be fine to drive yourself home afterwards.

Occasionally people ask for tranquilizers and that is perfectly OK.  Bring a driver and get it done at Onehunga if we are going to use tranquilizers. Ring Dr Calveley about this first if you think this is a requirement.

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Afterwards
Two days of almost complete rest are needed to give the internal raw areas a good chance to seal over.  There should be complete rest lying down for the first day and minimal activity on the second day.

Most men will be able to return to work after two days but if you have a very active job, it may be prudent to have a few more days off.  It's a bit like a small shaving cut, if it gets knocked around on the first day it will almost certainly bleed - after 2 - 3 days it almost certainly won't.

Vigorous exercise should be avoided for a week.  If there is bleeding or persistent oozing from the wounds, some pressure from an ice- filled, clean cloth or a packet of frozen peas may stop it.  Sufficient internal bleeding to warrant hospital care is rare, about 1 in 2000, but if this happens contact us, your Doctor, or go straight to hospital casualty.

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Collection of Semen
One month after the vasectomy, we need two completely negative sperm tests to confirm the success of the operation.  The most important to exclude is the 1 in 1000 failure where the test would show large numbers of mobile sperm.  We aim to get two consecutive completely negative tests.  People often pass through a near negative phase with small numbers of dead sperm (non motile) on the way to the completely negative stage
; in some this process is prolonged for months or years. If we have several (3) tests with a “few non-motile” (i.e. dead) sperm that is as good as a completely negative test. Both carry the same pregnancy rate of around 1:10000 pregnancy rate (lifetime)

Semen should be obtained by masturbation and the whole volume collected into the bottle provided.  Condom specimens are not useful.

The sample should be delivered within a few hours to any of the laboratory depots listed on the reverse of the forms that are posted out with the book. The labs cannot do this test at the weekends or on public holidays.

If the first is negative, about 70% are, do another to confirm as soon as you like.  If there are still small numbers of dead sperm leave it a few weeks, it sometimes takes several months to get complete clearance. 7% of men still produce small numbers of dead sperm 10 years later but carry no increased pregnancy risk.

The reason for this slowness is that some men have large seminal vesicles and small ejaculatory ducts.

Once sperm tests are alright, then you can stop other contraception.

 
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