Vasectomy

Vasectomy

Vasectomy Wamuran Doctors

Dr David Easton has been performing vasectomies for over 35 years using the surgical technique under a local anaesthetic, it’s simple and completed in under an hour. All of our reception staff and nurses are friendly and well trained.

The practice prefers a pre consultation between the patient and the doctor to ensure a full understanding of the procedure and ensuring all questions are fully answered.

The doctors also perform neo-natal circumcisions for babies under the age of 4 months using a local anaesthetic block to ensure their comfort.  The doctors use the ‘Gomco Clamp’ method.

Referrals are not required from your general practitioner for vasectomies or neonatal circumcision.

What Is A Vasectomy?

Vasectomy is the name given to the operation which makes men infertile by producing a block to sperm movement from the testes and is the most efficient form of contraception currently available.

Sperm are produced in both testes (testicles) and are then carried by a tube on both sides (called the vas deferens: plural=vasa) to the seminal vesicle at the back of the bladder where they are stored. Most of the fluid ejaculated (approximately 98% of the semen) is actually produced in the seminal vesicle and prostate gland. To prevent the passage of sperm from the testes to the seminal vesicle the vasa are cut and tied. This means that when you ejaculate after a vasectomy the seminal vesicle is gradually depleted of sperm so that eventually the semen will be free of sperm although the volume is unchanged.

The production of the male hormone testosterone by the testes is completely unaffected as it all continues to go directly into the blood stream hence sex drive and libido are unaltered.

What Happens?

The procedure is very simple and takes only 30 minutes. It is performed in a dedicated procedure room using local anaesthetic to block the pain.  Once the procedure is complete the patient is free to drive themself home or back to the office (provided no heaving lifting is involved).

Pre-Operative Instructions

  1. Stop taking asprin, ginko, olive leaf extract, fish oil and other natural medicines for 1 week before your procedure as these may increase bruising and bleeding
  2. Tell us at the time of booking and ask for more information:
    • if you are taking aspirin, warfarin or other ‘blood thinning’ medication prescribed by a doctor for instructions from the doctors before ceasing these medications.
    • if you have had previous surgery for undescended testes as a child.
  3. Ring and confirm your attendance 48 hours before the procedure
  4. At home on the morning of the procedure shave the scrotum as shown in the photograph, please shave the underside of the penis and all of the front wall of the scrotum, remove the hair all the way to the top of the penis, including any pubic hair that seems to fall onto the scrotum  (we suggest that you dont use depilatory creams such as Veet and Nair as these can cause chemical burns, waxing is good but hurts too much!)
  5. Wear supportive underwear (not boxers)

Note: There are no other special requirements

As the operation is carried out under local anaesthetic alone:

  • It is quite safe to drive to and from the surgery yourself
  • You can eat and drink as normal (no restrictions required)

Post Operative Instructions

EXCESSIVE BLEEDING, SWELLING OR PAIN IS NOT NORMAL. IF ANY OCCUR, CONTACT THIS SURGERY ON 1300 364 480 OR YOUR LOCAL DOCTOR

Pain Management

If you have discomfort in the first 24-48 hours after the local anaesthetic wears off, rest with your feet up and take anti-inflamatory medication such as ibuprofen 200mg, 2 tablets 4 times a day after food. Ibuprofen can be obtained from any supermarket or pharmacy. You will be also be given given a script for a strong pain reliever, Panadeine Forte, in case ibuprofen is insufficient but should not be filled as it is very rare for this to be needed.

Rarely an ache and/or swelling can develop after a few days or even weeks which is usually due to inflammation of the epididymis and testes. This usually responds to anti-inflammatory medication.

Note: you should not take ibuprofen if you have had a stomach ulcer in the past or suffer from asthma

Bruising

Bruising of the skin on the scrotum is not a concern as long as it is not associated with scrotal swelling as it reflects only blood just under the skin and will disappear with time.

Bleeding

In the rare case that the wound bleeds, “pinch” over the wound with some gauze for ten minutes, then let go very slowly. Contact the surgery if it continues.

Washing

You may shower but do not rub soap directly into the scrotum for the next 2 days.  Do not have a bath or go swimming for 3 days until the wound heals.

Wound care/Support

It is advisable to continue to wear supportive underwear for 2 days (place the gauze provided over the wound till healed).

Activity and sex

Strenuous exercise, prolonged walking, bike riding, climbing and heavy lifting should be avoided for the first two days. Then your level of activity including sex should be guided by your degree of comfort.

Sterility

You are not sterile yet! Sterility takes both time and an adequate number of ejaculations after a vasectomy. Most men have very low or zero sperm counts after about 12-14 ejaculations over about eight to twelve weeks. One in five can take longer, but by 6 months 99% are clear. Your operation cannot be considered successful until you have confirmed that a ‘zero’ sperm count has been achieved. The risk of failure after this is extremely low.

Instructions for Collecting a Semen Sample

You will be given a pathology request slip and a specimen jar at your visit. Check details of courier collection times with the pathology provider that you wish to use. Eight to twelve weeks after your operation collect a semen specimen by hand massage (masturbation) directly into the jar supplied (do not use a condom). Screw the cap onto the jar firmly and label the jar with your name, time of collection and date. Take to your nearest pathology collection centre, you have a 2 hour window from collection to dropping the specimen to pathology. Please phone 1300 364 480 three days later for the result. This will either confirm achievement of a ‘zero’ count or the need for further testing.

Frequently Asked Questions

Is it painful?

Most patients report that “it was much better than the dentist”. The slow introduction into the skin and alongside each vas tube with a very fine needle, as small as diabetics use to inject themselves with insulin of a warmed mixture of quick and long acting local anaesthetics with a “no sting” additive is relatively painless, works almost instantly and lasts for 4-6 hours. One can feel a tiny poke in the skin, then a bit of a squeeze as the anesthetic is applied to each vas tube. There is no sudden pain post operatively which can occur after waking from general anaesthesia or after the use of standard local anaesthetics or sedation.

Can a vasectomy be reversed?

Vasectomy should be considered irreversible. If you are contemplating a reversal, sperm storage or intracytoplasmic sperm injection (ICSI) then vasectomy may not be the best choice for you. (ICSI involves taking an immature sperm directly from the testicle and injecting it into an egg) The success rate for reversal operations is 90% in the first 5 years. The success rate declines with time due to decreased sperm production and the development of anti-sperm antibodies.

Sperm storage is available and can be organised

Note: Medicare does not rebate reversal operations or ICSI or sperm storage.

Does a vasectomy affect sexual function?

Physically a vasectomy makes no difference to your sex drive or performance, as testosterone and semen production (apart from the sperm component) remains unaffected. Many men say their sex life is improved because they no longer have to worry about the higher rates of contraception failure with other methods.

What happens to the sperm?

The cut end of each vas closest to each teste is left open letting the sperm which are still produced in the testes after the vasectomy escape into the scrotum. As the volume of immature sperm is miniscule they are reabsorbed by the body without causing any swelling. This “open-ended” technique minimises post-operative discomfort as there is no build-up of pressure in the testes and epididymis.

Are there any side effects of vasectomy?

Serious side effects are rare. Most men experience some discomfort, bruising and swelling around the operation site of a minor and transient nature. This is usually relieved by simple pain medications and supportive underwear. In rare cases postoperative bleeding, inflammation of the epididymis and testes, infection, cyst formation, delayed wound healing or persistent pain can occur. If any unexpected symptoms or effects arise we are happy for you to ring for advice or return for review.

Prostate Cancer, heart attacks and other issues

Whilst there have been past media reports of links with cardiovascular disease, male menopause and cancer of the testes and prostate these have not been supported by large studies in many countries. Although this does not mean that there can be no possible ill effect on health, vasectomy remains one of the safest and most effective permanent contraceptive choices available.

Most prefer to have their pre-vasectomy consultation and vasectomy procedure performed on the same day.

Alternatively you can organise a separate pre-vasectomy consultation at no cost (bulk billed to medicare) and with no obligation to discuss the operation in detail and have time to consider the information before making an appointment for the procedure.

Note: you must ask the receptionist to notify the doctor and discuss at least by phone if:

  • you are taking medically prescribed anti-coagulants such as aspirin or warfarin
  • you have had previous surgery as a child for undescended testes

Phone our friendly staff on 1300 364 480

How much does it cost? – Cost as of 01/06/2014

The initial consultation is bulk billed and the vasectomy procedure is $400, a deposit of $100 is required at time of booking the appointment for the procedure, this deposit is fully refundable if notice of cancellation is given at least 4 days prior to appointment. The balance of $300.00 is payable on the day of your appointment, MasterCard, Visa and EFTPOS facilities are available. You will receive a rebate from Medicare of approximately $193. We have the Medicare Easy Claim System facility which allows Medicare to electronically put this rebate back into your account within 3 working days. To access this facility notify Medicare on 132011 and present your current Medicare Card on arrival.

We can help you, so don’t wait.