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| Vasectomy |
These notes give an overall guide to your stay in hospital. You may see some differences in the details of your treatment, since it is tailored to suit your own condition.
WHAT EXACTLY IS A VASECTOMY? First of all, the vas is the name of the tube that carries the sperm from each testicle up into the groin and then deep inside the body to the base of the penis. A vasectomy means that a piece of the vas on each side is taken out just above each testicle and the ends are tied off. Thus the sperm cannot pass into the penis and you will no longer be fertile. Is it reliable? Yes, once the vas tubing has cleared itself of sperms (which may take several weeks) the operation is very reliable. However, in spite of all surgical efforts, pregnancies do occur in about 1 in 2000 men after vasectomy. This is a very low chance and is lower than the chance of pregnancy when the contraceptive pill is used, lower than the 1 in 500 chance of pregnancy after female sterilisation, and much lower than when the sheath, coil or diaphragm are used. Can it be reversed? Yes, the cut ends can be joined up again but the rate of success in producing further pregnancies is only about 1 in 3. It is best to have a vasectomy on the understanding that it is NOT reversible. YOU NEED TO DECIDE THAT COME WHAT MAY YOU DO NOT WANT MORE CHILDREN Bear in mind that 1 in 3 marriages break up nowadays. Also, if you now have children that are under 1 year old, they do not have such a strong hold on life as older children. Do not make a hasty decision about vasectomy, it is very permanent. Are there any side effects? After vasectomy, the testicles still make sperm, but these sperm are melted away by the body as quickly as they are made. The testicles do not swell or feel heavier or tense afterwards. The testicles still make sex hormones, so that you still grow a beard, have the same abilities at sex, remain just as aggressive, do not put on weight and will not change your voice. You will still make fluid at intercourse after vasectomy because this fluid is made further down the tubing than the tied off part of the vas. The operation is free from long term side effects.  Reception When registering at reception your medical aid details will be required. Your medical aid may require that you obtain an authority number from them for the hospital. Please check this. If you are not on a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission. Welcome to the ward You will be welcomed to the ward by the nurses or the receptionist and will have your details checked. Some basic tests will be done such as pulse, temperature, blood pressure and urine examination. You will be asked to hand in any medicines or drugs you may be taking, so that your drug treatment in hospital will be correct. Please tell the nurses of any allergies to drugs or dressings. The surgeon will have explained the operation and you will be asked to sign your consent for the operation. If you are not clear about any part of the operation, then read this again and then ask for more details from the surgeon or from the nurses. EITHER You have the skin of the scrotum numbed with an injection of local anaesthetic just as a dentist numbs a tooth. A small cut is made on each side in the front of the scrotum and the operation is done in 20 minutes. There are catgut stitches in the cut. You can expect to feel some pushing and pulling, but it is less uncomfortable than having a tooth filled. You do not need to shave or starve beforehand and you can drive home straight away afterwards. You should wear Y front or slip underpants, but not boxer shorts. OR You can have a general anaesthetic when you would be asleep during the operation. Then you WOULD need to starve beforehand, but you would be able to go home the same day. You would not be fit to drive, use machinery or make big decisions for 24 hours. Visit by the anaesthetist If you are having a general anaesthetic, the anaesthetist who will be giving your anaesthetic will interview and examine you. He will be especially interested in chest troubles, dental treatment and any previous anaesthetics you have had. After local anaesthetic you will not have any discomfort for an hour or two, so that is a good time to get home. Take aspirins or paracetamol if you feel discomfort coming on. It is not severe. Take things quietly for the rest of the day. After a general anaesthetic you will feel sleepy for 2 to 4 hours. Aspirins or Paracetamols will control discomfort from the wound. On the next day you may feel sore, perhaps as bad as after a black eye. You can take off the dressings and wash, bathe or shower. You will have spare dressings to cover the wound. Use underpants to hold them on. On the third day you may notice black bruising in the skin. This fades away in a day or two. After a week the wound has settled almost completely and the stitches will have dissolved out. Sperm tests You need to have sperm counts about 8 to 12 weeks after your operation to test that the tubing is clear of sperms. On the appointed day you should produce a specimen by masturbation and put it in an appropriate pot supplied by the pathologists. This we will arrange for you and will provide you with the pot and forms at the time of your checkup after the operation. If the tests are not clear then we will contact you for futher tests. Only when the tests are finally clear should you stop using a contraceptive. Passing urine The operation does not upset passing urine. The urine will not sting or get bloody. Work You can work the next day, but you would find it more comfortable to take a day off after the operation. Sport It is sensible to avoid mild sports for 3 or 4 days and violent sports for a week or so. Sex You can start again as soon as the wound is comfortable. That is after about a week. Remember, you are still fertile until the sperm tests are clear. Carry on with a contraceptive until you get the go ahead from your surgeon. Are there any risks? There is always a swelling about the size of a marble on each side due to the internal stitches and minor bleeding. This settles down in a week or two. Perhaps 1 in 100 men notice bleeding which causes swelling bigger than marble size or which comes through the dressings. If this happens (it will be in the first 12 hours), get advice from the surgeon. Sometimes the stitches do not drop out in a week. If this happens they can be nipped out easily. Very rarely there is some pain and discharge due to infection 4 or 5 days after operation. Even more rarely swellings appear 4 to 6 weeks after operation on each side where the internal stitches have been. These usually settle down but can be removed if necessary. Minor twinges may be felt for several weeks. Your main decision is that you do not want to have any more children. After that, the operation is straightforward. You can always get help if you have queries or problems. Overall the operation is most satisfactory. |
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