St Luke’s Surgery The Pinfold Health Centre, Bloxwich, Walsall

No Scalpel Vasectomy Leaflet

Our Contat Numbers 01922 775136/ 775137/775515 07801369602.
What is vasectomy?
Vasectomy, male sterilisation, is a reliable method of achieving permanent contraception. A simple operation prevents sperm from the testes reaching the semen sac. The semen you ejaculate will not contain sperm. The body continues to produce sperm after the procedure, but the testicles naturally reabsorb the unneeded sperm.
Who is suitable for vasectomy?
Vasectomy may be suitable when a man or couple have made the decision not to have any more children. It may be chosen as a simpler and more reliable alternative to female sterilisation.
If you have any doubts at all then you should consider an alternative method of contraception until you are 100% sure. If you have a partner it is good to discuss having a vasectomy with them and you both agree before you proceed. However, it is not a legal requirement to get your partner’s permission for you to have a vasectomy.
When should it be done
A vasectomy can be performed at any stage of adult life. However, research has shown that if you are under 30 or if you do not have children already then you are more likely to regret having a vasectomy.
How is it performed?
A vasectomy is usually performed under local anaesthetic If you are allergic to local anaesthetic or have other specific contraindications then it is possible to have a general anaesthetic at the Hospital but this is not normally necessary. There is usually a little pain when the skin is injected with anaesthetic. After this there may be some pulling sensation. The procedure lasts about 30 minutes.

Vasectomy

St Luke’s Surgery
Pinfold Health Centre
Field Road
Bloxwich, Walsall
01922775136
www.stlukesurgery.co.uk

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Vasectomy


Sperm produced in the testicles travel via the tubes (vas deferens) to the semen sac ( seminal vesicles) to be stored there. At any time there is enough sperm for 16 to 20 ejaculations stored there. Vasectomy operation is to cut the tubes just above the testicle. However the sperms already in the semen sac will continue to come out in ejaculation for up to 4 months. There fore , contraception should be continued after vasectomy for 4 months, then a semen test should be done to confirm success of the operation. Contraception should be continued until semen tests prove sterility.

What are the advantages of Vasectomy?


As vasectomy is normally permanent, once it has been carried out successfully and semen tests have shown there are no sperm present, long term partners may not need to use any other form of contraception

Traditional Vasectomy Vs No scalpel Vasectomy. (NSV)

Traditional vasectomy involves making 2 cuts on either side of the scrotum, bringing the tubes out and tying them off. The wound is stitched and stitches may have to be removed later.
No Scalpel Vasectomy was developed in China about 50 years ago and used through out the world now. It was introduced to the US in 1988 and to UK much later,
The doctor feels the tube under the skin . A small amount of anaesthetic is injected with a tiny needle. A single small needle hole is then put in the skin of the scrotum. A loop of tube from both sides is brought out through this hole and cauterised or burned off. There are no stitches.
Research has shown this produces less complications, less failure of sterilisation and much less pain during and after operation. Therefore it is the recommended procedure by the Royal Colleges, UK and worldwide.

Comparison of traditional vs NSV

Item Description TRADITIONAL NSV
Total cases 523 680
Infection % 1.4 0.1
Bleeding % 1.7 .3
Complications % 3.1 0.4

No Scalpel Vasectomy


1.Less Discomfort
2.One key hole opening instead of 2 cuts
3.No stitches
4.Faster Operation
5.Faster Recovery
6.Less chance of bleeding and other complications
7.Just as Effective TRADITIONAL NSV CASES 523 680

What are the Limitations?

After a vasectomy has been performed some sperm will survive in the upper part of the vas deferens tubes. Until your semen has been confirmed free of sperm there is still a risk of pregnancy and you should continue to use another form of contraception.
A vasectomy does not protect against AIDS or sexually transmitted infection (STI). So, even after a vasectomy, you should continue to protect yourself with condoms with any new partner and an STI test is a good idea before ceasing to use condoms with an existing partner.

After the procedure

After a vasectomy has been performed some sperm will survive in the upper part of the vas deferens tubes and in the semen sac ( Seminal Vesicles)
At least 16 weeks after the procedure you will need to do a semen test, which will be checked for sperm. If there are any sperm present in the test, it will have to be repeated in 4-6 weeks. These tests will also help to identify the rare cases in which the tubes naturally rejoin themselves. Once the tests have been confirmed free of sperm the vasectomy has been successful and further contraception can be stopped.

Sample Collection


Samples of semen will need to be collected at 16 weeks from the date of your operation.
You must ensure that you have had at least 24 ejaculations before taking a sample for testing. This will reduce the number of false positive samples and minimise inconvenience to you by having to take repeat samples.
You must not have had sex or masturbated for 48 hours before collecting the sample but, you should not have had an abstinence period of longer than seven days.
Please use the sterile container provided to collect the semen. Do not open the container until you are ready to produce the sample. Collect the semen sample by masturbation, collecting the entire specimen directly into the container (do not use a sheath or condom for collection, as they are harmful to the sperm). Seal the container immediately after the sample collection and make sure the lid is on tightly. Do not use adhesive tape. Write the date and time of collection on the container and the date on the laboratory form.
The current procedure for semen analysis is for you to ring the laboratory at the Manor. They will send you the sample pot and instructions. You will then have to collect the sample and take it the lab asap.

Delivery of the sample


Deliver the sample and completed form ideally within one hour of collection to the Manor Hospital Histology Department. The samples must be kept at body temperature before delivery to the hospital.

Results of the semen tests.

Your results will be sent to your own GP and a copy sent your address given. We are unable to give results over telephone. If you give us a private email address we can email the result to the address.
If the result of the semen examination shows no sperms, you will be advised that the operation can be considered complete and that you no longer need to use any other form of contraception. However, if it shows any sperm dead or alive, you will be advised that you need to take some further semen specimens to the Pathology Department. You must collect two further containers and forms from your GP. You must ensure that there are four clear weeks between the two samples.

Special Clearance.

Some men continue to produce occasional dead sperm in the semen for many months. This is not considered a failure of operation and has not been associated with pregnancy. Therefore, if there are only few dead sperms in the sample at seven months post operation, the operation is considered successful and you will be given ‘special clearance’ to stop contraception.

Recovery


There is a small hole in the scrotum which is unstitched. It may ooze some blood and will seal up in 2-3 days. It takes a total of Six weeks for the burn inside to heal completely. Some bruising and tenderness is possible for up to 3 weeks. If there is any undue swelling, redness or throbbing you should consult your GP.
It is not uncommon to have some blood in the semen for up to 6 weeks after the operation. This is of no concern.
You can have sex again as soon as it is comfortable to do so, though it is best to wait for a week.
Avoid heavy lifting, strenuous exercise and sex for a week
However, you are not sterile immediately after the operation as it takes time to clear the remaining sperm in the tubes. Until you have had clear semen tests you will still have to use another method of contraception.

Complications of NSV


Pain and other problems after a vasectomy are uncommon and even less in NSV compared to traditional Vasectomy.
Pain. Post Operative pain is minimal and is usually controlled by Paracetamol or Ibuprofen. The scrotum will remain sore for 2 –3 weeks. Ibuprofen can help reduce the inflammation. Significant pain could be due to blood clot or infection, see your doctor or telephone us.
Infection. Infection risk is reported to be 3.5% - 4%.
Incidence is less with NSV technique. If there is redness, throbbing pain and pus discharge from the wound, you may need antibiotics.
Bruising and Swelling. Blood may seep under the skin, so that penis and scrotum appear bruised. The scrotum may become swollen. It often happens after a few days but in most cases has mostly disappeared after two weeks. Ice/Frozen peas and supportive underwear/jockstraps will help.
Bleeding and Haematoma. Bleeding into the scrotum can occur and is usually minimal. The incidence of significant Blood clot is from 1 to 5%. It can be painful and sore. Small clots usually clears in 3 weeks but massive clots can take 6 weeks or may need to be surgically evacuated.
Blood in the semen. Often in first 2 weeks, but can happen for up to 6 weeks. Appears as a brown sludge in the ejaculate and needs no treatment.
Sperm Granuloma and Epididymitis. Occasionally, sperm may leak into the scrotum and form a swelling (sperm granuloma), or sperm may collect at the epididymis (the coiled tube through which sperm exits your testes) and cause epididymitis. Both can inflame the vas and cause prolonged pain, but both will usually go away with rest and anti-inflammatory medicine.
Granuloma's typically occur in the 2nd or 3rd week2 in 60% of men with vasectomy, but are troublesome in only 3%-5% .
Post Vasectomy Pain Syndrome
This is pain in the scrotum which can go on for weeks , months or years. The intensity can vary from mild tolerable pain to quite severe pain. The reason for this pain is largely unknown, there fore there is no effective treatment . Fortunately it is very rare and happens in about 1in 2000 operations.
Getting back to work. If your work is office based, sitting down you can return to work next day. You can drive after a few hours if comfortable. If you have a heavy lifting job a week off work is necessary
Failure of Vasectomy Rarely the tubes may re-join. It can happen within months of the operation or very late up to 2 years after the operation. If it fails, the operation can be done again. If it fails after 2 operations, it is best to resort to alternate methods of contraception.

FAQ

1. Can it be reversed?
Reversal is possible, but it is not under the NHS. It is often expensive and frequently unsuccessful. If you are thinking about reversal, perhaps Vasectomy is not right for you.
You should be absolutely sure that you do not want to father a child under any circumstances, when you decide to have vasectomy. You should ideally talk to your partner and consider other forms of birth control.
Other reliable long term reversible contraception includes a small implant under the skin, a coil in the uterus or 3 monthly injections for your partner.
Vasectomy may not be right for you if you are very young, your current relationship is not stable, if you are under a lot of stress or if it is just to please your partner.
2. Does it cause any medical problems?
Medical experts, including WHO has concluded that it is a safe procedure. A number of studies have examined the long term effects of Vasectomy and evidence shows vasectomised men are no more likely to develop cancer, heart disease or other illnesses.
3. Does it protect me from Sexually Transmitted Disease or AIDS.
No. Use a condom if there is a chance to get STD or AIDS.
4. Will this change me sexually?
No. You will continue to produce the hormones that makes you a man. You will have the same amount of semen. Your muscle bulk, beard, sex drive, erections, ejaculations and climaxes will remain the same. And you won’t sing soprano!
In fact, without the worry of pregnancy, sex can be more relaxed and enjoyable.
5. Do you inject the anaesthetic into the balls?
BY GOD,NO !
The injection with a tiny needle is into the skin and along side the tube. After this you will not feel any pain, just a pulling sensation occasionally.
Private Operations
Patients not under Walsall CCG can have this done privately her. Cost 350.00
Contact No. 01922 775515/775136/775137.