What are the benefits of having a vasectomy? Are there any risks involved in having a vasectomy? At your out-patient consultation

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1 Having a Vasectomy

2 Vasectomy You have chosen to have a vasectomy. This involves severing the tube which connects the testes (where sperm is produced), to the penis (from where they are ejaculated). Vasectomy of both ducts causes sterility and is an increasingly popular method of birth control. This booklet contains some of the questions you may want to ask before you decide if you want to go ahead with the operation. What are the benefits of having a vasectomy? It is the most reliable method of contraception and the operation is a fairly minor one. Are there any risks involved in having a vasectomy? Bruising is common after the operation, but usually subsides in a few days. Infection is possible, but unusual. At your out-patient consultation You will be asked to sign a consent form to say that you understand what you are coming into hospital for and what the operation involves. Your partner is also asked to sign this form, though this may not be essential. Getting ready for the operation On the day of surgery, you will normally be asked not to eat or drink for four hours before your operation. This is very important if you are to have general anaesthetic. Before you come to hospital you will need to shave the scrotum and have a bath or shower.

3 You will need to let the doctor or nurse know if you are taking any medication and you will be asked some general questions about your health. How long will I have to stay in hospital? You will normally only need to be in hospital for a few hours-as the operation is a day case procedure. What anaesthetic will I have? The operation is normally carried out with a local anaesthetic, but some patients prefer to have a general anaesthetic, so they are asleep throughout the procedure. Please discuss this with the doctor when you attend the out-patient clinic. What happens in theatre? Once you are in the operation theatre, the skin of the scrotum will be cleaned with an antiseptic solution. A small area of the skin is made numb with a local anaesthetic injection. This is similar to a dentist numbing a tooth. A small cut is made on each side of the scrotum and the operation is complete in around 15 minutes. The cuts are closed with dissolvable stitches. What should I expect after the operation? You will have some soreness and swelling for a day or two. Take it easy and avoid any strenuous activity. Simple painkillers, for example, paracetemol will help. The stitches will dissolve or drop out and do not need to be removed. How long will it take me to recover? Most men are fully recovered in a week. You can resume sexual intercourse as soon as the wound is comfortable. Remember: You are still fertile until sperm tests are clear. Continue to use other contraceptives until you are given the all-clear from the doctor.

4 When will I be able to go back to work? This depends on you, your job and how much discomfort you are in. Normally about two days off work is enough. Will I be able to drive? Normally after a few days. Are there any long-lasting effects? Four months after the operation you will be asked to provide a semen sample. This is analysed and your consultant will write to you with the result. Occasionally, you may need to send in further samples, but normally all the sperm will have gone after four months. It s important to wait until you have the all-clear letter before stopping other methods of contraception. The operation is successful in over 90% of cases. Occasionally there are still sperm present after the vasectomy and if this happens, you consultant will arrange to see you again. Despite an 'all-clear result there is a small chance (about one in every 200 operations) of a very small number of sperm re-appearing in the ejaculate. These are almost always very poor quality sperm, believed incapable of leading to a pregnancy. Very rarely (fewer than one in 2000 cases), the tubes may re-join of their own accord, even after many years. Good quality sperm may then re-appear in the ejaculate and possibly lead to further pregnancies. You may notice small swellings in the scrotum where the tubes were cut. These are harmless, but if you find any new swellings in the testicles, you should arrange to see your family doctor (GP). A degree of mild, long-term scrotal discomfort is not uncommon after vasectomy. Patients do not usually find this of any concern. More rarely (about one in 100 cases), there may be severe longterm pain which can sometimes prove difficult to treat. It is not possible to predict which patients may be affected by such pain, but it does not usually mean there has been a technical problem in carrying out the operation.

5 Who to contact for more information We hope that you have found this information useful. If you have any questions, or you are worried about anything, please speak to you family doctor (GP) or contact Elizabeth Ward on:

6 Vasec04

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