Vasectomy
Why Vasectomy?
Vasectomy is intended to be a permanent form of contraception. It is a safe, quick minor surgery which by removing a piece of "Vas" on either side (you have two) of your scrotum stop your sperm cells from being ejaculated in your semen (they cannot reach it to mix with it). Vasectomies can be reversed in some cases but it is costly and not easy to perform. Vasectomy should only be considered if you are truly ready to give up your fertility!
A Vasectomy is considerably less expensive than the equivalent procedure for woman/those with female reproductive organs. It is also considerably safer in that no anaesthetic is required. You come to the GP surgery, we talk, put music on (if you want) and the whole thing is over quicker than a trip to the movies! Your Vasectomist Ken is available by phone or in person to discuss any concerns you may have afterwards, and advice is free of charge. The cost you pay is a one-off and all your follow-up care is included within this.
The Procedure
The first step is to come in and meet Ken. Ken is a Scottish trained GP who has lived in Dunedin for the last ten years and received further training in Vasectomy from Prof Amir Zarrabi, ex of Dunedin Hospital. If the examination has gone well, you will arrange a date which suits. Ken will talk through the procedure and he will make sure you understand the main considerations and any complications of relevance. If you are happy with this you will sign the consent form.
On the day in question you will come to clinic with a hot pack on your scrotum. This keeps your testicles hanging low to make it easier for Ken. When you are ready, Ken will give the anaesthetic. Once numb, Ken will make a small hole above the vas (sperm tube) to be cut and then widen it with his instrument. There are no scalpels! This reduces bleeding. He will then grab the vas bundle. Once he has it secured, he carefully extracts the vas from the tissues which surround it. He clamps above and below, and cuts at one end. He then buries one of the ends back inside some of the supporting tissues. This separates one end from another which makes it very hard for the ends to re-join. Then he uses heat to frazzle the inside of the other end of the vas. Again, this makes the vas very difficult for sperm to pass through successfully. Then he cuts a small piece of vas out (less than 1cm). He will do this procedure twice - once on each side. These three things will make the vasectomy more than 99% effective.
The procedure only takes 30-60 minutes, and you’ll be able to drive home however we recommend taking the day off to recover.
Is it painful?
There is a very small amount of pain involved:
First, when the local anaesthetic is given (into the skin on each side of the scrotum and into the vasa - sperm tubes - lying beneath)
And second, once the local anaesthetic wears off. This can be helped by lying flat applying ice packs for the first 24hrs, doing nothing for the rest of the day, and taking simple pain meds such as paracetamol.
Can it fail?
Yes. Despite skill and adequate levels of training, sometimes sperm still find their way out into the ejaculate. This might be due to extra vasa, though this is uncommon. There is a 1% chance of this happening.
After the vasectomy, we test your semen once at 12 weeks, and once again if you have any "motile" (swimming) spermatozoa in your semen. If it is still positive for swimmers after 20 weeks, we would regard the procedure as unsuccessful.
At this point we could discuss repeating it, either with Ken or someone like Mr Zarrabi. There is also a " late failure" rate of approx. 1 in 2000, when the sperm ends somehow join up. With all due care this is very uncommon but is a risk which must be considered.
How much time off will I need?
Ken recommends 24 hours of absolute rest, ideally Thursday into Friday. Then 48 hours of relative rest is advised, but you will be able to get up and about. If your job is not too manual you can go back on the Monday (or after day 4). If you have a manual job, it’s best there is no heavy lifting for at least 7 days.
The more you rest at the very start, the less the chance of bleeding. A very small amount of bleeding after the procedure is to be expected as we have to separate fibres to reach the vasa. The vasa are the only things which are "cut". Everything else is separated. Ken will check thoroughly for bleeding before he lets you go home but bruising/slight oozey bleeding from the vas tissues is the number one side effect of vasectomy. Many people might be alarmed by bruising of the scrotum but it should be regarded as relatively normal. You will have Ken's contact details if you need to get in touch and he can help guide you.
How much does it cost?
The procedure costs $550. This includes the $75 cost of the preliminary consultation where you will meet Ken for the first time. We would prefer payment before the procedure takes place. If for any reason the procedure does not happen/cannot succeed, you will be refunded the procedural cost of the package less any agreed upon costs.
What next?
Feel free to contact Ken via Mosgiel Health Centre reception on 03 489 5135, or you can contact him directly via snipdocmosgiel@gmail.com
Ken is available for vasectomy procedures every other Thursday afternoon or a Tuesday morning if this suits better.
