Vasectomy

Why is it done?

• For sterilization
• For completed family numbers
• For legal reasons such as sterilization of a mentally handicapped adult or minor. In such instances a court order needs to be obtained prior to the consultation.

Pre-requirements

• An informed consent is required from the patient.
• Patients may not eat or drink from midnight the previous evening.
• Patients are to refrain from smoking before the procedure.
• Patients allergic to IODINE / CHLORHEXIDINE should clearly state this to theatre staff and Dr Schoeman.
• Any anti-coagulants such as Warfarin or Aspirin must be stopped 7 days prior to surgery.
• The whole scrotal area is shaved by yourself the morning of the procedure.
• This is a day surgery procedure.

How is it done?

• This procedure is done under general anaesthetic.
• A single, 5mm cut is made on the midline raphe (line in the middle of scrotum).
• The 2 vas deferii (rubbery cord) are then individually extracted through this incision.
• A 1 cm piece of each vas is then removed and sent to Pathology for confirmation.
• The edges of the cords are then coagulated, tied off with a suture and then buried at different levels of the scrotal wall.
• A dressing is then applied, which should be removed after 72 hours.
• A local anaesthetic is injected around the vas deferii and into the wound, thus giving post-operative pain relief for the next 4-6 hours.

NB! You are required to bring 2 pairs of tight new undies for post-operative scrotal support.

What to expect after the procedure

• Any anaesthetic has its risks and the anaesthetist will explain such risks.
• Bleeding is a common complication.
• A haematoma (blood collection under the skin) may form and needs to be reviewed by Dr Schoeman as soon as possible.
• An infection of the wound can occur and requires immediate review.
• Owing to the nature of the surgery and the soft skin of the scrotum, bruising may appear to be much worse than it is and is no cause for alarm.
• DANGER SIGNS: A scrotum that swells immediately to the size of a football, fever, or puss. Contact Dr Schoeman or the hospital immediately as this may occur in up to 5 % of all cases.

What next?

• The dressing should be removed 72 hours after the procedure by soaking in a bath until it comes off with ease.
• The dressing may sometimes adhere to the wound causing slight bleeding on removal. Don’t panic, the bleeding will stop.
• Condoms (protected intercourse) must be used for the next 3 months, as viable sperm are still present in the seminal vesicles (behind the prostate).
• A semen analysis will be requested3 months after the procedure. Only if there are no viable sperm in the collection, may one proceed with unprotected intercourse.
• Patients will be informed of the semen analysis results by Dr Schoeman’s rooms.
• Please direct all further queries to Dr Schoeman’s rooms.
• PLEASE CONTACT THE HOSPITAL DIRECT WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL SHOULD THERE BE ANY SIGNS OF SEPSIS.

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Vasectomy