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Clifton beach medical & Surgical – Vasectomy Procedure Information

Clifton beach medical & Surgical – Vasectomy Procedure Information


Hi, my name is Dr. Peter Smith. I’m the
principal of Clifton Beach Medical and Surgical and I’d like to take this
opportunity today to talk to you about vasectomy. Vasectomy is a very common
procedure for men today and there’s often a lot of misconceptions and
misunderstandings about the procedure and what actually happens. So this video
is really to talk to those men who are contemplating or are about to have a
vasectomy to help them through the journey and understand the procedure
that we perform here at Clifton medical and Surgical. First of all, it’s very
important to understand the anatomy of the male genitalia because there’s a lot
of myths about how having a vasectomy might affect sexual function or ability
to enjoy sex after the procedure which is really, totally unfounded. So, if you
look at the diagram I’ve got on the screen, you’ll see that we’ve got the
anatomy of the male genitalia and it’s important just to understand that the
testes produce the sperm, they then transport it up this tube called the vas deferens and very importantly it’s
important to understand that the body stores about two to three months worth of sperm in this structure called the seminal vesicle, which is located here. So
because of this, when you have the operation you’re not actually sterile
from the word go. You have to wait three months, approximately, before you can do a sperm test to show that you don’t have any viable sperm left in your semen. So we stress this very strongly with all potential surgical candidates. The other
important thing is that a lot of men think that their ejaculate will
disappear after they have a vasectomy but this is not true, only about one or
two percent of the ejaculate is actually made of the sperm or the swimmers. Most of the ejaculate is actually made by the prostate and the seminal vesicle. So, all men will ejaculate normally, it’s just that they won’t have
any sperm in the ejaculate and they won’t notice that difference.
They’ll also produce the normal amount of testosterone, still have normal sexual
function and normal sexual drive, it’s just that they won’t have sperm
traveling up the tube. During this procedure we use an anaesthetic called a neurolept anaesthetic which is like a twilight anaesthetic which keeps you sedated and
pleasantly relaxed. We also use a long-acting local anesthetic that lasts
for about four to six hours which helps with pain relief after the operation. With this operation we ask people not to be taking Aspirin, Nurofen and fish oils
turmeric and some other herbal extracts may affect the bleeding potential prior
to the operation and please discuss these with your doctor when you’re
having your consultation. It’s also very important that after the operation that
no heavy physical exertional activity should occur for 10 to 14 days after the
procedure and indeed no immersing underwater for the same period of time. Usually after about 2 or 3 days post vasectomy most men are able to do light
duties, desk duties, supervision but heavy physical exertion as I said should be
delayed for at least 10 to 14 days. There’s a couple of questions that men
ask when coming in for a vasectomy, one is can we proceed to be reversed and yes
the procedure can be reversed however there is some problems with a thing
called sperm antibodies. So, after a period of time and it’s usually about
five years, the body produces antibodies to the sperm so it can be reabsorbed by
the body. The consequences of that is that sperm doesn’t swim as well and
therefore fertility is reduced, not because the tubes can’t be physically rejoined, it’s that the sperm can’t swim as well. So, we strongly
suggest that men consider this as an irreversible procedure and not go into
it thinking that they could get reversed down the track because of that. There’s
also some myths in the popular media or on the internet about the link between
prostate cancer and heart disease with vasectomy and this is totally unfounded.
Vasectomy procedures have been around for many years, in fact, I’ve been
doing this procedure for about 25 years myself and there’s certainly no link
with these conditions, so you can be reassured. The procedure itself, now, it’s
important to realise that this is a keyhole procedure so we put two tiny
little nicks in the scrotum. The advantages of this is that the procedure
will allow you to heal much quicker and with less bruising and swelling. The
disadvantage of this procedure is that some guys are not suitable for this
procedure, some guys because of previous surgery, because of previous trauma or
indeed because of their anatomy, we can’t access the little tubes in a keyhole
fashion and if that’s the case then we have to opt for a more open procedure
which has to be done in hospital and we would refer you off if that was needed.
So, importantly you must have a physical examination prior to the operation to
make sure that you’re a suitable candidate and also indeed to make sure
you’re a suitable candidate to have any operation or any anaesthetic. So, at the
time of the operation, what will happen is that you will come in and have some
pre anaesthetic checks with blood pressure etc., you will be asked to
undress and be put in a gown then prior to the operation starting, a little
needle will be placed in the back of your hand to administer
the anaesthetic and then during the procedure we actually inject a small
amount of long-acting local anesthetic in the scrotal region to keep the area
quite numb. We also allow for music to be played during the procedure so requests
taken. So, it takes approximately an hour and a half for the pre operation,
operation, post operation to occur and we have a recovery area which has an
ambulance bay access so the patient can actually leave by the back door through
the ambulance bay into a waiting car and taken home. With all procedures
unfortunately there are potential for possible complications and I guess the
two most important complications we see with vasectomy are bruising or bleeding
and infection. Now, as I mentioned before avoiding things that make you bleed like
Aspirin, Nurofen and those other agents should be taken into account. Also, we ask about previous bleeding problems that you might have had with other operations
but more importantly the message is that it is a very vascular area, there’s a lot of
little blood vessels in the area we do cauterise them quite well however if you
don’t rest immediately post procedure and go home, rest, put ice on the area
then you may get more bruising than we would like. Most men who go home, rest and put ice have very minimal bruising and so we put that challenge out to them to
rest because they will have a speedy recovery. Infection is also a concern
with this procedure and there are, because of where it is, it is a sweaty
area and so there is a slight increase of infection. However by doing three
things we’ve been able to really reduce the amount of affection risk significantly; One is to remove the hair from that area two is to
wash with an antiseptic soap the day before the procedure and the day of the
procedure and we will provide that soap for you. You must leave the soap on for a period of one or two minutes to give it some
contact time, making sure you get it into all the creases in the area and
washing it off, so the night before and the day of the procedure. And also we give an
antibiotic the night before, the day of and for a few days after the procedure
and we find that these three things significantly reduce the risk of
infection and we very rarely see infections if those guidelines are
followed. There are also other complications that we see less
significantly, one is Cord Congestion Syndrome and also Granuloma, this is
where you can get an ache in the cord or a little lump in the cord after the
procedure. In the early days when we did this procedure we used to tie the bottom
ends of the cord and this led to more incidence of this particular problem. In
the last 20 odd years that I’ve been doing this procedure we have not tied
the bottom end so we seem to find that this is less of a problem. Usually, most
of these can be solved with a simple use of some non-steroidal anti-inflammatory
agent after the procedure if this occurs. We’ve also mentioned as a complication
is sperm antibodies and this is more to do with the reversibility effect and as
I said antibodies do form against the sperm approximately at five years. This
however has no effect on your health whatsoever it just affects the motility
of the sperm. And lastly, there is a risk of about one in two thousand, that even
though this vasectomy has been performed correctly that the tubes could regrow,
this is a international statistic and we are fortunate in our organisation
not to have had one of these episodes but it certainly worth knowing that it
can occur and it’s important that you understand that as a potential
complication to the procedure. All this information is provided in a booklet
that will be given to you at the time of your consultation. It’s also available on
our website and as I always said to my patients I’m available to answer any
questions before or after the procedure. You’ll also receive a pack and in that
pack will be a a summary of what to do before the procedure, at the time of the
procedure and after the procedure there’s also a consent form that
obviously needs to be signed before you do the procedure and there’s also a
checklist of things that you must do before the procedure like fasting, taking
antibiotics and being available for follow-up after the procedure. I hope
this has been helpful for your information regarding this important
operation.

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