Thyer Urology

The vas deferens is a paired tube that transports sperm from the testicle to the urethra. Vasectomy is a minor procedure, performed for contraception, where the vas deferens on each side is divided resulting in infertility. After the procedure you will still produce semen and ejaculate normally however you will be infertile (i.e. you will no longer be able to make a woman pregnant).

Pre operation

Ten days prior to the procedure you should notify Mr Thyer’s rooms if you are taking any blood thinning medication

The procedure

On arrival at hospital you will be prepared for theatre by nursing staff. Mr Thyer will see you just prior to being taken into the operating theatre. You will have the choice of local or general anaesthetic. The procedure should take approximately 20 minutes. Mr Thyer will make two very small incisions on each side of the scrotum, each vas deferens is located and divided and tied off. A section of vas is removed and sent to the pathologist to check that the correct tube has been divided (you may incur a pathologist fee). The wound on each side of the scrotum will be closed with dissolving sutures and glue. After the operation you will be checked by the nurse and discharged home after a few hours.

Risks

• Bleeding. Bleeding from the operation site is very rare. Very rarely a readmission to hospital may be required to control bleeding.
• Infection. Wound infection is rare but may require a course of oral antibiotics to correct.
• Injury to blood vessels to the testis. A recognised but very rare complication of vasectomy. This can result in reduced blood supply to the testis.
• Failed vasectomy. Very rarely the vas deferens can spontaneously re-join and live sperm can continue to be seen in the semen. If this happens a repeat vasectomy can be considered to attain infertility. It is important that you use an alternate form of contraceptive until proven infertile with a semen test 3 months following the procedure.
• Non-motile sperm in semen. At the follow up semen test we see a few non-motile (dead) sperm in the semen in 10% of men undergoing vasectomy. In this situation, a repeat test will be requested after a further 4 months after the vasectomy. If there remains a few non-motile sperm then special leave to discontinue the alternate contraceptive will be given (ASERNIPS protocol).
• Chronic testicular pain. 2% of men develop a chronic scrotum pain syndrome after vasectomy. This can be improved with vasectomy reversal but this does not always help relieve the pain.
• Vasectomy reversal. Some men desire their fertility to be re-instated following vasectomy. Vasectomy reversal can be performed but is often unsuccessful. The quality of sperm production in the testis is is reduced after vasectomy. If you think that you may desire fertility in the future then perhaps vasectomy is not the right choice for you.
• There are risks with any general anaesthetic which are very rare including blood clots, heart or lung problems and adverse drug reactions. The anaesthetist will discuss these with you at the time of the procedure.

Follow up

You should rest, avoid heavy lifting, exertion and sexual intercourse for 1 week following the procedure. You will need a semen test 3 months after the procedure to check you are infertile. This test needs to be done at a laboratory in Perth (not at a rural lab) and delivered to the collection centre for analysis within one hour of ejaculation. You should continue to use another form of contraceptive until you have a follow up consultation with Mr Thyer at 3 months. Mr Thyer’s rooms will contact you to arrange a follow up telephone consultation 3 months after the vasectomy to check your recovery, pathology and semen test result.

When to contact Mr Thyer

Following the procedure, you should contact Mr Thyer if you:

• Have a fever over 38 Degrees
• Develop significant and worsening scrotal swelling
• Have not received a follow up appointment
• You can contact Mr Thyer via his rooms during working hours or after hours via the after hours nurse at Hollywood Hospital on (08) 9346 6000
• You can attend the emergency department at the hospital at which you had your procedure. (Hollywood Private Emergency Department charge a fee for attendance).