VASECTOMY BIRTH CONTROL

Vasectomy : This is the removal of a section of the vas deferens from each side with the aim of achieving infertility.

Indications : A method of birth control

Anaesthesia : Local or general

Post-operative care and common post-operative complications and their management :
Post-operative haematoma can occur. If large, evacuation may be required. Infection can occur, but is usually superficial. Two semen samples are required, usually at 10 and 12 weeks post vasectomy, before unprotected intercourse can take place. Viable sperm can remain distal to the site of vasectomy (in the distal vas deferens or seminal vesicles) for some weeks after vasectomy, and even longer. Occasionally a persistently +ve semen analysis is an indication that the vas was not correctly identified at the time of surgery and has not been ligated (or, very rarely, that there were 2 vas deferens on one side). The potential for fertility remains in those with +ve semen analysis and re-exploration is indicated. Warn the patient that the vas deferens can later recanalize, thereby restoring fertility.

Sperm granuloma a hard, pea-sized lump in the region of the cut ends of the vas, forming as a result of an inflammatory response to sperm leaking out of the proximal cut end of the vas. It can be a cause of persistent pain, in which case it may have to be excised or evacuated and the vas cauterized or re-ligated.