Vasectomy

Casebank Counselling
1

Married man, 26 years old, asking for Vasectomy.

  • Doesn’t want to tell wife. They have kids (complete family).

Explore General Knowledge

What do u understanding about Vasectomy?
From where did you learn about it?
Do u know anyone who got this done?
Since when are u thinking about this? (1wk or 1yr)
Why you’ve decided to get Vasectomy? P: I don’t like using Condom.
In terms of method, do you know how they do it?
Do you know what kind of changes vasectomy can make into ur body?
Do you the benefit and disadvantage? Success rate? Reversibility?

I would like to ask you some personal questions, may I know if u are in a relationship?
How long have you been in relationship?
Does she have any contraception?
Do u have any kids? Would u plan to have kids one day?

D: Have u discussed it with your wife?
P: No
D: May I know why?
P: (gives reason)
D: I understand that its ur decision but do discuss with her as it’s a life changing decision and this
will definitely affect her too.

OR
P: Long time ago
D: What’s your partner’s opinion?
D: Does she know that you’re here today?
Does your partner would like to have any children in future?
Is there anybody forcing you to make this decision?

General health, Risk factor and Social History

MAFTOSA: Bleeding disorder, previous history of STI
Social: How is the relationship between you and your partner?

Thank u for answering my questions, let me explain to you, what’s Vasectomy?

  • It is a surgical procedure to cut/seal the tubes that carry the sperm which will permanently prevent pregnancy. It’s a day care procedure, usually carried out under a local aesthetic where you’ll be awake but don’t feel any pain and takes about 10 to 15 mins.
  • Alternate explanation, It’s a male sterilisation procedure, preventing sperms from entering the ejaculate. There is a tube called vas deferces in testicle, which transfers the sperm. In this procedure, we’re going to interrupt the transmission, thereby cutting the tube or puncturing it or sealing it with occlusive method, done by clips or plugs.
  • Failure rate: 1 in 2000
  • It’s permanent one, so once it’s done cannot be reversed.

Covered by NHS

  • Let me tell you that Vasectomy is covered by the NHS, so if in future u change ur mind and u want to reverse this procedure and have kids. It will be very difficult and might be impossible and this
    wont be covered by NHS u need to get it done privately.

Benefit

  • It’ll not affect the sex drive.
  • Very effective.
  • Success rate very high
  • Minor surgical procedure

Disadvantage:

  • It takes about 12 weeks to confirm
  • Doesn’t protect against the STI
  • We are always here to help you with any kind of referral and we want the best care for you
  • Low success rate of reversibility
  • Risk and complication: Hematoma, Chronic pain in testies (Post vasectomy pain)
  • You are quite young and don’t have any kids, sterilisation is for people who don’t want any more children. Therefore, may not be the best choice for you. Our research shows that patients younger than 30 years old generally they regret their decision and if they want a reversal that’s not possible later. I would suggest to you to take some time, may be several months to think about your decision again, Is that alright with you?
  • You mentioned that you don’t want to discuss this with your wife, that’s oay
    know something that you will decide but maybe you can try TALKING THERAPY to discuss this with somebody neutral, to really understand what exactly do you want, then we can meet in couple of months and see if you still have the same decision.

P: Doctor, is it legally required that I talk to my wife about this.
D: No, it’s not a requirement but we will be very glad if you can discuss this with her because this decision will affect both of you in the life. Its a life changing decision so it’s better to discuss with the loved one.

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How to prepare for a vasectomy

Before your surgery, you’ll receive information explaining how to prepare for your vasectomy. You may be asked to:

  • shave your testicles a few days before the procedure – the information will tell you how to do this at home safely
  • have a shower or bath on the morning of your vasectomy – this helps reduce the risk of infection
  • wear or bring tight-fitting underwear on the day of the surgery

You’re likely to have some pain after the procedure. Make sure you have painkillers at home for the pain. If you’re concerned about pain, speak to the nurse or doctor. They may be able to offer you extra pain relief.

Ibuprofen is usually recommended, but you can use paracetamol if you cannot take ibuprofen.

It will not be safe for you to drive home afterwards. You will need to make other arrangements for getting home.

What happens during a vasectomy

How vasectomy works

A vasectomy works by stopping your body releasing sperm in the semen when you come (ejaculate).

After a vasectomy, you can still ejaculate but your semen will not have any sperm in it.

On the day of your vasectomy

Vasectomy is done at a GP surgery, sexual health clinic or hospital.

A vasectomy usually takes around 15 to 20 minutes.

The doctor will:

  • use a local anaesthetic to numb your scrotum (the skin around your testicles)
  • make a small cut in your scrotum
  • seal, block or cut the tubes that carry sperm (sperm ducts)
  • close the cut, usually with dissolvable stitches

Recovering from a vasectomy

It is common to have testicle pain and swelling for around a week after a vasectomy. Taking a painkiller such as ibuprofen or paracetamol should help.

At first, getting an erection may feel painful and there may be some blood in your semen. These symptoms should quickly pass.

There is no evidence that having a vasectomy affects long-term sexual performance or enjoyment.

You should be able to return to work within 24 hours.

Do

  • wear tight-fitting underwear for about a week to support and protect your testicles
  • avoid sport or lifting anything heavy for as long as the doctor or nurse advises – this is usually 1 to 2 weeks
  • use another method of contraception until a doctor confirms that the vasectomy has been successful – this usually takes around 12 weeks

Don’t

  • do not take part in sexual activity, including masturbation, for at least 2 to 7 days after having a vasectomy
  • do not drive until you can safely do an emergency stop – check with your insurance company

Side effects of a vasectomy

A vasectomy is usually a very safe type of surgery and serious side effects are rare.

Side effects include:

  • mild bruising and swelling of the testicles
  • a small yellow lump (or lumps) on the scrotum – these lumps are made up of sperm (sperm granuloma) and are usually harmless
  • infection

Bruising and swelling of the testicles should go away as your scrotum recovers from surgery.

Sperm granulomas should also go away by themselves. Anti-inflammatory types of painkillers, such as ibuprofen, can help with pain caused by a granuloma.

An infection will need treating with antibiotics.

Urgent advice:

Ask for an urgent GP appointment or get help from NHS 111 if after your vasectomy :

  • the pain and swelling in your scrotum and testicles suddenly gets worse or shows no sign of getting better after a few days
  • you have a high temperature
  • you notice blood, pus or liquid leaking from the wound
  • a lump develops inside your scrotum (the skin around your testicles) and it keeps getting bigger
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It can be reversed, though the success rate is low.

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