Vasectomy Clinic is now at 155 Kilmore Street, between Manchester and Colombo. Phone 981 8181

Procedure

Vasectomy Clinic in Christchurch.
Link to MenzMedical

the-procedure

Procedure

The procedure is very “user friendly” with, in addition, no special preparation needed. Vasectomies are now the most popular form of contraception in New Zealand, with the failure rate 10 – 100 times less than tubal ligation or long term pill usage.

If you are booking-in for the procedure we would like you to read all the information here (and if it still sounds OK!!) you can then sign a consent form on arrival.

Delivery of local anaesthetic is via a very fine high speed spray and is surprisingly painless – that is the “no needle” bit. The no scalpel part means the job is done with some special small instruments leaving just a tiny hole in the skin.

Despite this easy access we remove a very small piece of vas, tie and cauterise the ends. This produces a very low contraceptive failure rate, currently nil in the last 10 years. Technical failure rate is approximately 0.25% (1 in 400) which is on par for this type of procedure.  For more on this subject, refer to the RCOG (Royal College of Obstetricians and Gynecologists) website www.rcog.org.uk. From studies mentioned on the RCOG website, contraceptive failure rate for vasectomies is 1 in 2000

Dr Rob Williams performs this almost painless and effective operation from a clinic in Christchurch, New Zealand. Throughout Rob’s medical career, he has performed over 4000 vasectomies and continually updates his methods to keep up with the most effective techniques.

The Decision

Don’t be surprised if it takes a couple of years to phone for an appointment after making the logical decision ‘to get it done’.

Sometimes a ‘near miss’ or another pregnancy will accelerate things, but often the logic has to be filtered through a whole heap of emotional “what ifs”.

There is of course some natural apprehension about getting the job done but I notice as the years go by this is getting less, perhaps as vasectomy becomes a very common ‘rite of passage’, and the current methods are less of a challenge.

It is almost impossible to make the decision 100% certain. Eventually you may decide it’s better than the other options that are available in your situation.

It is good to talk to your GP because he / she will have an impartial view of all the choices and may know something that would influence your decision (e.g. the possibility that your wife or partner will need a hysterectomy etc.).

Also, talk to your GP about whether you would like to provide samples of semen for “sperm storage”. Should life’s circumstances change in the future, and you would like to father another child, reversal is expensive and doesn’t always work, so sperm storage for a few years can give you some “insurance”. We like to think that men who have a vasectomy realize that this is permanent form of contraception. If you are thinking about the possibility of reversal, then you shouldn’t be getting a vasectomy. Having said that, there are always a small number of men who change their minds in later years and want to become fathers again.

How it works

Men produce 1000 sperm a second. Normally 95% of these go nowhere and get recycled in the testes. The remaining 5% travel up the vas, get stored in the seminal vesicles near the prostate (which supplies the juicy bit) and get fired out through the ejaculatory ducts during ridiculous acts of bizarre behaviour on Friday nights and Sunday mornings.

Removing a little (5 to 10 mm) portion of vas and sealing both ends of the tubes just above the testicle cuts off the supply line but from then on it will take one to three months (or even longer) to completely empty the dying residual sperm in the seminal vesicles. The prostate keeps on supplying seminal fluid so all that stays the same. Only 5% of the volume of seminal fluid is made up of sperm, so the volume of the ejaculate remains pretty much the same. It may have a slightly clearer appearance without the sperm being there.

What happens to the sperm once their supply line is blocked? Well just like a factory that is full of produced goods and has no room for any more, production is cut. There is a negative feed-back system which tells the testicles not to produce so much sperm – the same process that occurs in a celibate man who doesn’t masturbate. What sperm are produced, collects in the “warehouse” (the epidydimis) and are broken down and  re-absorbed after a few weeks.

Hormones are made in the testes but produce their effects by getting into the blood stream and are, therefore, not affected by vasectomy.

The Operation

No preparation is needed apart from shaving. The main areas to shave would be at the front of the scrotum under the penis. It makes life a little easier for the vasectomist to have a relatively hairless area to work in.

There will be some medication given prior to the procedure which we will supply for you when you come for your nurse interview. The lorazepam 1mg is taken 12 hours before, and 1 hour before the procedure, along with some Panadeine. The lorazepam is used as a pre-operative sedative, so you won’t be able to drive from the clinic. Arrange to have transport.

The infection rate is practically zero and pain is very rarely worse than a dull ache. Many people are surprised at the ease of the “no needle/no scalpel” operation.

After shaving a little area on each side of the scrotum and using a small amount of local anaesthetic with a Madajet (a needleless anesthetic device) a small loop of vas is brought to the surface, a small section is removed, the testicular end is sealed with fine absorbable suture and cautery, and the prostatic end is diathermied with a fine hot-wire diathermy. Checking for any oozing, they are replaced and the skin is sutured again with absorbable fine suture.

The complete time involved is about 1 hour although only about 15 minutes is needed for the real work.

You won’t be able to drive yourself home afterwards after taking a sedative like lorazepam. If you choose not to take lorazepam, and you feel ok, you can drive yourself home.

Afterwards

A few hours of complete rest is needed to give the internal raw areas a good chance to seal over. Some restraint over the next two days is advised with minimal activity.

Most men will be able to return to work after two days but if you have a very active job, it may be prudent to have a few more days off. It’s a bit like a small shaving cut, if it gets knocked around on the first day it will almost certainly bleed – after 2 – 3 days it almost certainly won’t. We advise to avoid heavy lifting, straining, bicycling, contact sports and sexual activity for the first week after a vasectomy. It also helps to wear supportive underwear for a week, so that your scrotum has support against flopping about.

Vigorous exercise should be avoided for a week. If there is bleeding or persistent oozing from the wounds, some pressure from an ice- filled, clean cloth or a packet of frozen peas may stop it. Sufficient internal bleeding to warrant hospital care is rare, about 1 in 2000, but if this happens contact us, your Doctor, or go straight to hospital casualty.

Collection of Semen

We require two completely negative sperm tests to confirm the success of the operation. These should be done 2 months and 4 months post-vasectomy. This is to check for “technical failure” where there are still motile (moving) sperm. We aim to get two consecutive completely negative tests.

People often pass through a near negative phase with small numbers of dead sperm (non motile) on the way to the completely negative stage; in some this process is prolonged for months or years. If we have several (3) tests with “Small numbers of non-motile sperm” (i.e. dead) sperm that is as good as a completely negative test. Both carry the same pregnancy rate of around 1:10000 pregnancy rate (lifetime).

Semen should be obtained by masturbation and the whole volume collected into the bottle provided. The specimen must go to the lab within 2 hours of collection, and should not at any stage be put in the fridge. Condom specimens are not permitted. In Christchurch, we ask that men take their specimens straight to Canterbury SCL (Southern Community Laboratories) at 18 Logistics Drive near the airport where the specimen can be analysed directly.

The labs cannot do semen analysis at the weekends or on public holidays.

If the first test is negative (about 90% are), do another to confirm as soon as you like. If there are still small numbers of dead sperm (the lab calls them ‘non-motile’), leave it a few weeks, it sometimes takes several months to get complete clearance. 7% of men still produce small numbers of dead sperm 10 years later but carry no increased pregnancy risk.

The reason for this slowness is that some men have large seminal vesicles and small ejaculatory ducts.

Once sperm tests are alright, then you can stop other contraception.