Waverley Vasectomy Clinic

www.non-scalpelvasectomy.co.uk

No Scalpel, No sitches anywhere, minimal trauma (quick healing) technique

Operation Procedure:

As the name suggests a sharp scalpel is not used to cut the skin, but a small opening is required in either process.

• To perform NSV a tiny puncture in the skin is needed. This puncture is made over a small patch of anaesthetised / numbed skin. An injection of local anaesthetic is given very superficially which is almost painfree. Further injections of anaesthetic are given deeper in the scrotum around each vas (the tubes carrying sperms). This injection may be slightly uncomfortable but it only last for no more than few seconds. After local anaesthetic the whole procedure is entirely pain free but the sensation of touch and pulling or tugging still persists.
• Surgeon then locates the vas under the skin of scrotum by hand which is then held by a surgical clip. This allows separation of the vas without causing harm to other tissues in the scrotum.
• Small pointed forceps then perforates the skin and sheath of Vas, thus exposing the Vas which enables operator to promptly lift the vas out. This perforation may also be made by using an electric cautery, called Hyfrecater (at our clinic this is preferred currently).
• The exposed portion of vas is then cauterised and lumen of Vas is split open, using an electric (Hyfrecater) or Radio Cautery.
• Cauterised and split Vas is then cut, again by using Hyfrecater to separate the two ends, thus minimising the chances of re-joining/ failure. In most cases there is no need to tie the ends of divided Vas with suture.
• Cut ends of vas are returned to scrotum and similar steps are then repeated for other side Vas.
• Antiseptic spray which also seals the skin wound is sprayed (This stings momentarily). A small plaster size dressing is applied. External skin opening does not require any sutures in majority of cases but surgeon may elect to do so if there is any bleeding from the superficial layers.

Benefits of NSV:

• Less trauma to other scotal tissues and much less complications
• Fast recovery period and early return to work
• During the whole operation testicles are not interfered with at all.

Post Operative complications and their management:

Complications resulting from vasectomy are not frequent and are mostly treated very easily if these do occur. Following complication may occur:-
Swelling and Bruising
Following are important possible post-operative complications, which are fortunately very rare. There may be other general complications, still rarer which are explained in ‘Frequently Asked Questions’ section.
• Some superficial bleeding after the operation is common over scrotal and penis area but this resolves very quickly spontaneously. In rare cases there may be some internal bleeding or oozing causing large swelling of the scrotum Called Haematoma. Again this usually settles itself although the healing process may delay somewhat. Very rarely the haematoma may need evacuation. Surgeon will usually observe this at the post operative check appointment; otherwise patient should report it if this appears at a later stage
• All surgical wounds can get infected if not kept clean. Vasectomy wound may get infected too. This is easy to treat mostly with Antibiotics.
• Failure of the operation may occur very rarely, by natural re-joining of the Vasa (tubes) This may occur soon after the operation or in even rarer cases this may happen late, several months or weeks after the operation. It is therefore very important to have post-operative sperm count after about 3 months of operation, while other contraception must continue until advised by the Surgeon. Unfortunately if late re-joining takes place after negative sperm count, this can only be detected accidentally when pregnancy has taken place.
• Post-operative pain is usually easily treated by simple analgesia, but rarely there may be chronic testicular pain lasting many weeks or months after the operation.

Post Operative Care:

• Go directly home and rest, elevating your feet. Walk only minimally and stay off your feet for first 24 hours. This reduces chances of swelling.
• Any discomfort is usually mild and simple pain relievers such as ‘Neurofen plus’ should be used if necessary. Take two tablets after reaching home after the operation to control the pain after the local anesthetic wears off.and after that every 4-6 hourly only if needed.
• Apply an ice pack to the scrotum periodically during the first 24 hours after the procedure to ease swelling if necessary.
• Wear triangular / tight underwear instead of boxer’s shorts to help apply pressure against the procedure area and for support of the scrotum for the first week or two.
• You should collect your semen (usually at home) and take it to hospital lab within 2 hours to be examined under a microscope, at approximately 4 months i.e. 16 weeks after the surgery. You will then be informed of the result by telephone, If you call us about a week later, and also in writing; which is usually the preferred method. If there are no sperms in the sample as confirmed by the test report you may stop other contraception. Sometimes it is necessary to repeat the test after another month to ensure that there are no sperms shown in the sample. Some people may continue passing sperms for upto 7 months but that is rare. Continue other contraception until no motile or non-motile sperms are seen in the sample and your Surgeon advises you to stop it.
• Contact your doctor if you experience fever and chills, increasing pain, drainage (sign of infection), a growing mass (sign of internal bleeding or infection), or other concerns.