Vasectomy

Abstract

Follow-up data were gathered on 903 vasectomies performed under local anesthesia in the Family Planning Association Clinic Cardiff Wales. After surgery there was discussion of anesthesia anelgesia and surgical dressing. Wounds were examined after 1 week and semen specimens were requested at 12 and 16 weeks postoperatively. Patients were questioned regarding pain and lost work time; these responses and physiological data were recorded and analyzed. Early complications included 164 instances of hematoma 26 cases of infection (24 superficial) 120 instances of scrotal bruising and 121 cases of pain (generally not severe). 63% of the patients took no leave from work: 11% took the recommended amount of time 11% took less and 15% took mor e. The single psychiatric complication was a patient with serious family and financial problems. The completion criterion was aspermia in 2 consecutive specimens; patients were instructed to use contraception until this time and received written notification of completion. 575 of the 903 patients met the completion criterion in the 12- and 16-week postoperative specimens. 149 of the 328 remaining patients did not comply with instructions. Multiple sperm counts were required in 179 cases possibly because of too few ejaculations. There were 3 recanalizations. Recommendations based on experience with these patients include 1) preoperative counseling to identify psychosexual problems and review by the surgeon 2) use of outpatient double ligation procedures under local anesthesia 3) taking specimens at 12 and 16 weeks after intercouse has been resumed 4) counseling patients that 8 ejaculations are necessary to empty vesicles and that sterility is not assured until 2 consecutive sperm counts are negative and 5) requesting repeated specimens from late completers to encourage ejaculations.