Vasectomy is a commonly performed urologic procedure, which can be either under a short general anaesthetic as a day procedure, or at times under local anaesthesia. Dr Haddad prefers to perform vasectomy under general anaesthesia in a hospital setting.
After the scrotum is shaved a few days pre-operatively by the patient, the vasectomy is performed through two separate tiny incisions, and the vas tube is dissected free of other spermatic cord structures, that supply and drain the testis. A segment of vas is divided and the two ends are cauterised and subsequently tied off and then buried in separate tissue planes, in order to prevent re-canalisation down the track. This is a well tolerated procedure, requiring simple pain relief afterwards for a few days and the patient can get back to normal activities within 24-36 hours. Tight underpants are required for scrotal support and Dr Haddad checks the wound at one week, and subsequently needs to review the patient at two months after 20-25 ejaculates, with a sperm analysis, confirming that there are no motile sperm (azoospermia) within the seminal fluid.
When azoospermia is confirmed on this two-month seminal analysis, the patient is then free to use vasectomy as a permanent contraceptive method. Until that point, alternate forms of contraception are required.
Vasectomy is able to be a reversed, with a 70-80% efficacy rate, by way of vaso-vasostomy, or vaso-epididymostomy, performed under the operating microscope. Other methods of retrieving testicular sperm, after vasectomy, would include open or needle testicular sperm extraction.
There is a slight incidence of chronic testicular pain after vasectomy, but this is rare.