The Darlington Vasectomy Clinic

Founding member of the British Association of No-Scalpel Vasectomists (BANSV) www.bansv.org

As well as the information below we have a DOWNLOADABLE LEAFLET

General Information

We have carried out over 3000 vasectomies since 1986 and are accredited by County Durham & Darlington Health Authority to provide this service. The Clinic started at Neasham Road Surgery in Darlington, but increasing demand has necessitated a move to separate premises near Newton Aycliffe. We also hold regular sessions at The Claypath Medical Practice in Durham and at Shotley Bridge Hospital in Consett. A survey of local GP’s and their patients confirmed high levels of satisfaction. We are accredited in the No Scalpel Vasectomy method which is the method of choice in the States; the method is promoted and taught by Engender Health Care (formerly known as The Association of Voluntary Surgical Contraception). The No Scalpel vasectomy is simpler to perform and has a much lower complication rate than the traditional techniques.

Patients referred by their GPs are sent a detailed information leaflet (extracts below) to read, which includes details on how to book in for the operation. We are currently providing this service to most of south Durham and parts of north Durham as an NHS service. Patients can be seen privately if they wish, but there is little advantage in doing so!

Male sterilisation (vasectomy) is a safe, effective and simple method of permanent birth control. Nothing is taken away except the ability to father children. The only difference after the operation is that the seminal fluid contains no sperm. Since sperm only makes up a tiny part of the volume of the seminal fluid, this is not even noticeable. Vasectomy does not change who you are or how you feel about sex; it only prevents pregnancies.
Because the operation is permanent, it is vital that you and your partner read and reflect on the following information, to ensure that you make the right decision for yourself.

As a couple you must be absolutely sure that you do not want any more children, under any circumstances. Most men who choose to have a vasectomy are in a stable relationship and have fathered one or more children. However we will consider any man for a vasectomy, with or without children, who has seriously considered the implications regardless of his marital status or age. Please do not rush your decision on such an important issue. There are many family planning methods available that will allow you plenty of thinking time.

Please consider the following:

None of us know what the future holds for us. What may seem very reasonable and sensible now may be bitterly regretted later on.

One in three marriages end in divorce.

One in twenty men who have had a vasectomy will seek to have it reversed. Sometimes it is due to new relationships forming, but more often a couple simply change their minds and feel they want to have more children. Please be aware that the success rate of vasectomy reversal is poor.

Please do not have a vasectomy if you have any personal or sexual problems. The operation will not help these problems and may well add to your difficulties. It is best to delay until you have sorted your problems out.
The operation is not immediately effective as it takes three/four months to clear your system of sperms, after the tubes have been blocked. This means that you must use effective contraception until your tests are clear; we will send you a letter confirming when it is safe to stop using contraceptive precautions. If you have an accident, we advise the use of ‘emergency contraception’ which can be obtained from your GP or family planning clinic.

Failure rates [TOP]

The bodys’ repair system is fantastic and despite our best efforts, the tubes re-join in about one in two thousand men. Most re-joins will occur before you produce your tests so at least you will know it hasn’t worked for you, before you rely on the operation.

Once you have produced two clear tests, there remains a 1 in 2,000 risk of failure over the rest of your life-time; this is due to the re-joining process occurring much later than normally.

Complications

About one in one hundred men will develop a problem after their vasectomy. Most problems are minor and will get better without any treatment.

After the operation, we advise that you rest for two days. This will minimise the risk of swelling or bruising which can be a problem if you do too much too soon. It is better to rest for two days than risk serious problems, which could put you off work for three or four weeks!

Swelling and bruising does not need any treatment other than rest and ice. Very rarely, a leaking blood vessel will need to be found and sealed.

Infection may cause pain and swelling three or four days after the operation. Treatment with antibiotics is effective and should be started quickly.

Pain after the operation is usually mild and more of an ache than actual pain. Paracetamol or co-codamol is strong enough for most people. Aspirin can increase the amount of bruising, so we advise against it for this purpose.

The first ejaculations after vasectomy may be blood-stained. This settles with time.

A tiny number of men may experience pain or discomfort for months, or even for one or two years, after the vasectomy. This nearly always gets better without treatment, but further surgery is sometimes needed.

Long term effects

There are no confirmed long-term problems associated with having a vasectomy. There was a scare some years ago suggesting a higher risk of prostate and testicular cancer in men who had a vasectomy. This work was later shown to be inaccurate.

The Operation [TOP]

We use the no-scalpel vasectomy method which has one eighth the complication rate of other methods, as well as being more comfortable & quicker to perform. First of all, the skin and the tubes are numbed with a local anaesthetic injection through a very fine needle. You will feel a pin- prick and a slight stinging for a few seconds. After that you should not feel any discomfort at all. Contrary to what your ‘friends’ will tell you, the injection is not inserted into the testicle itself! The tubes are then held in place with a special instrument, before being blocked using an advanced electro-surgery technique. There will be one tiny puncture wound; no stitches are needed. The whole operation takes about twenty minutes to complete.

If you have had previous operations on the scrotum or testicles, the vasectomy may be more difficult. If this is the case, I will discuss with you, whether or not we should proceed. Also, a small number of men have abnormalities that make the vasectomy very difficult. If this is the case, I will advise you to have the operation done in hospital under general anaesthetic.

All men are anxious about the operation, but most manage to relax and the usual comment afterwards is ‘nowhere near as bad as I thought it was going to be!’ However sedation is available by injection if you want it.

If you wish to view a series of photographs of a no scalpel vasectomy please click here for Dr Muktars' site and then click on Slides.

Before the operation

* Are you certain that you want no more children?
* Have a light meal
* Trim the hair on the scrotum so that it is very short, especially the top part under the base of the penis. Shaving is not necessary.
* Bring some tight underwear for support afterwards. Swimming trunks are very effective.
* Stock up with paracetamol or co-codamol for afterwards.
* Please arrive in good time and allow 45 minutes for your visit. Your partner is very welcome to accompany you.
* Arrange for someone to drive you home.
* Book two days off work.

After the operation

We will give you an instruction sheet before you leave the clinic.

The anaesthetic effect will wear off after 2-3 hours, leaving you with an ache or throb rather than severe pain.
REST! Lie flat for the first 24 hours and potter about for the next 24 hours. Most sports can be resumed in 7-10 days time.

Sexual activity can be resumed as soon as you feel comfortable.

Tests

You need to produce two clear tests in a row, to be sure that the operation has worked for you. The samples can be taken to your GP’s surgery or local hospital and I will write to you with the results. Most men are clear on their tests at twelve to fourteen weeks after the operation. Some men take longer, in which case we will advise you when to do your extra tests. In extreme cases, this may take up to a year. It is vital that you use effective contraception until we inform you that it is safe to rely on your vasectomy.

Booking [TOP]

Once we have been contacted by your family doctor, we will send you our information leaflet. Once you have read it & decided you wish to proceed please telephone The Langton Medical Suite to make an appointment for your operation. Operating sessions are held at Durham on Wednesday afternoons, Aycliffe on Thursdays and most Fridays and Consett on two Friday afternoons per month. If there are no suitable appointments, please inform my staff and we will try to arrange a different time for you. If you need to alter your appointment, please let us know as soon as possible.

Please note that if you are not referred by your family doctor, you will have to pay for the operation as a private patient.

The average waiting time is two weeks, but to ensure a convenient appointment, we advise you plan about four weeks ahead. If you have any worries or questions that my staff cannot answer, please ask to talk to me.

Audits

The Dec 2000 audit was done to assess the effect of introducing the No-Scalpel (NSV) method in June 2000. Records for the first 140 NSV cases were compared to the last 140 cases using the traditional cut & tie method. Total number of cases examined was 280. Further audits are done to assure the quality of the service and our figures are compared with other members of the BANSV to ensure quality.

The conclusion is that the NSV method is significantly better tolerated than the traditional method. I would expect the problem rate to decrease further as more experience is gained with the NSV method.

The vast majority of the consultations after the operation are for minor wound problems that require no treatment. There were no hospital admissions in either group.

Web sites of interest

www.vasectomy-information.com - General information site, including personal stories and humour.
www.VasectomyMedical.com - Another general information site
www.engenderhealth.org - Site of Engender Health who promote the no-scalpel method.
www.ukvasectomy.com - Dr Laurel Spooners site; she is an approved NSV trainer
www.vasectomy-clinic.co.uk - Dr Muktars' site which includes a fine series of photographs of NSV.
www.pollockclinics.com - Canadian site again containing good diagrams of the procedure.
Introduction of No Scalpel Vasectomy into the United States 1988-1992
www.vasectomyreversals.co.uk - Hartlepool Vasectomy Clinic site; they also provide a vasectomy reversal service.
Schuco - leading NSV equipment supplier.