: When men in Minnesota consider male sterilization, a preoperative interactive consultation is an important step in planning on vasectomy. Dr. Shu in One Stop Medical Center recommends that a preoperative consultation should be conducted in person, so the vasectomy consultation will be more effective.
The minimum and necessary concepts that should be discussed in a preoperative vasectomy consultation include the following: (based on American Urological Association Guideline)
• vasectomy is intended to be a permanent form of contraception.
• vasectomy does not produce immediate sterility.
• Following vasectomy, another form of contraception is required until vas occlusion is confirmed by post- vasectomy semen analysis (PVSA).
• Even after vas occlusion is confirmed, vasectomy is not 100% reliable in preventing pregnancy.
• The risk of pregnancy after vasectomy is approximately 1 in 2,000 for men who have post-vasectomy azoospermia or PVSA showing rare non-motile sperm (RNMS).
• Repeat vasectomy is necessary in ≤1% of vasectomies, provided that a technique for vas occlusion known to have a low occlusive failure rate has been used.
• Patients should refrain from ejaculation for approximately one week after vasectomy.
• Options for fertility after vasectomy include vasectomy reversal and sperm retrieval with in vitro fertilization. These options are not always successful, and they may be expensive.
• The rates of surgical complications such as symptomatic hematoma and infection are 1-2%. These rates vary with the surgeon’s experience and the criteria used to diagnose these conditions.
• Chronic scrotal pain associated with negative impact on quality of life occurs after vasectomy in about 1-2% of men. Few of these men require additional surgery.
• Other permanent and non-permanent alternatives to vasectomy are available.
