There is a growing demand among the population to ask for a vasectomy as a method of contraception due to its simplicity, high efficacy (results may be checked through a seminogram) and low morbidity. The vasectomy is a procedure which requires a minimal dosage of local anaesthetics, an almost imperceptible incision and is over in barely ten minutes, also allowing the immediate return of patients to their usual daily activities.

Procedures

A.- Pre-operatively:

• Admission and registration
• Anamnesis and clinical record: underlying conditions, background of coagulopathies, mictional disorders, balanitis, etc.
• Personal background: age, marital status, number of children (were they wanted or not), regular contraceptive method, etc.
• Genitalia examination: penis, scrotum, deferens vas and testes.
• Interview: psychological evaluation of the patient, information relative to the procedure and what the operation entails, obtention of patient’s informed consent.
• Pre-operative evaluation: determination of surgical-anaesthetics risks based on the anamnesis, physical examination, complete haemogram, coagulation tests, etc. Written information on the procedure.

B.- Surgical management:

• The procedure uses local anaesthetics with infiltration of the subcutaneous tissue of the scrotal mid-raphe in the basis of the penis and then both vasa at the peri-deferential level; also, where indicated, patients are pre-medicated with parasympatholytics and antianxiety drugs.
• Usual vasectomy technique: exteriorization, section and coagulation of both deferent vasa, ligature of distal end to testicle (which is tied in a more superficial level) and skin closure with a single stitch of absorbable material.

C.- Post-operative monitoring:

Absence of side-effects to vagal reactions and bleeding at the surgical wound. Patient evaluation prior to being discharged:

• correct level of consciousness and orientation.
• walking ability.
• good level of analgesia.
• assessment by an anaesthesiologist or a clinician.

D.- Patient information:

• Written instructions to be followed post-operatively, insisting on the need to continue with the previous contraceptive method until the seminogram shows absence of spermatozoa.
• Prescription of suitable medication.
• Specific discharge report.
• Written appointment for a follow-up visit, and a 24-hour hotline phone number.