Vasectomy Guidelines

Question 1

What are potential complications of Vasectomy?

Answer 1

Infection, bleeding hematoma, primary surgical failure, chronic scrotal pain, delayed vasectomy failure

Question 2

does data demonstrate a clear association bw vasectomy and prostate cancer

Answer 2

NO NO NO

Question 3

what is the rate surgical failure with vasectomy?

Answer 3

0.2-5%

Question 4

Is a cool down/off period needed after initial consult for vasectomy?

Answer 4

Nope, In Canada most men would have had good enough access to info, vasectomy can be performed shortly after initial consult.

Question 5

Should more time be given to patients in their 20s prior doing vasectomy?

Answer 5

yes, they are 12.5 times more likely to want a reversal.

Question 6

Are there any special precautions needed when performing a vasectomy on someone who has had a varicocelectomy?

Answer 6

Yes, the testicular artery may have been damaged and differential veins may be the sole veins draining the testis. So need to be extra careful about the differential vasculature as you can compromise arterial supply or venous drainage of testicle.

Question 7

Is there a benefit with use of pneumatic injector for local anesthetic for vasectomy?

Answer 7

NO

Question 8

What are two techniques for accessing Vas during vasectomy?

Answer 8

Traditional method( use a scalpel to make 1 or two cuts) and No-scalpel technique(puncture the skin)

Question 9

what are benefits of NSV?

Answer 9

lower risk of perioperative hematoma, pain during surgery, preoperative scrotal pain, wound infection

Question 10

NSV is associated with a significantly
higher risk of postoperative complications (hematoma, pain,
infection) than conventional vasectomy

Answer 10

No, Lower

Question 11

Fascial interposition during vasectomy
is associated with a significantly higher rate of azoospermia
at three months than no interposition

Answer 11

Correct

Question 12

Cautery of the vas is associated with
a lower risk of failure (defined as >100 000 sperm in the
ejaculate) than fascial interposition

Answer 12

True

Question 13

It is unlikely that the reappearance (or persistence)
of immotile sperm years after vasectomy is of clinical significance,
as this has not been associated with documented
pregnancies.

Answer 13

Correct

Question 14

How long do you have to deliver a semen specimen to the lab?

Answer 14

30-60 minutes

Question 15

What period of abstinence is appropriate for semen collection post vasectomy?

Answer 15

more than 2 less than 7

Question 16

How many post vasectomy semen specimen are needed to determine success?

Answer 16

The evaluation of two post-operative
semen samples is a better predictor of success than the
evaluation of a single semen sample.

Question 17

Post-vasectomy testing should be conducted

three months after vasectomy

Answer 17

CORRECT

Question 18

When can contraceptive measures be abandoned (successful vasectomy)

Answer 18

After men have produced one azoospermic sample or two with <100 000 immotile sperm

Question 19

Presence of any motile sperm or substantial
numbers of immotile spermatozoa (>100 000) in
the semen is an indication of vasectomy failure

Answer 19

Correct, you should repeat the Semen analysis and once confirmed proceed to treat as failure