Reasons For Vasectomy Consultation
A consultation visit is always recommended if you have questions or concerns you feel have not been adequately addressed.
Vasectomy consultations are also appropriate for men who have medical conditions which make vasectomy more high risk or men who have additional conditions which may be simultaneously treated in a hospital setting at the time of vasectomy.
The following are reasons to have a consultation visit.
Just want to talk with the doctor first
It can be very unnerving and intimidating to have a procedure as personal as vasectomy with a physician you have never met. If you feel more comfortable talking with me first during a consultation then I actively encourage you to make a consultation appointment.
Your partner can’t take any birth control
If you are choosing vasectomy only because your partner has had problems with birth control then you should consider a consultation appointment. Ideally you and your partner should come to the consultation. If you are comfortable with the idea of a vasectomy then a consultation is not absolutely required. If you are choosing vasectomy out of desperation because your partner is having birth control problems then a consultation may be warranted.
The reality is women have many more options available to them in comparison to men. Not only do they have more options but they also have more reversible options. Intrauterine contraception (IUC also known as the IUD) is the best reversible form of female contraception. I wholeheartedly endorse intra-uterine contraception for the vast majority of women because it is easy to use and similarly effective as tubal ligation or vasectomy. The best selling point about an IUD is that it is also 100% reversible.
Men who are having vasectomy because they feel forced into it because of their partner’s inability to tolerate birth control are at much higher risk of vasectomy regret.
Uncertainty about vasectomy
If you are not certain vasectomy is the best choice for you then you should make an appointment to discuss vasectomy and vasectomy alternatives.
Active urinary tract, scrotum, prostate or epididymis infection
If you have an active infection then you may need to be evaluated before the vasectomy, may need antibiotic treatment, and will need to have your vasectomy postponed until the infection has cleared.
Some men who have chronic prostate and epididymal problems may be more at risk for Chronic Scrotal Pain after vasectomy.
Taking prescription blood thinners
If you are currently taking a prescription blood thinner other than aspirin (Coumadin, Warfarin, Lovenox, Fragmin, etc.) for a medical condition then your procedure is at higher risk for a bleeding complication. It is my recommendation you schedule a consultation appointment to discuss your medical condition, the risks associated with vasectomy, if vasectomy is appropriate for you, and consider the alternatives to vasectomy. If we feel vasectomy is appropriate and worth the risk then we will plan the procedure during a time when you can temporarily stop the blood thinning medication.
Men who are taking these medications are at increased risk of hematoma formation. Some men may have medical conditions that are so high risk that stopping these blood thinners increases their risk of having a complication. The preoperative visit allows us to discuss your medical history, decide if vasectomy is the best option for you, and coordinate with your physician temporarily stopping these medications before having a vasectomy.
Have a bleeding disorder
If you have a bleeding disorder like Von Willebrands Disease or thrombocytopenia (low platelets) then you should make a consultation appointment to discuss if vasectomy is safe and appropriate for you. If the vasectomy is performed we will need to formulate the best plan to take anti-bleeding medications before the vasectomy procedure.
Have an artificial heart valve or history of bacterial heart infections
If you have an artificial heart valve, previous surgery on a heart valve, or a history of bacterial heart infections then a consultation appointment is appropriate to discuss pre-operative antibiotics.
Undescended testicle or previous surgery for undescended testicle
The medical term for this is cryptorchidism. If you currently have an undescended testicle(s) or previously have had surgery for an undescended testicle(s) then a consultation visit should be considered.
Each cryptorchidism situation is unique and surgical decision making depends on how easily accessible each vas deferens is during an exam and if the undescended testicle is accessible. If you have had surgery to repair an undescended testicle then you will need to be examined to see if out-patient vasectomy is safe and feasible.
Previous vasectomy and vasectomy reversal
With multiple surgeries to the vas deferens each subsequent surgery can become more challenging due to altered anatomy and scar tissue formation and the risk of vasectomy complications can increase. A consultation and an exam is helpful to evaluate for the presence of scar tissue.
Have an unrepaired abdominal wall or scrotal hernia
If you currently have an unprepared abdominal wall or scrotal hernia then a consultation visit is advised. The risk of hematoma formation or injury to the hernia sac contents may be increased during vasectomy. Occasionally it may be best to surgically repair both conditions at the same time and it may be more appropriate for your vasectomy to be performed in a hospital setting.
Suffer from chronic pain
If you have a history of chronic pain then it may be appropriate to have a consultation visit to discuss pain management during and after the vasectomy and the possible increased risk of Chronic Scrotal Pain after vasectomy.