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Vasectomy Haiti: Treating Hydroceles And Meeting A Man Of God

September 14, 2015
‘Vazektomi team’ poses for a photo after performing vasectomies in Ft Bourgeois.

In my previous blog entry I discussed the case of the man with the missing testicle. I thought this man would be the most interesting case of the day.

As luck would have it we had many more interesting and unique cases during the remainder of the vasectomy mission.

I would now like to discuss the case of the man with the scrotal hydrocele.

What is a hydrocele?

A hydrocele is a non-cancerous accumulation of fluid around the testicles. It can be a very common condition and can involve either one or both sides.

Hydroceles within the first year of life usually resolve without treatment. Those that do not resolve may remain stable but can grow overtime. Hydroceles are often small but can be as large as softballs or even as large as a basketball.

If hydroceles are uncomfortable or grow then they need to be surgically removed.

Large bilateral hydroceles

 A man and his hydrocele

One of our last patients laid down on the vasectomy table for his vasectomy. When he pulled his pants down we were shocked at what we saw!

His right testicle was about the size of an orange and his left testicle the size of a cantaloupe! It does not take much of an imagination to understand this man had very unique challenges in his life and having a vasectomy would be one of them.

A large hydrocele can significantly distort the scrotal anatomy making the vas deferens more difficult to identify. It can also cause enlargement of the blood supply and increase the risk of a bleeding complication during a vasectomy.

Fluid drained from the hydrocele was placed into this water bottle.

In the United States it is not common to see hydroceles as large as the ones we saw in Haiti. In the US, most of these patients would have been referred to a urologist to have a simultaneous vasectomy and hydrocele repair in the operating room under general anesthesia. In Haiti, we did not have these resources available to us to complete this guy’s hydrocele repair; however, the vasectomy team would not be so easily discouraged.

Drain hydrocele and have a successful vasectomy

We came up with an improvised plan. We would drain the hydrocele on the table. Removing a large amount of fluid would decrease the volume and tension within the scrotal sac allowing us to safely perform the vasectomy.

This would require the teamwork of two doctors. We were able to locate a large needle; however, we only had a small syringe to withdraw the hydrocele fluid.

Vasectomy patient holding fluid drained from his hydrocele in water bottle.

Under local anesthesia, we inserted the needle. One doctor held the needle in place while another doctor attached the syringe, removed 10 cc of fluid, and emptied the fluid into an empty water bottle.

This was repeated over and over until the scrotal tension decreased enough to allow completion of the vasectomy. After removal of 500 to 800 ml of hydrocele fluid, we were able to reduce the size of the hydrocele enough to complete the vasectomy.

Another difficult but successful vasectomy accomplished by the No-scalpel Vasectomy International team.

After completing the hydrocele vasectomy, we were ready to move locations. We had performed 18 vasectomy procedures during our morning session.

It was then God graced us with the presence of Pastor Joel.

Pastor Joel: A True Missionary of God

As we were packing up a portly white man walked into the room. We immediately noticed his presence. He was introduced to us as Pastor Joel and he wanted to stop by, see what we were doing, and say “Bonjour!”.

“In Haiti, white people are fairly rare and when you see one they tend to stand out. I would imagine it is the same as seeing a black person in Idaho.”
– Haiti Vasectomy: No Reservations

I only spent a handshake and several minutes with Pastor Joel but I immediately sensed a goodness about him. He came to Haiti and felt God’s calling and he decided to stay. That was 40 years ago and he has never left!

Pastor Joel of Haiti

Pastor Joel’s main focus is spreading the word of God to the people of Haiti but he also helps improve social services in the country. He maintains a cable television channel and has been a leading advocate for Haiti to people from other countries. He offered to film a segment about our vasectomy mission to spread the word about vasectomy to the people of Haiti.

I thought this would be a great opportunity to spread the word about vasectomy in Haiti.

Dr. Stein vs Pastor Joel: Immovable object and the irresistible force

As the team was about to leave, I literally drug Pastor Joel to Dr. Stein and informed him Pastor Joel would be interested in filming the vasectomy team on a future mission. Dr. Stein thought that was a marvelous idea…only he did not want to wait for the future. He wanted him to film us TODAY.

Pastor Joel was amicably reluctant because he had prior commitments for the day but little did he know Dr. Stein is rather tenacious when he gets something in his head. I knew what was coming so I just stepped back and enjoyed the show! It was like watching a good boxing match.

Dr. Stein would jab with a suggestion of when or how to video us TODAY and Pastor Joel would duck and weave with an excuse of what other obligations he had to do TODAY.

When Dr. Stein gets something in his head he won’t let it go and he will prevail. If Pastor Joel had told Dr. Stein we were expecting an earthquake that evening then Dr. Stein would have responded by saying, “No problem..we will do the vasectomy in the street so we will be safe from falling objects there and these iPhone 4’s have great image stabilization…wont be shaky at all!”.

Pastor Joel did not realize he was dealing with a master negotiator and before you knew it Pastor Joel was agreeing to video us later in the day. I love watching Dr. Stein work!

More about Pastor Joel in the next blog article: Haiti: Disney World For Christian Missionaries

Supporting vasectomy in the developing world

Dr.-Charles-W.-Monteith-Medical-Director (1)Help provide vasectomies in the developing world by contributing to No Scalpel Vasectomy International. You can donate directly through their website:
No-Scalpel Vasectomy International

For less than $50 you can help a man have a vasectomy procedure. In doing so he will be better able to provide for his family and their future.

Dr. Monteith is an OB/Gyn who supports NSVI and participates in vasectomy missions with the organization. Dr. Monteith participated in a NSVI sponsored vasectomy mission trip to Haiti.

Dr. Monteith performs No-scalpel vasectomy in his office in Raleigh, North Carolina. You can learn more about his vasectomy practice: His Choice: Vasectomy and Vasectomy Reversal

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