Thursday 16 October 2008

The Vasectomy

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Okay, so it is vasectomy time at last. The day started with the youngest Manley throwing a whole large tin of golden syrup on the floor (which was harder to clean up than I had thought) which served to take my mind off the oncoming procedure rather well.

The eldest at school already, the lovely Helen came to collect the younger brace and took them off for a picnic, so there was no real excuse to do anything other than press on to the surgery.

It's a fair old walk down to Dr Watson's dungeons, but I am legally excluded from driving home afterwards, so a walk it is. Normally it would be no problem, but I have a fairly nasty cold and my knee is playing up, not to mention the ever increasing feeling of impending doom.

Of course the receptionists are expecting me and all have a bit of a chuckle - you would think that, by now, they would be used to this sort of thing? Anyway, i settle down for a read of HEAT and associated pulp dross. I did find a nice article about retreats for the famous, which appeared in two seperate magazines, each professing to be from a seperate publishing house, with the same imagery, decoration and words.

A good rant about the improbably low quality of today's print media does help a little, but then Dug arrives. Dug is my boss and, if you want a top Search Consultant, Dug's the man. He also has a new car, so whether his readiness to collect me from the surgery was entirely down to his decency as a human being and his excellent man management has to be questioned when measured against his glee at now having a manual gearbox. Either way, Dug is here to collect me and I have not even gone in yet. I do a little jig as I go to meet him and there is a level of forced jocularity, although we both know that today is not going to be about fun.

Eventually I am called in and Jim comes with me. She is needed to take video footage and photographs, as well as there being the reasonable chance that she might faint, which would lighten my mood considerably, but she is sent out by the nurse. Apparently the first stage is mine to suffer alone.

First off I am placed behind a curtain and invited to strip from the waist down. I have got my massive padded cycling boxer shorts on, so I am a little bit pleased to have privacy, but I have always found it most odd that I get to hide whilst undressing, but then the nurse comes back to prod around with my goods.

Anyway, I get a hot water bottle to apply to my freshly shaven testicles and the doctor arrives. Making a loop in the end of an elastic band (questioning unearths that these are just normal elastic bands and that, indeed, he asks his postman for them) he slips it around my ever shrinking penis (by the time I lost sight of it I essentially only had a tube of skin left, as my willy disappeared back into my spine to escape the hell of surgery) just below the head.

This slips off and I have to reattach it myself, whereupon a pair of scissors shaped clamp is passed through the loop and the clamp attached to my shirt, serving to pull my phallus up onto my stomach and keep it out of the way. A green sheet with a small hole is placed on me, with the target items on the outside and Jim is finally allowed in.

To be honest the nurse was a bit more upset when I showed the elastic band to my wife than I was expecting. She was positively horrified, from what I could gather, but as far as I am concerned, I am doing this for Jim and she has to put up with seeing it, warts and all. I have no warts on my penis or elsewhere.

The next problem is losing cameras - the nurse is quite keen on removing them beyond my reach, but I am adamant. Many people do not understand, but if I am going to go through this then it is important to me to know what happened. It is also worthy of record, just so that, when my memory fades and I recall a 40" blade and searing pain I am able to correct myself.

Then it's the injections. They really hurt. Here, look for yourself:



How much does it hurt? The "Little scratch" (and I was most disappointed that there was no "little prick" joke) was not too bad, but the actual injecting of the local anaesthetic was bloody awful. You are aware, no doubt, of the pain of a dental injection, when it goes all the way to the back of your throat? This is the same. Yes - the back of my throat.

Next comes the vasectomy itself.



I can hear it burning my flesh, I can see the smoke and smell the singe. You hear in that clip how the doctor says there 'It's not a soldering iron'?




Soldering iron?

Soldering iron.



Here the vas deferens has been brought to the surface and Dr Watson is burning through with the soldering iron:



The tube serves to take away the smoke and the smell.

The hole has been clamped and the vas deferens burned, so it is time to locate the other vas deferens now (the left one was first, then the right).

There are two clamps in this image - the sharper, more standard clamps, which are used to seperate the tissue and find the vas (the scrotum not being a sack, but a series of layers of tissue) and the special device used to seperate the vas from everything around it, with the curved ends:



After another round of anaesthetic, it is time for searching for the other vas:



And there it is! (although actually this is the left one again - the right side proved harder to work on and needed a second run - when the second run started I had an active nerve and Jim had to put the camera down to be with me.



All in all, it was not as bad as it might have been, but still considerably worse than I had hoped. I have a couple of giant containers for samples and Dug drove me home so that I could get on with some work.

I'll update on the recovery later.

To give you an idea of what is going on down below during those videos, here's a bollock shot. This chap cuts and ties the Vas, but mine was burned with the soldering iron:

I am a Jaffa

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It hurt and it hurts, but it is all over now, bar the wanking.

Vasectomy consent: Given.

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Surprisingly it seemed to take Jim more summoning of nerve to sign the forms than it did me. I still feel terribly put out that Jim has to be involved in the decision.

As it happens this is her idea, although she is going off it as it comes near, in case I blame her in later life if she dies and I cannot sire children by another woman.

I am waiting with two children whilst Jim takes the third to school and yes, I suddenly can see all sorts of reasons to have a fourth. I wish I was dim enough not to realise that I am looking for outs here, so that I could legitimately bottle it, but to be honest I never want to shave my 'nads again anyway.




I, Richard Manley of XXXXXX
Hereby consent to undergo the operation of bilateral vasectomy, the nature and purpose of which has been explained by Dr M B Watson.
I consent to the administration of a local anaesthetic.
I have been told that the intention of the operation is to render me permanently sterile and that there is a very small chance I may become fertile again, even after two negative sperm counts.
I understand that two negative sperm counts must be obtained at 12 and 16 weeks after the operation to confirm my sterility. Until this has been confirmed my partner and I must continue to use a method of contraception.
I have been warned that the operation has a low complication rate usually due to infection or bleeding into the scrotum. I have been told that men occasionally experience some scrotal pain following vasectomy but due to the technique used by my Doctor this is considered to be unlikely.
Date.................... Signed....................................................... (Patient)
Date.................... Signed..................................................... (Girlfriend/Wife)
I confirm that I have explained to the patient the nature and purpose of this operation.
Date.................... Signed....................................................... (Doctor)

Vasectomy day.

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My freshly shaved balls are itching, my heart is aching and my hay fever is perverse.

I am sitting contemplating the vasectomy consent form before me.

I will sign, but I do need to consider it for a while, none the less.

The first half of this is terrifyingly appropriate.



Wednesday 15 October 2008

Vasectomy shave 3

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This goes on a bit, but it is probably worth watching me cut my own testicles twice.

Vasectomy shave 2

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A second attempt - the scissors worked well, but I just lose my nerve part way through and need a break.

UPDATE: The final instalment of the shave

Vasectomy shave 1

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Not much to say here - the beard trimmer simply did not work, so I have to find some scissors somewhere.

I am nervous as hell.

Sound quality is poor (well, very quiet) so you need headphones - although, to be honest, it is not worth watching really.

Update: I continue my shave.

Vasectomy instructions, an analysis.

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Padded pants, requests for sex and raw fear.

Instructions for a vasectomy

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BEFORE YOUR OPERATION

Please attend for your vasectomy on 16/10/2008 1115
Please note that you will need to come to the back door of the building through the car park as the main doors will be locked

1. Please shave the hair from the scrotum with a safety razor but it is not necessary to have a complete shave of the pubic area

2. Please wear tight underpants, which give support to the scrotum.

3. When you attend for the operation, please bring someone with you who are able to take you home. For legal reasons you must not drive yourself.

4. Please bring something interesting to read whilst the vasectomy is being carried out.

5. Be prepared to rest for 48 hours after the operation and if you have a very heavy job please arrange for some days off work if at all possible.

AFTER YOUR OPERATION

1. Please take it easy for at least 3 days avoiding heavy lifting and rushing about.

2. You may shower in the evening following your vasectomy but avoid bathing for 3 days.

3. Some pain and bruising is usual. Paracetamol should help but if you are worried in any way please contact us Tel: XXXXXXX. Urgent advice over the weekend: XXXXXXX

4. Please make love when you feel comfortable, for most men this is at least 7 days after vasectomy. It takes about 20 ejaculations to clear active sperm left in your system.

5. Remember to use other contraception until you have had two negative sperm counts and a letter stating that you are sterile.






The chances of failure of vasectomy are very small (less than 1 in 2000 vasectomies), but even after being confirmed sterile there is stiii a remote chance of the tubes healing together. We emphasis that pregnancy occurring after vasectomy is however a rare event and as a comparison vasectomy is 10 times more reliable than a sterilisation operation for your wife.

HOW TO COLLECT YOUR SPERM SPECIMENS
Two specimens of semen are required: the first at 12 weeks and the second at 16 weeks after the operation. The whole of the ejaculation needs to be collected in the plastic container provided and posted through the letter box beside the door of the pathology building at RD&E Wonford Hospital before 9am. Please do not take specimens on a Saturday or Sunday as the laboratory is closed.

After your second negative sperm count has been received we will write to you within 10 days and confirm that you are sterile. Please remember we cannot under any circumstances give results out over the telephone and we appreciate your cooperation in this matter.

Monday 13 October 2008

Vasectomy shave.

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Well, I have to shave my testicles prior to the operation and I thought it best if I had a dry run.

I won't spoil it by explaining it all here, I shall just let you see it for yourselves (SFW except perhaps for the manic hippy in it).



Right, well I think that covers everything.

Having shaved the area with my beard trimmer I shall move on to a cut throat razor and clear the area of any stubble, ready for the vasectomy on Thursday.

Also, I think it is noteworthy that I would never do this outside of a medical scenario where I absolutely need to be clean shaven in the testicle area - bald balls are just not my thing.

Update: The actual shave.

Saturday 4 October 2008

Vasectomy leaflet.

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Well, I have a leaflet explaining my vasectomy to me.

I am having what is called a 'No Scalpel Vasectomy', which is a Chinese practise and which scared the crap out of Manleys.



No Scalpel Vasectomies at St Thomas Health Centre
Available: You can get an appointment now for a vasectomy within 3 months
Local: At St Thomas Health Centre. Run by a local general practitioner for Exeter patients
Convenient: Procedure out of normal working hours. Minimal disruption to your job

Advantages of No-Scalpel Vasectomy over conventional methods:
  • Less discomfort
  • One small opening in the skin instead of two incisions
  • Faster procedure
  • Faster recovery
  • Less chance of bleeding and other complications
  • Just as effective


How Can I Be Sure I Want a Vasectomy?

Be absolutely sure you don't want to father a child under any circumstances. Talk to your partner; it's essential to make the decision together. Consider other kinds of birth control as well. A vasectomy might not be right for you if you are very young, your current relationship is not stable, you are having the vasectomy just to please your partner, or if you are under a lot of stress.


Well, I am not very young, so that's one anyway!




What is different about a no-scalpel vasectomy?
No-scalpel vasectomy differs from a conventional vasectomy in a number of ways. Instead of two cuts the doctor makes one tiny opening with a special instrument. The "tubes" are then blocked using a cautery method. There is very little bleeding and no stitches are needed.

The no-scalpel vasectomy was invented by a Chinese surgeon and is used throughout China. It was introduced in the United States in 1988 where it is now the preferred method because of its low complication rate. Dr Watson, a St Thomas general practitioner, is fully trained and accredited to perform the no-scalpel vasectomy.

Is no-scalpel vasectomy safe?
Vasectomy in general is safe and simple. Vasectomy is an operation and all surgery has some risks such as bleeding, bruising, or infection. However, serious problems are very rare; less than 1 in 100 cases have even a minor problem.

Does no-scalpel vasectomy work?
Yes. It is estimated that after a vasectomy there is less than 1 in 2000 chance that a man's partner will become pregnant. This is ten times more reliable than if your wife had a sterilisation operation.

Do I need a referral?
Yes. Please consult your GP first. Provided there is no medical reason would make it unwise or unsafe to have a vasectomy your GP will refer you to our clinic.

How long will the no-scalpel vasectomy procedure take?
You come to see us for a consultation at which we explain the procedure and answer your questions. Your partner does not have to attend with you but it may be helpful if she does. You then book in for the procedure to be done on another day.

On average the procedure takes about 10 minutes but you will be at the surgery about 30 minutes in all. You should bring someone with you to drive you home afterwards.


"Bring Jim!" Bloody sexism that is!





Will it hurt?
Before the vasectomy if you feel especially nervous, we can give you a mild sedative to be taken an hour beforehand to relax you. When the local anaesthetic is injected into the skin of the scrotum, you will feel some discomfort but as soon as it takes effect, you should feel no pain. Afterwards you may be sore for a couple of days and you might want to take a mild painkiller. But the discomfort is usually much less with the no-scalpel technique because there is less injury. Also there are no stitches. You will be provided with complete instructions about what to do after surgery.

How soon can I go back to work?
You should not do heavy physical labour for at least 48 hours after your vasectomy. If your job doesn't involve this kind of work, you can go back to work sooner.

Will vasectomy change me sexually?
The only thing that will change is that you will not be able to make your partner pregnant. Your body will continue to produce the hormones that make you a man. You will have the same amount of semen. Vasectomy won't change your beard, your muscles, your sex drive, your erections or your climaxes. And you won't sing soprano! Some men say that without the worry of accidental pregnancy and the bother of other birth control methods, sex is more relaxed and enjoyable than before.

Will I be sterile right away?
No. After a vasectomy there are always some active sperm left in your system. It takes about 20 ejaculations to clear them. You and your partner should use some other form of birth control until two samples of your semen have been tested and confirmed free of sperm,

When can I start having sex again?
As soon as you are comfortable, but remember to use some other
kind of birth control until you have received the letter to say that you
are sterile.


Well, that is less comforting. I might need a sedative and I will no longer be able to sing soprano.




Does vasectomy cause any medical problems?
Medical experts, including special panels convened by the World Health Organisation, have concluded that vasectomy is a safe procedure. A number of studies have examined the long term health effects of vasectomy and the research evidence continues to be reassuring and suggests that vasectomized men are no more likely than other men to develop heart disease, cancer or other illnesses.

Will it protect me from getting or passing on STDs or AIDS?
No. It will only prevent you from making your partner pregnant. If you or your partner have a sexual disease, or have more than one sexual partner, the best way to protect yourself and your partner is to use a condom.

Can a no-scalpel vasectomy be reversed?
No more than any other vasectomy procedure. Remember that vasectomy, especially by the no-scalpel method is quick, convenient and causes very little discomfort but vasectomies should be considered permanent. Reversal operations are expensive and often unsuccessful. If you are thinking about reversal perhaps vasectomy is not right for you.

To book an appointment, please see your GP.


Well, I had thought about freezing something, although that was more for future practical jokes than anything else.

I find it very hard too understand that there are poeple out there dim enough to think that burning through their scrotum (oh GOD!) will stop them from contracting AIDS and I wonder if we should tell them. Perhaps they deserve to be caught out?