Consultation Note

 

History

 

Patient presents requesting a vasectomy

 

Is aware of the other forms of contraception available:

- condoms

- abstinence

- Female contraception

 

Number of Children: 

 

Ages of Children:

 

Medical History:  NIL

 

Medications: NIL

 

No History of Aspirin, Clopidogrel, Warfarin or NOAC use

 

Allergies: No known drug or other allergies

 

Occupation: 

 

 

 

On Examination

 

Testicular Exam:

Left:

Hernia: No

Hydrocoele: No

Varicocoele: No

Testicular lumps: No

 

Right:

Hernia: No

Hydrocoele: No

Varicocoele: No

Testicular lumps: No

 

Scrotal Length (Distance between testicles and penile-scrotal junction):  average

 

Vas Palpable both sides

 

Investigations:

 

No investigation were considered necessary

 

Clinical Impression: 

 

Patient suitable for vasectomy under local anaesthetic

 

Fully aware that vasectomy is PERMANENT CONTRACEPTION

 

Informed Consent provided in writing

 

The following risks were explained to the patient:

 

Failure

Bruising / swelling

Haematoma

Granuloma

PVPS

Bleeding

Infection

Congestion

 

Procedure

 

Vasectomy performed under local anaesthetic

 

Patient shaved and provided written informed consent

 

Betadine used to clean the patient's scrotum

 

2ml of 2% Lignocaine injected into the scrotum 1cm below the scrotal - penile junction in the midline

 

Blunt dissection made into the scrotum through skin and dartos layer

 

Further anaesthesia with 2ml local anaesthetic into the scrotum for both sides of the vas

 

 

 

Left vas in sheath removed from the scrotum. Diathermy and blunt dissection to expose vas

 

Additional sheath removed to clean the vas.  Prostatic end - intraluminal electrocautery performed and then cut with hyfrecator

 

Fascial interposition with 1 x medium clip. Testicular end returned to the scrotum

 

 

 

Right vas in sheath removed from the scrotum. Diathermy and blunt dissection to expose vas

 

Additional sheath removed to clean the vas.  Prostatic end - intraluminal electrocautery performed and then cut with hyfrecator

 

Fascial interposition with 1 x medium clip. Testicular end returned to the scrotum

 

 

 

Haemostasis achieved.   Wound closed with steristrips

 

 

 

The patient was given a Post operative instructions sheet and my mobile number to call me if he has any issues,

 

Patient advised to have a Semen analysis in 3/12 (form and jar provided) and consider himself fertile until that time

 

 

 

 

 

I hereby confirm this consultation and procedure was performed in accordance with Health Insurance Act 1973 (Medicare)

 

 

 

Dr Geoffrey Cashion