The beginning
My wife and I decided some time ago we didn’t want more
children. We have two happy, healthy kids and a modest but comfortable
lifestyle, it’s enough for us. Kids are rewarding but maintaining family life
whilst both working full time is hard. A vasectomy seemed the long-term solution
to contraception. My Dad had one after my younger sister was born, and my
brother-in-law had one a couple of years ago, so it wasn’t a ground-breaking
decision, even for a practising (Cafeteria) Catholic.
Around the middle of 2015 I discussed it with a GP at my
local surgery and he made the referral. I hoped it would be something that
could be done quickly, but I struggled to find the right time as I was doing a
stressful job I hated. Just over a year ago I took voluntary redundancy and got
a less stressful job. I’m now much happier, my career prospects and work life
balance are better and crucially it’s easier taking time off.
The run-up
After the referral I received a letter from NHS Choices explaining
how to go online and choose a provider. There were two in my area; one was BMI Shirley
Oaks, a private hospital in Croydon I’ve used before, the second was a GP
surgery in Redhill which does outpatients appointments. Neither is great
location wise, but BMI Shirley Oaks is easier. Due to my circumstances it was
September 2016 before I actually booked an appointment.
The booking process was straight forward, but there is a
lack of information about the medical process that follows; you simply book an
available slot. I assumed, in the absence of alternative information, the actual
procedure would be carried in that slot. So I booked a couple of days off work
in October, Thursday for the appointment itself and Friday to recover (plus the
weekend). It was only when the appointment letter arrived I found it was just a
consultation. So I cancelled the Friday leave. Annoying.
The appointment came; I was seen quickly and professionally.
I spent about ten minutes with the surgeon, the discussion was pretty much as
I’d expected from reading the NHS website and covered similar ground to the GP.
He asked if I had kids (yes), any medical issues (CKD) and explained the nature
of the surgery and associated risks. He did a quick physical exam, jokingly
asked if I wanted a circumcision too (no), and told me I would need to shave my
scrotum before surgery. Then he pencilled me in for surgery under general anaesthetic
on a Friday morning in January 2017. I then went to see a nurse who recorded my
height and weight and informed me that if my BMI had been over 40 I would have been rejected for NHS funded surgery at that hospital, I inferred it could be
done there privately which suggested bizarre healthcare rationing rather than clinical
based commissioning.
I thought that would be it until the big day, I was wrong. The
next week I received another letter with a date for a previously unmentioned
second consultation. I thought it must be a mistake, but I was wrong, I needed pre-surgery
tests. Annoying again. Fortunately it was between Christmas and New Year and I
already had leave booked. I went back to
the hospital, saw a nurse, she took some swabs, went through the medical
history form I’d completed at the first appointment, put me on an ECG machine
for five minutes, weighed me again, and took some bloods (giving me matching
arms as I’d had my regular CKD bloods taken at the GP surgery that morning). I
never saw the results of these tests, but I was told NOT to shave my scrotum
ahead of surgery as nicks might cause infection, if necessary it would be done in
theatre (in the event I used electric clippers a couple of days before to
‘thin’ things out).
The day itself: pre-surgery
I was told not to eat or drink anything after midnight the
day before but I played safe and consumed nothing after 7 pm. On the day itself
I was told to arrive for 7.30 am, so I got up 5.45 am and caught an early bus
into Croydon and a bus back out to Shirley leaving myself good time. It was an
absolutely freezing January morning and given my actual slot wasn’t till after
11 am I’m far from convinced I needed to be there so early. Mildly annoying.
I was quickly shown to a perfectly pleasant room and told a
nurse would with me shortly to do check in. After 9 am the surgeon popped his
head in to say hello, then about twenty minutes later the anaesthetist came and
ran through some basic health questions. He asked why it was being done as a
general rather than local, I told him it was the surgeon’s decision. He offered
to switch to a local, which he said carried less risk. I considered this, but to
be perfectly honest I preferred a general as I wanted to be asleep whilst they
were fiddling around my undercarriage (yes I know they’ve seen it all before,
but that wouldn’t make it any less embarrassing or uncomfortable for me).
Sometime after 10 am the ward sister came to see me, she
answered a few questions such as how long I was likely to be kept in (basically
until after I’d passed urine), offered me something to eat after surgery, and
reiterated the advice in the appointment letter about not driving or drinking
alcohol after general anaesthetic. She asked who was collecting me and I said
depending on time it would be my Mother-in-Law or I’d get a taxi (which was
true), and asked if someone would be at home afterwards and I said yes (which
was a lie). My wife was taking the kids to my parents for the weekend, partly for
a family birthday party and partly to give me a few days peace.
But I still hadn’t had a visit from the nurse to check me in.
It was gone 11 am when two nurses rushed in offering apologies. There had been
a mix up; they thought I’d been checked in by the night staff when I first
arrived. So after spending three hours hanging around doing nothing I was
speedily checked in, changed into a gown and ushered down to the operating
theatre.
The day itself: post-surgery
I came around after midday in the recovery area. My senses
came back pretty quickly and I didn’t feel any pain, I was just a bit hazy with
temporary difficulty swallowing. After a short time I was moved back to the
room and within ten minutes I was up and out of bed. Moving around was okay, I just
felt very tender with a dull ache down below. Going for a wee was a bit
awkward, not because of any physical restriction, but because the bandaging got
in the way. My scrotum was held in a sort of string net jock strap contraption packed
with surgical wadding, it kind of pushed everything upwards making aiming
straight a little tricky (although my wife would say that’s not new).
I spent a few more hours in the room. Nurses came in and out
to do checks, I was able get dressed, have some water to drink, and the ward
sister came back to give some post-op advice such as when I could remove the
dressings (next day in the shower). About an hour after surgery some tea and
sandwiches arrived, which was much appreciated given I hadn’t eaten since the
previous evening. I was eventually discharged around 4 pm (on the understanding
that someone was home). It was too late for my Mother-in-Law to collect me, so
I got a taxi home where aside from making myself cups of tea (I chose to follow
advice about not drinking alcohol) and some dinner I basically spent the rest
of the day watching television in bed.
I didn’t feel the need to take any painkillers, there was a
constant low level ache, and occasional sharp spasms of pain when I moved too
fast, but it was tolerable. My mobility was restricted, I shuffled around being
careful not to make sudden movements, and I made sure I slept on my back. Most
of all I was immensely grateful my son was away for the weekend given his habit
of jumping on me when I’m lying in bed!
The days following surgery
I generally took things very easy for the next couple of
days. I let the dressings come off in the shower the next morning. I did have a
look at myself in the mirror, my scrotum was very red and hugely swollen which
meant everything looked and felt very unfamiliar, especially when going to the
toilet. I had two small nicks, one on either side, that had been sutured
closed. I was advised to wear snug fitting underpants to provide support, which
was not a problem as I usually wear briefs. For the first few days I wore a
base layer under my trousers which added extra support, and also kept me warm
as it was bloody freezing outside. I also wore a clean pear of briefs each night
underneath my pyjama bottoms.
The next day I felt well enough to clean out the rabbit
hutch and to meet up with a mate at the pub for a few drinks and something to
eat. We bumped into an old acquaintance that used to play rugby league with us,
upon learning of my plight he giggled each time I shuffled slowly past his
table on the way to the toilet! Sunday I did very little till my wife and kids
got back in the afternoon. My step count went through the floor!
Monday I went back to work. It was a little uncomfortable,
mainly during the commute to and from the office. Fortunately there was no strike
that week so Southern Fail merely offered its standard mediocre service rather
than the ‘unfit for transporting cattle’ effort that sometimes (don’t) turn up.
As I do a desk job there was nothing to stop me working and I didn’t even tell
my colleagues what I’d done, but I doubt I could have done a manual job.
It is difficult to describe the way I felt for those first
few days. I was tender, I was swollen and things felt different, my scrotum was
large and heavy like an overinflated water balloon. There was some pain, but it
was not acute or chronic. I can best describe it as being in a state of hyper
sensitivity, I think boys learn very quickly how sensitive their reproductive
organs are and act accordingly, if the same sort of discomfort came from any
other part of the body i.e. a stiff shoulder or a mildly sprained ankle, I
would have simply carried on regardless. But the locus of the discomfort and
infrequent bursts of pain when I inadvertently applied pressure to the area e.g.
lying in the wrong position; meant I was constantly aware of it. There was also
an annoying tendency for the areas around the two little scars to itch
slightly.
It took a couple of weeks for the swelling to go down. But
after four weeks it was completely healed, the sutures had disappeared and
everything was back to normal. On Thursday, approximately one month after
surgery, I went back to see the surgeon for a check-up. The consultation lasted
about five minutes and he gave me a letter for my GP to arrange sperm count
tests in May. In my case I hardly needed a follow-up; all it did is confirm
everything is okay, but I understand it’s a necessary step as there may have
been issues.
Conclusions
Was it worth it? I can’t tell yet, I still need to wait a
couple of months before I get the all clear to say my sperm has been permanently
restricted. I can say that it’s not as onerous as it seems. I think there is a
natural and sometimes perfectly sensible tendency for men to be cautious when
it comes to their reproductive organs. I certainly found the physical exam to
be a little embarrassing, I was very self-conscious about the idea of a room
full of people looking at my private parts even though I’m perfectly aware it’s
just a job to them, so I’m grateful I was able to sleep through it. I feel no
regret about having it done; providing it works the temporary discomfort is a
small price to play for a permanent solution to contraception. The people involved
were all thoroughly professional and treated me with respect and care, the only
thing that could have been better is more clarity from the very beginning about
the steps in the process, I had four different appointments not counting the
original one with the GP, I also had contradictory advice about shaving my
scrotum, and I probably didn’t need to be checked in four hours before surgery.
But overall I wouldn’t hesitate recommending the procedure to others looking
for a permanent contraception solution.
