After booking a date, the patient fills in a health questionnaire. This questionnaire is part of the medical interview and the qualification process. The physician performing the procedure (Robert Kulik) reviews the questionnaire. The next stage is a telephone call. Before the appointment at the clinic, the doctor contacts the patient by phone and, if the information in the questionnaire is unclear or incomplete, takes a further history. During the call he may also order additional tests – mainly for patients with concurrent conditions. Then, during the appointment, the doctor performs a physical examination of the candidate (palpation is usually sufficient).
Vasectomy – medical history
The medical history is a series of questions the doctor asks the patient about past illnesses, current complaints and diseases in the family. The questions relate to any past illnesses listed in the form and to the patient’s social and family situation.
Andrological consultation
The qualification consultation for vasectomy also covers information about the procedure, possible complications of vasectomy, options for preserving fertility, and for restoring it should you change your mind in the future. As the experience of countries where vasectomy is very popular shows (in the USA over 500,000 vasectomies have been performed annually for many years), up to 6% of patients (roughly one in 20) later undergo a vasectomy reversal because they want more children! Another, probably equally large group of patients may try for a child using assisted reproduction techniques (IVF, ICSI). Unfortunately, these clinics do not publish statistics on post-vasectomy cases. All these patients were previously certain they would never want children again!
Vasectomy – initial physical examination
At ZdrOva in Warsaw, the examination of a vasectomy candidate includes inspection and palpation of the genitals to rule out infection and abnormalities such as hydroceles, tumours, scarring, or large varicoceles of the spermatic cord.
Vasectomy – contraindications
Although very rare, contraindications to vasectomy do exist. They must be ruled out before the procedure. Contraindications include:
- massive varicocele of the spermatic cord
- a huge hydrocele of the testicles
- massive post-operative adhesions (after varicocele or hernia surgery) – these are very rare
- a large inguinal hernia with displacement of the bowel into the scrotum
- genital infections – until cured with antibiotics
- poorly controlled blood clotting disorders (untreated haemophilia)
- no indication for the vasectomy procedure