1 / 29

Dr.Jayaram Reddy, MS, MCh Professor, Dept of Urology, Hyderabad Dr. Sasikala Kola ,

Dr.Jayaram Reddy, MS, MCh Professor, Dept of Urology, Hyderabad Dr. Sasikala Kola , Consultant Obs- Gyn Hyderabad. NO SCALPEL VASECTOMY. CONVENIENT SAFE MORE EFFECTIVE IN POPULATION STABILISATION. WHY VASECTOMY. RELIABLE NO MORBIDITY. WHY IS IT NOT ACCEPTED READILY.

moses-gates
Download Presentation

Dr.Jayaram Reddy, MS, MCh Professor, Dept of Urology, Hyderabad Dr. Sasikala Kola ,

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Dr.Jayaram Reddy, MS, MChProfessor, Dept of Urology, Hyderabad Dr. Sasikala Kola, Consultant Obs- Gyn Hyderabad

  2. NO SCALPEL VASECTOMY • CONVENIENT • SAFE • MORE EFFECTIVE IN POPULATION STABILISATION. WHY VASECTOMY • RELIABLE • NO MORBIDITY

  3. WHY IS IT NOT ACCEPTED READILY • MISCONCEPTIONS – LIKE SEXUAL DISABILITY PHYSICAL DIABILITY • FEAR OF CUTTING / SUTURES • MALE PREDOMINANCE.

  4. NO SCALPEL VASECTOMY • FRIST DEVELOPED IN CHINA BY DR.LI -1974. • OTHER DEVELOPED COUNTRIES 1988. • Acceptance for vasectomy progressively increasing after introduction of NSV. • Office procedure. • No incision / suturing. • No morbidity. • No bleeding. • Minimal physical discomfort.

  5. COUNSELLING • Discuss Family Welfare chances. • Assess his contraceptive knowledge. • Provide him with accurate & unbiased information. • Encourage him ask questions. • Correct his misunderstanding. • Assess clients decision to have vasectomy. • Does he know. NSV is a terminal method. NSV is a surgical procedure.

  6. ASSESS • Family size. • Support from wife. • Realistic expectations. ENSURE • Stress free. • Confident. • Well informed. Inform about the procedure • Explain procedure in simple language. • Stress need for additional post operative contraception. • Explain no protection against HIV / STD. • Take informed consent.

  7. INSTRUMENTS

  8. EXTRACUTANEOUS VAS FIXATION CLAMP

  9. VAS DISSECTING FORCEPS

  10. SCISSORS

  11. ANAESTHESIA • LOCAL ANAESTHESIA • VASAL BLOCK

  12. LOCAL ANAESTHESIA

  13. VASAL BLOCK

  14. STEPS OF OPERATION • Site middle of 1/3 of scrotum on median raphe for skin puncture. • 3 Finger technique for vas fixation • Holding with ringed clamp • Piercing the skin with dissecting forceps • Spreading tissues with forceps. • Delivery of vas • Vas occlusion LigatureCauteryHaemoclips • Facial interposition • Dressing

  15. 3 Finger technique for vas fixation

  16. Holding with ringed clamp

  17. Piercing the skin with dissecting forceps

  18. Delivery of vas

  19. Vas occlusionLigatureCautery Haemoclips

  20. Dressing

  21. POST OPERATIVE INSTRUCTIONS • Antibiotics. • Analgesics. • Scrotal support for 7 days. • Rest.

  22. POST OPERATIVE INSTRUCTIONS • Resume light work immediately. • Avoid heavy work for 2 days. • Discontinue cycling for 7 days. • Don’t kick start scooter for 2 days: can ride one.

  23. POST OPERATIVE INSTRUCTIONS • Keep operated site dry for 2 days. • Can take bath. • Remove dressing yourself on 3rd day at home. • Return if there is any fever, discharge or swelling that increases in size.

  24. POST OPERATIVE INSTRUCTIONS • Use additional contraception for 3 months or 20 ejaculations whichever is earlier. • Then, report for semen analysis to verify azoospermia.

  25. RELATIVE CONTRAINDICATIONS • LARGE HYDROCELE. • ELEPHETIASIS. • INGUINAL HERNIA / • SCROTAL MASS. • BLEEDING DISORDERS

  26. COMPLICATIONS • INFECTION • HEMATOMA • SPERM GRANULOMA • ANTISPERM ANTIBODIES.

  27. Thanks to all contributors. Dr Adarsh Bhargava. Dr Ashwini Bhalerao. Dr Alka Kriplani. Dr. Kalpana Apte. Dr Mala Arora. Dr.Meenakshi Bharath. Dr. Mandakini Parihar. Dr.Nozer Sheriar. Dr.Parikshit Tank. Dr. Roza Olyai. Dr.Sasikala Kola. Dr.Sujata Mishra.

More Related