Fifty consecutive patients who underwent vasectomy were followed up over a period of two years, and were subjected to a questionnaire, and the results were analysed. The technique for vasectomy is described and a few modifications are suggested, so that there is a reasonable chance of reversing the operation if need be. Special emphasis has been placed on the poorly understood medicolegal implications of vasectomy.
PIP: A review of 50 consecutive patients who had had bilateral vasectomy is presented. 34 returned a questionnaire. Postoperative histories were followed for periods from 9 months to 2 years, age range varied from 25 to 50 years, all except 3 were blue-collar workers, and most were Protestant. Reasons for wanting a vasectomy were usually because family size was already sufficient or that use of other contraceptive methods was unsatisfactory. In Australia, legal opinions about vasectomy are important but speculative and qualified. The husband and wife should be interviewed together by the surgeon. Then a special cons ent form is to be signed by the husband, wife, and surgeon. A 2nd medical opinion may be obtained if desired. Excised tissues are to be sent for histological confirmation. The couple is informed that the husband is not assured of being sterile until 2 consecutive semen specimens confirm azoospermia. These specimens are to be taken at 3 months after the operation and again 3 weeks later. Until final review at 4 months postsurgery, some other form of contraception is needed. The psychological stability of both husband and wife must be evaluated. Doubtful cases are rejected. All patients were operated on under local anesthesia. Vas ends were doubly ligated with chromic catgut or fixed with a modified version of the Rolnick loop so that the severed ends pointed in opposite directions. Absence from work was usually only 1 day. Complications have been minor, although a superficial infection rate was reported by patients to have been 29%; however, this was not confirmed by the surgeon. In some cases, psychological sequelae have resulted. Only 1 couple requested further consultation. To lessen waiting time after surgery before sterility is achieved, injection of th e distal vasa and seminal vessels with an antiseptic solution at the time of operation has been suggested. Sperm-immobilizing and sperm-agglutinating antibodies may develop in about half of patients. This may later inhibit subsequent fertility should a vasovasostomy be done. Almost all were satisfied with the results of the operation.