29,000 Australian men have a vasectomy each year, and that number’s growing A vasectomy is one of th...
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A vasectomy procedure involves cutting the vas deferens to prevent sperm from entering the ejaculate. The vas deferens are the two tubes that carry sperm from the testicle to the glands at the base of the bladder called the seminal vesicles and the prostate gland. It is at this point that the sperm mixes with the seminal fluid to form fertile ejaculate. A vasectomy is typically performed via small incisions in the front of the scrotum. It is important to note that the production of the male hormone testosterone or a man’s ability to perform sexually is not affected by this procedure.
A true vasectomy should take at least 25 minutes to perform. This procedure involves two tiny incisions to access the vas tubes. The tubes are then cut and the testicular end is left opened and unsealed, with both ends of the tubes separated by layers of tissue within the scrotal sac by fine suturing.
Sperm continues to be produced after the vasectomy so this fluid travels from the testicle up the vas where it then flows out of the vas and into the tissues. The body reabsorbs this naturally. The testicular vas deferens and the vas deferens that leads to the prostate reconstructed in separate compartment to minimise the risk of failure.
A traditional vasectomy takes around 10 minutes to perform. This technique uses either a scalpel or sharp forceps (see No Scalpel Vasectomy below) to access the vas deferens tubes. It is usual to have either one central or two large incisions, the vas deferens tube is cut and sealed (either burnt, tied or stapled) and sections of the vas deferens may be removed.
If large sections are removed and sutures or staples damage the blood supply in the scrotum, then a vasectomy reversal may be more difficult after this technique is used. By tying the ends attached to the testicles, blow outs and scarring of the fine storage tubules called the epididymis is more likely to cause chronic scrotal pain of varying severity (post vasectomy pain syndrome) and a more complex vasectomy reversal.
A “no scalpel” technique merely describes how the vas tubes are accessed. Once the skin is opened, a traditional technique is generally used to perform the vasectomy.
A “no scalpel” technique involves tearing the skin with sharp pointed forceps to access the vas tubes. Both ends of the tubes are then cut, tied or cauterised to prevent the movement of sperm. Sperm production continues once the vas deferens sealed, and the sperm build up in these tubes can clog the system over a period of time.
The vasectomy we offer at Metrocentre offers a range of benefits over traditional procedures.
Dr Lekich has trained extensively under Dr Bruce Errey, who has pioneered and performed over 30,000 open-ended vasectomies. As men continue to produce more than 20 million sperm per day after a vasectomy, the open ended technique is engineered to reduce the inflammatory pain associated with the blockage of the testicular vas deferens that occurs during traditional vasectomy procedures.
During this procedure the testicular end of the vas deferens is left open to allow sperm to continue to move through the surrounding tissues, which means that the clogging and inflammation associated with the sealing of the vas tubes is avoided.
Contrary to popular belief, vasectomies do not have a higher failure rate, as the two ends are separated and placed in different scrotal positions to prevent the two ends joining together once more.
Dr Lekich sees many vasectomised men utilising the ultrasound for vasectomy reversal assessment and is amazed that even at 30 years after a vasectomy the testicular structures look much less inflamed and scarred than those of a traditional vasectomy performed six months earlier.
Dr Lekich is the medical director of Metrocentre. He is a Queensland medical graduate with a 15-year microsurgical background working in the field of ophthalmology and retinal microsurgery, hence his love of microscopes. He changed his pursuits for eye surgery to the treatment of varicose veins using endovenous laser and ultrasound guided sclerotherapy (hence his love of ultrasound) training and becoming a fellow of the Australasian College of Phlebology. This came about due to the serious blood clot his wife developed in varicose veins during pregnancy. It was his wife’s necessity to get off the oral contraceptive pill due to her venous disorder that led him to a decision for a vasectomy and after much personal research to Professor Owen’s team to perform this as an Open Ended Vasectomy.
Professor Owen referred Dr Lekich to Dr Bruce Errey (the pioneer of the Open Ended Vasectomy and 30,041 vasectomy fame) to be trained to perform this specialised type of vasectomy so that his female patients with severe varicose veins could get off the pill and ensure that their partners were looked after with an excellent vasectomy . On retiring Dr Errey asked Dr Lekich to succeed him, and as a result, Dr Lekich was suddenly very busy performing vasectomies.
Professor Owen then suggested that Dr Lekich try out for a position as his successor. After attending master class sessions with Professor Owen at the Microsearch Foundation, and it was determined that he had the attributes to perform the most exacting microsurgery, Professor Owen undertook a personal full-time three (3) training of Dr Lekich at the microscope. This involved over 200 hundred sites performing the Owen 3 Layer Microsurgical Vasectomy Reversal pioneered and perfected over 40 years. This also involved the management of Post Vasectomy Pain Syndrome and the most exacting microsurgical procedure known to man, the Bypass Epididymovasostomy (EV) as per Professor Owen’s account only mastered by few in the world. He retired his vasectomy reversal practice of 6000 cases to Dr Lekich when he felt that it was like looking at his own fingers down the microscope.
Dr Chris Lekich recognised a need for a reliable
vasectomy technique which would be: