Vasectomy: performing the operation and counselling your anxious patient.

In counselling the increasing number of men applying for vasectomy the practitioner should be aware that anxiety demonstrated in office interviews has no correlation with postoperative satisfaction. Young, childless men need special consideration, and a waiting period of at least one month is recommended for all. The operative procedure should be kept as simple as possible without reducing effectiveness. The use of the Weck clips is a step in this direction. Special attention to hemostasis is necessary to avoid postoperative swelling. Operative techniques, management of complications and the status of reversal operations are discussed. Small amounts of sperm in the semen after three months are not uncommon, but the testing routine recommended allows surety of permanent sterility.