Questions for Urologist
tcwalk...@gmail.com
his physician prior to a vasectomy. This is to guage the doctor's
knowledge and also to make sure the patient is informed. I have made a
PDF for my website (http://www.consideringvasectomy.com) that a man
could take with him to his doctor to begin the rapport at his
consultation.
Can anyone think of any other good questions I should add? David,
please forgive me if you have already done something like this for your
site, I haven't had a chance to look.
Ross
Here it is pasted from my PDF:
_______________________________________________________
Question Sheet for Vasectomy Consultation
Ask your doctor these questions at a minimum.
Name of Doctor: ________________________
Date Procedure is to be Scheduled: ____/____/____
1.How many vasectomies do you perform per week or per year?
2.What are the common and less common complications of vasectomies?
3.What sort of complications have you run into with a vasectomy and
what have you done to treat them?
4.What is Post-Vasectomy Pain Syndrome? Note: If your doctor is
unaware of this syndrome, consider seeking another professional to
perform this procedure.
5.If I developed Post Vasectomy Pain Syndrome, how would you treat me?
(Wait for answer). What would you do if that didn't work?
6.What is a sperm granuloma?
7.What is an epididymis?
8.What is an epididymal blowout?
9. Do you perform a closed-ended procedure or an open-ended procedure?
10. Do you use the no-scalpel method of vasectomy? If not, which
method do you use?
Biker
vasectomies on have had complications.
By the way, what is an epididymal blowout??
David
> please forgive me if you have already done something like this for your
> site, I haven't had a chance to look.
Yes, there are two checklists - one short, one long. General information |
vasectomy consult checklists. You might like to look at these, and our FAQ
to add more questions to it.
The only thing I'd say is that I personally don't really like .pdf files. I
can see that you intend men to print it, so I see the logic behind having it
in .pdf. As a web user, I prefer to have documents in .html - or at least
the choice. I would say that my weblogs show where I offer a .pdf version,
very few request it. It's probably a personal thing I guess!
> 1.How many vasectomies do you perform per week or per year?
Good.
> 2.What are the common and less common complications of vasectomies?
Also good
> 3.What sort of complications have you run into with a vasectomy and
> what have you done to treat them?
Exactly what we also recommend
> 4.What is Post-Vasectomy Pain Syndrome? Note: If your doctor is
> unaware of this syndrome, consider seeking another professional to
> perform this procedure.
> 5.If I developed Post Vasectomy Pain Syndrome, how would you treat me?
> (Wait for answer). What would you do if that didn't work?
I would point out that it may well be the doc hasn't seen many cases of it,
so he may be aware of the condition, but hazy on very close questioning
about treatments.
Also, as pvp is often as a result of rough surgery (according to Pollock).
If he's a good surgeon then it *is* unlikely he will see many (if any)
cases.
In addition, pvp isn't a defined syndrome, and can have many causes. CTP
isn't necessarily as a result of vasectomy - it's equally common in
unvasectomised men. So the answer he is likely to give should indicate this.
It's not saying pvp doesn't exist, but pointing out a fact.
My feeling is to have a general discussion about complications including
pvp - not necessarily centre on just this one issue.
> 6.What is a sperm granuloma?
Good, but it might be an idea for you to add info to your site on this. The
guy wants to go to the doc well clued up with relevant, incisive questions.
Ask the question by all means, but if the guy has some basic knowledge
beforehand would be good.
> 7.What is an epididymis?
Basic anatomy question. My feeling is it's better to get men clued up on
male anatomy and the way it works beforehand, and then get the doc to
explain anything not understood. My personal feeling is that the consult
should be focussed on things other than basic information that can be got
beforehand whilst researching.
> 8.What is an epididymal blowout?
I think that this is really covered above, but ask it as a general
discussion point.
> 9. Do you perform a closed-ended procedure or an open-ended procedure?
Not many do perform open ended, so the answer is likely to be no anyway. In
any case, there dissadvantage of the open ended method is an increase in
sperm granuloma's to some 97%. The thing that's likely to make the most
difference to the chances of getting post vasectomy problems is the skill of
the surgeon performing the vasectomy. Statistically, compications such as
hematoma and infection are less with more experienced practitioners. Also as
above, rough surgery is a cause of pvp, and that's what men are trying to
avoid in the first place.
It's a question to ask, but because he doesn't perform open ended isn't an
indication that he's a poor urologist. It's not something I'd make an issue
out of. One doctor in the UK I know of used to perform them, then switched
to NSV because of the granuloma issue. I think type of procedure is less
relevant than skill and experience.
> 10. Do you use the no-scalpel method of vasectomy? If not, which
> method do you use?
In the US the answer is a 50/50 likelihhod of being yes, but if he doesn't,
that isn't an issue either. there are legitimate reasons to perform
bilateral incisions - namely if the vas is difficult to access then it will
make the procedure a lot easier to do, and it's arguable that therefore it's
less likely to cause later complications. My incisions are in different
places on either side. I'm guessing it may have been harder to do if I'd had
a midline incision.
It's a question to ask, but not to make an issue out of - the skill of the
guy doing it is much more important an issue.
Generally, if your target audience is men considering a vasectomy, then they
will have many other questions - not just the pvp centred ones you list. It
might be an idea to add some more general questions, and also add some links
to general info to get men clued up about their own bodies, and information
on who vasectomy is / isn't suitable for. I'd certainly be inclined to get
the guy to think about if it's suitable for him BEFORE going down the
checklist route. You'd be surprised how many men don't really consider the
question of suitability, regardless of risks!
The guy isn't necessarily going to get all the exact right answers, but
sometimes the general feeling of how open he is to discussing all the issues
is a better guide than some of the exact answers.
Thanks for keeping us updated with your site. Please let us know when you do
any updates!
--
David
www.vasectomy-information.com
www.vasectomy-faq.org
>
tcwalk...@gmail.com
An epididymal blowout is a rupture in the epididymis due to pressure.
I myself am not even sure how often they occur or whether all men even
feel them when they happen.
tcwalk...@gmail.com
Thanks for your comments. I really appreciate them and agree with most
everything you said.
> The only thing I'd say is that I personally don't really like .pdf files. I
> can see that you intend men to print it, so I see the logic behind having it
> in .pdf. As a web user, I prefer to have documents in .html - or at least
> the choice. I would say that my weblogs show where I offer a .pdf version,
> very few request it. It's probably a personal thing I guess!
Good point, and part of my learning to design a useful website. You
certainly have a lot more eperience with this so I appreciate the
advice. Maybe I could put several versions up there to suit all
preferences.
>> 5.If I developed Post Vasectomy Pain Syndrome, how would you treat me?
>> (Wait for answer). What would you do if that didn't work?
> I would point out that it may well be the doc hasn't seen many cases of it,
> so he may be aware of the condition, but hazy on very close questioning
> about treatments.
Yes, in fact, my original vasectomy doctor claims I am the first case
of PVPS he has seen in his 23 years of performing the procedure. If he
treats all his other patients like he treated me then when a patient
comes back with PVPS he diagnoses them with "prostatitis". So, had I
asked him this question (which I did not), he would probably have
stated that he had never even witnessed the condition. I would have
heard this, felt great about it, and gone on to have the procedure and
develop PVPS, like I did. I personally feel it is irresponsible for a
doctor to be entirely unaware of a complication of a procedure he
performs on a regular basis and not be aware how to treat it. I have
been working on data enterprise servers for 6 years now and I have
never had two hard drives crash at the same time (a server can suffer
one hard drive crash with no problem) but I know what to do if that
happens (probably a 1 in a 1000 chance that will happen or less).
> Also, as pvp is often as a result of rough surgery (according to Pollock).
> If he's a good surgeon then it *is* unlikely he will see many (if any)
> cases.
Ah, but rough surgery is but one of many reasons that Pollock states
that PVP may arise. But, I agree that it is a big reason. In my case
and the case of almost every man with PVP I have talked to, it seems to
be more of the back-pressure type of pain. I worry about a surgeon's
ego entering into the discussion if we go down this road. I think we
do need to remember that PVP can arise from situations other than
surgery damage. Sometimes, it appears, that the rearrangment of the
plumbing can cause PVP.
> 6.What is a sperm granuloma?
> Good, but it might be an idea for you to add info to your site on this. The
> guy wants to go to the doc well clued up with relevant, incisive questions.
> Ask the question by all means, but if the guy has some basic knowledge
> beforehand would be good.
This points to my being naive during my pre-surgery counseling. I'll
admit, I was an idiot. I thought that I could go into see a urologist
and he would tell me everything I needed to know. I thought that
reading the brochure would be adequate research along with a cursory
glance at some websites. Here I have a masters degree and with all
that studying I allowed myself to go under the knife without the full
knowledge of what could happen. I didn't even know what an epididymis
was. It is sad but true that it is up to the patient to inform
themselves. My pre-surgery counseling consisted of "So what can we do
for you today... (he looks at records) ...Oh, I see you want your tubes
tied. Well, do you have any questions?" Not kidding or exaggerating.
I am definitely following the old saying, fool me once, shame on you,
fool me twice shame on me. I don't put a pill in my body or agree to
anything without researching it ad nauseum. I will never engage in a
surgical procedure again unless I am dying.
> 7.What is an epididymis?
> Basic anatomy question. My feeling is it's better to get men clued up on
> male anatomy and the way it works beforehand, and then get the doc to
> explain anything not understood. My personal feeling is that the consult
> should be focussed on things other than basic information that can be got
> beforehand whilst researching.
Good point, David. Probably my goal here was to point out to the man
that he hadn't done enough research if he gets to this question and
doesn't know. I don't think all men would print this out and take it
in hand to the doctor. However, I would like men to glance at it and
get the idea that they may not have done enough research. See my last
comment.
> 9. Do you perform a closed-ended procedure or an open-ended procedure?
> Not many do perform open ended, so the answer is likely to be no anyway. In
> any case, there dissadvantage of the open ended method is an increase in
> sperm granuloma's to some 97%. The thing that's likely to make the most
> difference to the chances of getting post vasectomy problems is the skill of
> the surgeon performing the vasectomy. Statistically, compications such as
> hematoma and infection are less with more experienced practitioners. Also as
> above, rough surgery is a cause of pvp, and that's what men are trying to
> avoid in the first place.
> It's a question to ask, but because he doesn't perform open ended isn't an
> indication that he's a poor urologist. It's not something I'd make an issue
> out of. One doctor in the UK I know of used to perform them, then switched
> to NSV because of the granuloma issue. I think type of procedure is less
> relevant than skill and experience.
I didn't know what type of surgery was performed on me until I had PVP
and went back and asked. If a surgical procedure has a number of
different techniques, I think the man should know which he is going to
have done to him and the particulars that go along with that technique.
> Generally, if your target audience is men considering a vasectomy, then they
> will have many other questions - not just the pvp centred ones you list. It
> might be an idea to add some more general questions, and also add some links
> to general info to get men clued up about their own bodies, and information
> on who vasectomy is / isn't suitable for. I'd certainly be inclined to get
> the guy to think about if it's suitable for him BEFORE going down the
> checklist route. You'd be surprised how many men don't really consider the
> question of suitability, regardless of risks!
I didn't mean for it to be a "How can you ask about PVP in ten
different ways" list but I guess it did. There are more relevant
questions like "Will I still ejaculate and will it feel the same." and
questions like that but those are almost always discussed and the
questions I listed may not be discussed as often. There are definitely
things a man should ask himself before these questions like, "Who wants
this procedure, me or my partner or both?"
I appreciate your comments.
Ross
David
> Good point, and part of my learning to design a useful website. You
> certainly have a lot more eperience with this so I appreciate the
> advice. Maybe I could put several versions up there to suit all
> preferences.
>
Keep it simple! Have the html version that is the online version of the
page, and offer a .pdf version of the page for printing. You have very few
seconds to grab someone's attention, and the likelihood is that a lot of
people will click out before the .pdf has loaded.
> I personally feel it is irresponsible for a
> doctor to be entirely unaware of a complication of a procedure he
> performs on a regular basis and not be aware how to treat it.
I'd agree with this. My point is that good practice is not to make any
assumptions, but to diagnose and treat symptoms logically. I think it's a
good question to ask, as the answer could be revealing. Ideally I think he'd
accept that there is a risk, and go on to explain and discuss it. Denying it
exists at all would not be a good indicator IMHO.
>
>> Also, as pvp is often as a result of rough surgery (according to
>> Pollock).
>> If he's a good surgeon then it *is* unlikely he will see many (if any)
>> cases.
>
> Ah, but rough surgery is but one of many reasons that Pollock states
> that PVP may arise. But, I agree that it is a big reason. In my case
> and the case of almost every man with PVP I have talked to, it seems to
> be more of the back-pressure type of pain. I worry about a surgeon's
> ego entering into the discussion if we go down this road. I think we
> do need to remember that PVP can arise from situations other than
> surgery damage. Sometimes, it appears, that the rearrangment of the
> plumbing can cause PVP.
Yes, Agreed. The other point to bring up is any previous history of aches
and pains down there, plus anything that may be relevant. The guy who does
the consult may not have the medical records, and as we have seen here in
the past, men may have chosen to live with complaints. It's a time for us to
be honest with ourselves and our doctors by sharing relevant information.
I think we are heading towards a debate on PVP rather than a discussion on
your list of questions here, so I'll try and head back towards the thread
topic. I guess what I'm trying to say throughout is that asking questions is
great and to be encouraged. But in addition to the questions, it's an idea
to have a few words as to the reason for asking the question, and thus
provide some knowledge to enable the man asking the questions to interpret
the response.
>
>> 6.What is a sperm granuloma?
>
>
>> Good, but it might be an idea for you to add info to your site on this.
>> The
>> guy wants to go to the doc well clued up with relevant, incisive
>> questions.
>> Ask the question by all means, but if the guy has some basic knowledge
>> beforehand would be good.
>
> This points to my being naive during my pre-surgery counseling. I'll
> admit, I was an idiot. I thought that I could go into see a urologist
> and he would tell me everything I needed to know. I thought that
> reading the brochure would be adequate research along with a cursory
> glance at some websites. Here I have a masters degree and with all
> that studying I allowed myself to go under the knife without the full
> knowledge of what could happen. I didn't even know what an epididymis
> was. It is sad but true that it is up to the patient to inform
> themselves. My pre-surgery counseling consisted of "So what can we do
> for you today... (he looks at records) ...Oh, I see you want your tubes
> tied. Well, do you have any questions?" Not kidding or exaggerating.
Mine went along the lines of "How many kids, how old, you know there is a
risk of failure and the NHS won't pay for reversal? Give the nurse a ring to
book if you want to go ahead".
>
>> 7.What is an epididymis?
>
>
>> Basic anatomy question. My feeling is it's better to get men clued up on
>> male anatomy and the way it works beforehand, and then get the doc to
>> explain anything not understood. My personal feeling is that the consult
>> should be focussed on things other than basic information that can be got
>> beforehand whilst researching.
>
> Good point, David. Probably my goal here was to point out to the man
> that he hadn't done enough research if he gets to this question and
> doesn't know. I don't think all men would print this out and take it
> in hand to the doctor. However, I would like men to glance at it and
> get the idea that they may not have done enough research. See my last
> comment.
I think this is a key point - many men DON'T research thoroughly, despite
having access to the web. Getting a man to a) consider if it's suitable for
him, and b) do adequate research is a challenge. My overall point is that
the consult is time limited, so to make the best use of it you need to have
done some research beforehand in order to ask the right questions. Also,
have some basic knowledge in order to understand and possibly interpret the
doctors replies.
>
> I didn't know what type of surgery was performed on me until I had PVP
> and went back and asked. If a surgical procedure has a number of
> different techniques, I think the man should know which he is going to
> have done to him and the particulars that go along with that technique.
Absolutely. My point is that the key factor isn't the procedure itself, but
the skill of the guy doing it, and men shouldn't assume that type a is less
likely to result in problems than type c procedure. But you are right, he
should be aware of the procedure that applies.
> I didn't mean for it to be a "How can you ask about PVP in ten
> different ways" list but I guess it did.
I didn't mean my comments to come out that way - I really shouldn't post
first thing in the morning before my secong mug of coffee! The list doesn't
come over that way, as they are important questions that need to be asked.
My feeling is that as discussed, knowledge is often lacking in men
considering. So putting more general questions and a little info down would
be a help to them.
--
David
www.vasectomy-information.com
www.vasectomy-faq.org
paps
Also as someone in this thread said, ask the question even stupid one,
because that tells how well this doc want to engage with you. Because if
when problem arise if he is like "hi,-----ok, try
this --failed!----ok ---try this---still failed ok LIVE WITH IT." it is more
dangerous. So, this interviewing the doc not only give us knowledge, but
also tells how well this doc is interested in helping you. I have read many
posts on vasectomy problems where doc tells "I never saw that!"(WHAT A LIE).
Suppose in my case doc said when he saw water coming out after making
incision, "oh is that an hydrocele I never saw water coming out like that?".
Now after two months he says "oh, it is still swelling, I never saw swelling
statyed like that for that long."
This tells either this doc is lying or not studied properly. because he
says he did around 3500 , (Statistically finding hydrocele accidentally or
pre known is 5%). even if he did not find this he will atleast known from
his collegues.
Anyway ask as many questions as you want, if he is willing to answer and you
are satisfied then go ahead.ELSE do not go with that guy.
I would also like to add some questions:
*Do you use any glue on the inciscion?(to protect the area from water and
keeps the skin tightly attached)
*can you recommend antiinflamatory medcine just incase?(b'cas my friend got
that from his doc, my doc did not even said that)
*If any of the known complications arises what is his plan B?Did he ever
suceed with that plan B?
When I went to see my doc after two months with sizes 1*3 times ball and 1*1
ball ,
I asked a list of questions, at one moment he said some thing like "I can
not go over the encyclopedia and go over all the conditions, but you look
OK"
So goodluck to those who ask these questions.
Also, as some one said here that many people wont research, that may be
true.If possible , once in a while if these vasectomy sites can post a thing
in other websites or newsgroups or something like that, that will create
more awareness(even if it is spem email) among the men so they can be more
informed and prepared.
David
> Also, as some one said here that many people wont research, that may be
> true.If possible , once in a while if these vasectomy sites can post a
> thing
> in other websites or newsgroups or something like that, that will create
> more awareness(even if it is spem email) among the men so they can be more
> informed and prepared.
Well, I think there is good news here. I'm not going to bore anyone with
lots of numbers, but I can give some information that I feel is encouraging.
Virtually all my site visitors arrive via search engines on the simple term
vasectomy. We are talking of over 10K unique visitors per week here.
I get a lot of repeat visitors, and the average number of page views per
visitor is healthy.
The pages that get the most hits have always been pages that discuss risks
and complications in some way.
The patterns of pages viewed indicates that whilst there are some visitors
that wandered in by mistake, most visitors are interested enough to be doing
what I would call proper research, and many are there for the purpose of
serious research viewing many pages.
--
David
www.vasectomy-information.com
www.vasectomy-faq.org