Q: What is shrinkage of testes? How does it impair the conduct of Bilateral Vasectomy under local anaesthesia? Is it necessary to have a GA for this Bilateral Vasectomy if the vas deferens is difficult to get hold of under LA and the pain is severe?

A:There is difference in shrinkage of scrotum or testes. I think you mean scrotum. If the scrotum is small i.e. it doesn't hang, the doctor may have difficulty but this difficulty doesn't mean a big problem - he may take one or two minutes extra for holding it properly. One technique is to pour warm saline over scrotum so that it starts expanding- everybody knows that scrotum becomes smaller in winters and larger in summers. You go ahead and choose any anaesthesia- local or GA or spinal - all are good. If you have lot of anxiety, go for GA. In any case it is a small operation.