Vasectomies
A vasectomy is a safe and highly effective operation designed to make a man sterile. It is usually considered a permanent form of contraception, although in some cases the procedure can be reversed, if necessary, eg. if you decide to have children later on in life.
There is a small failure rate, usually in the first year, because the tubes grow back. Complications are rare and are generally associated with infection.
Which men should consider sterilisation?
Male sterilisation, carried out by means of a vasectomy, is a form of permanent birth control for men. It should be considered only if you and your partner do not want children or if your family is complete. It should be considered as a permanent procedure.
How does vasectomy work?
The principle is to prevent sperm from entering the fluid, which is ejaculated during orgasm. Sperm are produced in the testicles. They pass through tubes called the vas deferens to other glands where they mix with other fluids to form semen. Vasectomy blocks the vas deferens and keeps sperm out of the seminal fluid. The sperm are instead absorbed by the body. A small incision is made in the upper part of the scrotum under the penis. The vas deferens are tied off and cut apart. The skin incision is stitched and closed. Normally, you can return home immediately.
How do I prepare?
Ask your doctor about precautions. In general, don’t eat breakfast on the day of the procedure, and don’t take aspirin or ibuprofen for two weeks before your vasectomy and for a week afterward to decrease the risk of bleeding. On the day of the operation, shower beforehand and wear loose-fitting pants and underwear
How effective is vasectomy?
There is a small failure rate in the first year if the tubes grow together again. This happens in around one in 1000 cases. Vasectomy does not offer immediate protection against pregnancy since sperm remain in the system beyond the blocked tubes. You must use some other form of birth control until all these sperm are used up. This usually takes between 15 and 20 ejaculations. A simple semen analysis will show when there are no more sperm in the seminal fluid.
What complications can occur after vasectomy?
Generally, complications are rare. Those that do occur are usually associated with infection after the operation.
Warning signs include:
• A fever
• Blood or pus oozing from the incision
• Excessive pain or swelling
Other possible problems include
• Bleeding into the skin during surgery which may cause bruising. This will get better on its own.
• Fluid around the testes occurs in less than one out of 100 cases and generally clears up within a week.
• Sperm, which leaks from the tubes may cause a small lump under the skin near the site of the operation in about 18 out of 100 cases.
• Mild infections occur in up to seven out of 100 cases. Rarely, an abscess may develop.
• Very rarely, the cut ends of the vas deferens grow back together (recanalisation). If this happens, it is usually within four months of the operation.
• Decreased sexual desire or inability to maintain an erection can occur in around four in 1000 cases. This is usually an emotional problem since there is no physical reason why this should happen after a vasectomy.
Can a vasectomy be reversed?
Sometimes it is possible to reverse a vasectomy, but success is not guaranteed. Around 16 to 19% of men with reversed vasectomies will successfully father a child. In general, you should not consider vasectomy if you want to know about reversal.
When to see your doctor
If after the operation you experience:
• Excessive pain and swelling around the incision or in your testicles
• Any blood or pus oozing from the incision
• If you develop a fever
What are the benefits?
A vasectomy may be appropriate when a couple do not want any more children, or have decided not to have any at all. It may be chosen as a simpler and more reliable alternative to female sterilisation.
A vasectomy is normally permanent, so once it has been carried out successfully and semen tests have shown there is no sperm present, long-term partners may not need to use other forms of contraception. However, a vasectomy does not protect against HIV infection, or any other sexually transmitted infection (STI), so you should continue to protect yourself by using condoms with any new partner.
Did You Know?
The popularity of vasectomies vary from country to country. New Zealand seems to have the highest rate of vasectomised men (23%), US/Europe approx 11%, and the lowest is China and India on 7-8%. A recent US national survey found that 12% of married men aged between 20 and 39 have had a vasectomy, and of this 12%, nearly a quarter are in the 35 to 39 age group. Worldwide, some 50 million men have undergone the procedure - this represents about 5% of married couples of reproductive age.
This information has been reproduced with kind permission of Zahra Publishing, publishers of Easy Health, www.easyhealth.ie
