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Vasectomy

vasectomy


Vasectomy is an effective and permanent form of contraception. The operation is quicker, easier and more effective than female sterilisation. It is considered a permanent method of contraception, as reversal is a complicated operation, which is not always successful.

What do you understand by vasectomy?

Vasectomy is an operation involving cutting of the vas deferens. This is the tube that takes sperm from the testes to the penis. Sperm which are made in the testeswill  no longer get into the semen ejaculated during sex, if the vas deference is cut.

Is vasectomy a reliable procedure?

 Though vasectomy is a very reliable procedure, but still about 1 in 2,000 men with vasectomy will become fertile again at some point in the future. This is because, rarely, the two ends of the cut vas deferens re-unite over time.

How is the procedure done?

Vasectomy is usually done under a local anaesthetic, but sometimes general anaesthesia would be required.Local anaesthetic is injected into a small area of skin on either side of the scrotum above the testes. A small cut is then made to these numbed areas of skin.

The vas deferens can be seen quite easily under the cut skin. It can be cut with a scalpel (surgical knife) or using diathermy. Diathermy is electrical current that cuts the skin and stops bleeding at the same time. This is now more common. The small cuts to the skin are then stitched or stuck back together with tape. Dissolvable stitches are used if the cut is stitched. The operation takes about 15 minutes.

There is usually some discomfort and bruising for a few days afterwards. This normally goes away quickly. The discomfort can be helped by wearing tight-fitting underpants day and night for a week or so after the operation. It is also best not to do heavy work, exercise or lifting for a week or so after the operation.

What are the risks involved in the operation?

Most men have no problems after a vasectomy. Problems are uncommon but include the following:

  • There is a small risk of a wound infection.
  • The bruising around the operation site is sometimes quite marked, but will go in a week or so.
  • Rarely, sperm may leak into the scrotum and form a swelling, which may need treatment.
  • A small number of men have a dull ache in the scrotum for a few months after the operation. This usually settles over time.
  • If you have a general anaesthetic, as with any operation, there is a small risk associated with the anaesthetic.

What are the ways of knowing whether the operation was a success?

It takes about eight weeks after the operation for the sperms in the reproductive tract to die. After that you will need to produce two semen tests about 3-6 weeks apart. These are looked at under the microscope to check for sperm. If these have no sperm in them, you will be given the all clear, till then additional contraception, such as condoms, is advised.

How is vasectomy advantageous?

It is permanent and you don't have to think of contraception again. It is easier to do and more effective than female sterilisation.

Has vasectomy got any disadvantages?

Yes, it may take a few months before the semen is free from sperm. As it is permanent, some people regret having a vasectomy, especially if their circumstances change.

Does it affect your sex drive?

No. The sex hormones made by the testes (for example testosterone) continue to be passed into the bloodstream as before. Also, vasectomy does not reduce the amount of semen when you ejaculate (come) during sex. Sperm only contributes a tiny amount to semen. Semen is made in the seminal vesicles and prostate higher upstream.

Sex may even be more enjoyable, as the worry or inconvenience of other forms of contraception are removed.

What will happen to the sperm, which is produced?

Sperm are still made as before in the testes. The sperm cannot get past the blocked vas deferens and are absorbed by the body.

Important points to consider while having vasectomy?

  • Don't consider having the operation unless you and your partner are sure you do not want children, or further children. It is wise not to make the decision at times of crisis or change, such as after a new baby or termination of pregnancy. It is best not to make the decision if there are any major problems in your relationship with your partner. It will not solve any sexual problems.
  • Doctors normally like to be sure that both partners are happy with the decision before doing a vasectomy. However, it is not a legal requirement to get your partner's permission.

Is the operation painful?

No more than any other minor operation that uses local anaesthetic. The injection of local anaesthetic may sting a bit for a few seconds. It is put in just a small area of skin, so it is nothing to worry about. After this, the operation is usually painless. After the operation, when the local anaesthetic wears off, the top part of the scrotum is normally mildly sore for a few days.

Can vasectomy be reversed?

Though, vasectomy is considered permanent, there is an operation to re-unite the two cut ends of the vas deferens. It is a difficult operation and not always successful.

How soon after the operation can I have sex?

You can resume sex as soon as it is comfortable to do so. However, remember you will have to use other methods of contraception (such as condoms) until you provide two semen specimens which are clear of sperm. Some sperm will survive upstream from the cut vas deferens for a few weeks.

 


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