VASECTOMY

What is vasectomy?

Vasectomy is a simple and straightforward operation that stops sperm entering semen. It is a permanent form of contraception, but as a rule it shouldn’t interfere with your sex life because you will still have erections and produce semen.

However, it's clear that a very small number of men do run into trouble after the operation. These include males who have psychological problems such as fear of castration.

Also, there is an uncommon condition called ‘sperm granuloma’, which is a painful little lump occurring in the scrotum as a result of leakage of sperm. If it causes pain, it can be removed surgically or treated with anti-inflammatory pills.

A few men get chronic (long-term) testicular pain after the operation.

Nevertheless, vasectomy is a popular and routine operation these days, with about 18 per cent of British men having had ‘the snip’.

Who can have a vasectomy?

Provided you have thought it over carefully, any man can choose to be sterilised by having a vasectomy - though doctors are generally unwilling to do the operation on very young males, especially those without children.

Vasectomy is a much simpler procedure than the sterilisation of women and is almost always done on an outpatient basis – in other words, without having to stay in hospital. You can usually go home a couple of hours after the operation.

Does your partner need to know about vasectomy?

It is folly to have a vasectomy without your wife or partner’s consent. Taking such a unilateral decision can lead to marital discord.

In addition, it is technically possible that your spouse could sue you for depriving her of the chance of having further children.

A good clinic will want to discuss alternative types of contraception with you, and to make sure that you and your partner are really happy with the idea of vasectomy and that you understand that you are taking this decision for life.

What happens in a vasectomy?

The actual surgical procedure sounds a bit alarming for most men, but there's usually very little pain and the operation is short. These days, it's nearly always done under a local anaesthetic.
* You’ll be lying flat on your back. The surgeon will inject a little local anaesthetic into the skin of your scrotum, and after that you’ll feel no pain.
* The surgeon makes a small cut in your scrotum. Working through this incision, he finds the slim, spaghetti-like tube that carries sperms upwards from your testicle. This tube is called the vas.
* The surgeon cuts through the vas and then seals off the ends.
* The surgeon does the same thing to the tube on the other side – and that’s it.
* With modern techniques, the surgeon may not even need to use stitches. If there are any, they’ll probably be dissolvable.

There are minor variations in the way that different surgeons perform the operation. Whatever the method, it’s generally all over within fifteen minutes.

When can you have sex again after vasectomy?

After the operation, you will still have some sperm left in the tubes that lead to the penis. This means that you must use another contraceptive method for the time being. You can have sex as soon as you feel like it after the operation (some men have sex within hours), but you'll need to use an additional contraceptive method for a while.
Yes – you will produce semen. It will look just the same as before and the volume should be the same.
About two to three months after your surgery, you'll need to have a semen test to see if all the sperm have gone. Many surgeons like to make really sure by doing two tests.
Once you have been reassured that no sperm can be seen in your ejaculate - under a microscope - then you can rely on your vasectomy without using any back-up contraception.

Can vasectomy make you impotent?

Vasectomy does not cause impotence (erectile dysfunction). But it is easy to see that a man who already has psychological problems about sex could feel that his potency is threatened by the operation.

This is why every man who wants to have a vasectomy should have careful preliminary counselling.

If you are troubled by deep castration fears, and are terrified by the whole idea of the operation, then don’t go ahead.

Similarly, anybody who has difficulties with getting or maintaining an erection is probably not the best candidate for a vasectomy.

Is vasectomy 100 per cent effective against pregnancy?

Vasectomy is not 100 per cent effective. Occasionally, pregnancies do happen. In Britain, estimates are that one in every 2000 vasectomies fails. This generally isn’t anybody’s fault.

What about vasectomy reversal?

It is possible to reverse a vasectomy, but this procedure is frequently unsuccessful.

There are very few surgeons who can claim a success rate of more than 40 per cent.

Some surgeons claim they have much higher success rates, but it usually turns out they mean that they have succeeded in re-joining the tubes or enabling the man to produce some sperm. This isn’t the same thing as achieving fatherhood.

In general, attempts at reversal of vasectomy are more likely to succeed if they are carried out fairly soon after the sterilisation.

If you've had a vasectomy and later want to have children, there is the option of conceiving a child by artificial retrieval of sperm from your testicle. This is then followed by in-vitro fertilisation (IVF) of your partner's egg – in other words, a variant of the test-tube baby technique.

 (information written by Dr David Delvin, GP and family planning specialist - http://www.netdoctor.co.uk/sex_relationships/facts/sterilisation_men.htm)