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Vasectomy

What is a vasectomy?

A vasectomy is a minor surgical procedure used by urological surgeons to make a man sterile.  It is one of the most popular forms of contraception worldwide, and is regarded as safe, simple and highly effective.  It is estimated that 50 million vasectomies have been performed worldwide.

A vasectomy is performed by cutting the vas deferens, the small tube that carries sperm from the man's testicles to become part of his semen.  Although the man continues to have sexual intercourse and climax as before, his semen does not contain sperm and he cannot father a child following a vasectomy.

How long does the procedure and recovery take?

The procedure itself usually takes about 15-20 minutes.  However, including admission and preparation, the total time in a clinic may be about an hour.  The procedure is likely to produce tenderness, discomfort and slight swelling in the first two or three days afterwards, with a return to most activities typically within a week.

How effective is a vasectomy?

For couples who want a highly reliable and permanent solution, vasectomy ranks among the most effective means of contraception.  Although no procedure is totally safe or effective, the failure rate for a vasectomy is less than one percent (by comparison the failure rate for latex condoms is 12% or more).

Does it work immediately?

No, any vasectomy does not make you sterile right away, and you'll need to continue using some other means of contraception to guard against pregnancy until your doctor tells you otherwise.  Immediately after a vasectomy, active sperm remain in the semen for a period of time.  It may take 15 to 20 ejaculations and several weeks before your semen is free of sperm.  Your doctor will test the semen, and let you know when you can safely consider the vasectomy to be complete.  This may be as long as four months.

What happens to the sperm?

This is a mystery to some people, but the answer is both normal and natural. The body absorbs unused sperm cells normally - whether or not you've had a vasectomy. After the procedure, the testicles will continue to produce sperm but they will not leave the body in the semen.  They dissolve and are simply and naturally absorbed by the body.

Will my sex life be affected?

A vasectomy only blocks sperm and does not affect your sexual drive, your ability to have an erection, orgasm or ejaculation or your ability to have and enjoy sex. Sperm is only a small fraction of the total liquid in your semen.  The amount of fluid, intensity, color and texture does not appear to change when sperm is absent. Male hormones continue in the bloodstream, and secondary characteristics (such as beard or voice) do not change.  Some couples say their relationship is improved by not having to worry about contraceptive techniques or unplanned pregnancy.

Are there risks or complications?

Yes, as with any surgical procedure there could be complications.  However, vasectomy ranks among the safest procedures and the majority of complications, if any, are usually minor and easily treated.  These include a chance of infection, bleeding or transient bruising, temporary swelling or fluid accumulation.  Following the procedure, some men experience pain, often as a dull ache, caused by a pressure on the miniature tubes of the epididymis.  This is usually treated successfully with medication but the removal of the epididymis is sometimes recommended.

Some studies have found that some men, who had a vasectomy 20 years earlier, have a slightly higher risk of prostate cancer than others who have not had a vasectomy.  Other studies did not have the same results.

Can a vasectomy be reversed?

You should consider any vasectomy to be permanent.  There are delicate microsurgery operations that may be able to reverse the effects of a vasectomy, but there is no assurance that the flow of sperm can be restored or pregnancy will result in every case.  The likelihood of success can vary greatly depending on individual circumstances, including how much time has passed since the vasectomy.  If you are seriously considering a vasectomy, it's best to assume that it will be a permanent change.

Author: Mr Francis Chinegwundoh MBBS FRCS MS FRCS(Urol) FEBU MML 

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