My wife wants me to have a vasectomy but...

All Woman

Dear Dr Mitchell,
My wife and I have five children and she has suggested that I have a vasectomy because she does not want anymore kids. While I am not sure that I want to put an end to my siring potential, I have told her that I would consider it, especially in light of the fact that she is unable to use hormonal contraceptives and choosing birth control has always been a problem for her. I am afraid of both the process to get a vasectomy, as well as the finality of it all. Can you give me some guidance? Does it hurt? Will it affect my manhood? How long would I be out of operation? How long will it take afterwards before I'm sterile? And finally, in the event that I change my mind, can it be reversed with modern technology?

A vasectomy is a minor procedure that is done on men to prevent pregnancy; this is called male sterilisation. It is considered a permanent procedure and should only be done for couples who will absolutely have no desire for any further pregnancies.

The vasectomy is done under local anaesthesia and is generally not painful. You can return to work immediately and can resume sexual activity within a few days. Initially, there will be some soreness in the scrotum but this resolves with time.

It can be reversed in a few cases, but largely speaking reversal is usually unsuccessful and more difficult to perform than doing the actual vasectomy procedure.

There are two simple ways of doing a vasectomy: One procedure involves making a small incision in the scrotum and isolating both vas deferens and cutting and tying them off. The incision is then closed with sutures that are absorbed.

The second one does not involve any suturing. The vas deferens are identified then pulled through the incision with a clamp, cut and sealed off (no scalpel vasectomy).

A vasectomy is an effective form of permanent contraception. Usually it is advised to use another form of contraception until after 10 to 20 ejaculations. A test can then be done on the semen to determine if there are any sperm in the ejaculate. If there is none then you can be sexually active without the back-up method.

A vasectomy does not protect against sexually transmitted infections such as Human Immunodeficiency Virus and condom usage should be utilised if it is deemed necessary.

Some minor risks of getting a vasectomy include bleeding in the scrotum, blood in the semen, bruising of the scrotum, infection at the surgery site, mild pain or discomfort, and swelling at the site of the incision.

A vasectomy does not cause impotence or sexual dysfunction.

You should consider an alternative form of contraception if you are not completely sure that you will not want children in the future.

Other options include your wife putting in the intrauterine contraceptive device which lasts up to 10 years until you are sure about your future fertility desires.

Consult your doctor who will advise you further.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.

DISCLAIMER:

The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.

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