Should you have a vasectomy?

Should you have a vasectomy?

Men’s health

By Dr Belinda F MORRISON

Monday, March 04, 2013

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A vasectomy is a simple out-patient operation, done under local anaesthesia, that cuts and ties the tubes (vas deferens) that carry sperm from the testes into the ejaculate.


Vasectomy is an effective and permanent form of male contraception that is unfortunately underutilised in Jamaica. In the United States, vasectomy is the fourth most common method of contraception, following condom use, oral contraceptives and tubal ligation.


Vasectomy, a cost-effective method of sterilisation, is as effective, but safer, faster and cheaper than a tubal ligation. Despite this, tubal ligation is performed two to three times more than vasectomies in the United States. The difference is far greater in Jamaica.


What should a man do if he is interested in a vasectomy?


A pre-procedure consultation with a urologist is necessary to discuss the technique, risks and benefits.


A vasectomy is a permanent change in the fertility status. Therefore, men should have face-to-face discussions with the urologist and not make impulsive decisions. The procedure is done under local anaesthesia and takes about one hour.


The no-scalpel technique is quite popular. It may be done in the office or minor operating theatre. Patients may return to work the day of or after the procedure.


A vasectomy does not provide immediate sterility. An alternate form of contraception must be chosen after a vasectomy until a repeat semen analysis confirms absent sperm. This may take weeks or months. Patients should refrain from ejaculation one week after the procedure to allow for healing of tissue.


Risk of pregnancy after a vasectomy


A vasectomy is not 100 per cent effective. The risk of pregnancy after vasectomy is one in 2000.


What if a man changes his mind and wants to have a child after a vasectomy?


Vasectomy reversal is possible, however, the fertility rates in these situations are less than with men who never had a vasectomy. Artificial reproductive techniques such as in vitro fertilisation may also be considered.


What are the risks of a vasectomy?


A vasectomy is a very safe procedure and minor complications occur in one to two per cent of men. These include a clot (haematoma) in the scrotum, infections to the skin, and chronic scrotal pain.


Is vasectomy a risk factor for prostate cancer?


A vasectomy is not a risk factor for prostate cancer, coronary artery disease, stroke, hypertension, dementia or testicular cancer.


Does a man's partner need to be involved in the consultation for a vasectomy?


A man does not have to involve his wife or partner in the consultation for a vasectomy, but it is strongly advised.


Will a man's sex life be affected by a vasectomy?


The sex life is unaffected by a vasectomy. Most men resume sexual activity approximately two weeks post-procedure and are satisfied. A vasectomy can achieve family planning goals and allows for participation of men in achieving these. The procedure is safe and cost-effective and must be considered by men and families desirous of permanent contraception.


Dr Belinda F Morrison is a urologist and lecturer at the University of the West Indies. Contact her at Belinda.morrison02@uwimona.edu.jm.



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