Male Sterilization–Vasectomy

Male Sterilization–Vasectomy

The method used in male sterilization is analogous to the one performed in the female. In this case it is the interruption of the ducts that transport the sperm: the vasa deferentia. In this minor surgery, a local anaesthetic is used. The surgeon makes an incision at each side of the scrotum. The two ducts carrying sperm from the testes to the penis are gently pulled into sight. The surgeon then removes a segment of each vas and either cauterises or ties the remaining ends.

The operation takes around fifteen minutes, and after resting for an hour or so, the man can go home. Some patients may feel slightly bruised, others may experience no pain at all. Most surgeons advise that patients rest with their feet up for a day. This will minimize the chance of painful bruising or swelling. Sexual activity can resume after a few days – as soon as the man feels well. Unlike female sterilization, vasectomy does not lead to immediate sterility. Some viable sperm may be present in the vas and urethra. The surgeon may flush out this channel before closing the incision, but a man is advised to have sperm tests after his operation and wait for two clear results before trusting the operation.

In the main, it takes 10 to 15 ejaculations after vasectomy before he is completely sperm-free, during which time an additional form of contraception should be used as a safeguard.

Just as with female sterilization, the man will not notice any change because the male ejaculate is mainly semen and this is still produced. The man’s ability to erect, ejaculate and have an orgasm will be unaltered. However, because sexual potency is linked in many minds with fertility, some men have reported that vasectomy has led to a loss in sexual ability and pleasure. Such a reaction is not the result of any physical procedure but must be regarded as an emotional response to the vasectomised man’s perception of this ‘loss of manhood’. Careful counselling before the operation should locate these fears and such a man would be advised not to have a vasectomy. Similarly, a recent myth is that premature aging can be the result of a vasectomy. However long-term follow-ups of men who have been vasectomised show no such reaction.

Sterilization should always be considered an irreversible procedure. New techniques of micro-surgery have improved the chances of unblocking Fallopian tubes and the recanalising of the vas, but in the majority of cases such operations are not a success. However, sterilization performed in one of the partners when both do not intend to change their minds about their wish to have (more) children, is the most effective method of birth control.