About Last Night: What should I know before having a vasectomy?

Q: Claire (28) and I (37) have two wonderful children and feel our family is complete. Claire wants to get off the pill, and other forms of contraception are a hassle, so we’re considering sterilisation. As she’s had the babies, and I am a bit older, and definitely don’t want more kids, I’m planning to have a vasectomy. How safe and effective is it?

A: Generally speaking, issues of fertility and contraception are still seen as a female concern, but, when it comes to sterilisation, men can play their part. Vasectomy is quicker, easier and less invasive than female tubal ligation, but there is still some reluctance on the part of men to undergo this procedure.

Many men equate their genitals with their masculinity and are irrationally fearful of having them tampered with. They can also feel uncomfortable about medical issues in general, so it can be reassuring for them to attend a clinic specifically set up for men that addresses their health concerns.

Maureen MatthewsCredit:Simon Schluter

About 25,000 vasectomies are performed in Australia every year. Any kind of body modification, even ear piercing, can have some element of risk. Infection, pain or other complications are rare but possible. Vasectomy is no different, but it is fundamentally a quick, safe and effective treatment, with a 99 per cent success rate, when all of the doctor’s recommendations are followed.

The sperm, which are produced in the testicles, travel through tubes (vas deferens) to the penis, where they are emitted at ejaculation. After a vasectomy, ejaculation still occurs as sperm only make up a very small amount of the ejaculation fluid. It can takethree months for all traces of sperm to go, so maintaining contraception is recommended until you have been given the all-clear.

It is a good idea to get fully informed before having any elective medical procedure. I spoke to urologist and male fertility microsurgeon, Darren Katz, medical director at Men’s Health Melbourne. He reinforced the fact that this is a safe and effective procedure. Dr Katz has produced a fact-sheet on vasectomy and vasectomy reversals, which covers the common questions about these procedures. It is available on their website.

Vasectomies take about 15-30 minutes and can be performed by specialist surgeons (urologists or general surgeons) or GPs. The operation can be done under local anesthetic (numbing injection into the testicle) or general anaesthetic (where you are unconscious or asleep). However, Katz has found that most men, given the option, prefer a general anaesthetic when having a vasectomy. You will need to see a specialist and be admitted to a hospital if you want the procedure undertaken with general anaesthetic. If you have private health cover, you can claim for this.

The risks of vasectomy are very small. About 1-2 per cent  of men may get an infection or bleeding afterwards. A very small percentage of men have chronic discomfort. If this occurs, there are treatments available, which can be discussed with your surgeon.

There are some myths that people hear about vasectomies which are not true. Vasectomies are not associated with causing prostate cancer, erectile dysfunction, lowering libido or testosterone. Importantly, having a vasectomy does not protect against sexually transmitted diseases. After a vasectomy, the immune system can produce antibodies to sperm but this is a normal and harmless reaction.

Dr Katz performs a very large volume of vasectomy reversals and he says clearly there are some men who did not think through thoroughly enough the decision about having a vasectomy in the first place. Katz reinforced that men should consider this a permanent form of contraception and so you need to be certain that you and your partner have completed your family.

Once the sterilisation process is complete, and you have been assured that no sperm remain, you and Claire should experience a wonderful sense of liberation. It is possible to be more lighthearted and spontaneous in your sex life when an unwanted pregnancy is no longer a worry.

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