Vasectomy

Male sterilization, or vasectomy, is a surgical procedure that involves cutting and tying the 2 tubes called vas that carry sperm from the testicles to the seminal vesicles.

Vasectomy is usually done under local anesthetic. The surgeon makes a tiny incision on each side of the scrotum, and then cuts and ties both vas. It works by preventing the sperm from entering the semen. Semen is produced in the seminal vesicles and prostate. The amount of seminal fluid is not affected, as sperm account for only 2-5 per cent of ejaculated fluid. The sperm, which are still produced by the testicles but cannot travel along each of the tied vas deferens, are reabsorbed by the body.

Male sterilization is 99.9% effective at preventing pregnancy. About 2 months after the operation the semen is analyzed to find out whether sperm are still present. In the interim period, other contraception method should be used. In 0.1% or less, the vas may reopen and the man may become fertile again.

It is difficult to reverse the surgical procedure, and couples where the man has had a reversal of his vasectomy have a success rate of pregnancy of only 45-60 percent.

The advantages of vasectomy are that:

• it is reliable and permanent;
• it does not interfere with erection, sexual potency, hormone production or ejaculation;
• it does not interfere with spontaneity of sex;
• it is a quick and simple procedure; and
• There should be no long-term side effects.

The disadvantages of vasectomy include the following:

• It is not effective immediately, and may take 2-3 months (or 16-20 ejaculations) before all sperm have been cleared from each vas deferens.
• There may be short-term discomfort such as pain, bruising or swelling following the procedure.
• There may be complications such as bleeding, infection or an inflammatory reaction to sperm leakage.