Q. I have 3 children. My husband is thinking of a vasectomy. Can you tell me how vasectomy works? Are there any risks for the procedure? Will the operation affect his sexual performance? How soon can we resume sex without using contraception?
A. A vasectomy or male sterilization, is a surgical procedure in which the tubes (vas) that carry the sperm from the testicles to the penis are tied and cut so as to permanently prevent pregnancy.
It is usually done under local anaesthesia where a tiny incision is made on each side of the scrotum to reach the vas which is then cut and a small segment removed. The ends of the vas are then closed with sutures.
This procedure works by preventing the sperm from entering the semen. The amount of semen ejaculated is not affected after the operation, as sperm accounts for only 2-5 per cent of the total volume. The sperm, which is still produced by the testicles but cannot travel along the tied vas, are reabsorbed by the body.
The risks of operation are minimal with occasional bleeding, infection or an inflammatory reaction to sperm leakage. Discomfort such as pain, bruising or swelling may occur for a few days after the procedure.
Vasectomy will not affect an individual's sex drive or ability to enjoy sex. Erections and ejaculation are not affected.
You can have sex again as soon as your husband finds it comfortable to do so. However, you need to use other methods of contraception for at least the first 8 to 12 weeks, as there may still be sperm present in the vas leading to the penis.
To make sure that the vasectomy works, the semen should be analyzed twice to make sure that no sperm are present.
Vasectomy is 99.9% effective at preventing pregnancy. In about 0.1% or less, the vas may rejoin naturally and the man may become fertile again.
Surgical reversal of vasectomy is possible but the procedure is difficult and complex. If a reversal is carried out within 10 years of vasectomy, the success rate of impregnating the wife is about 55%. This falls to 25% if the reversal is carried out more than 10 years after.