A vasectomy is not castration

Vasectomy is a word that invokes a lot of apprehension in many men and outright condemnation from many others.

For this reason, the willingness of men to get a vasectomy remains significantly lower than the female equivalent, tubal ligation. Here are some of the frequently asked questions about vasectomy.

What exactly is a vasectomy?

A vasectomy is a permanent, surgical birth control technique. The procedure involves cutting and sealing off the cut ends of the vas deferens, the tube that transports sperm and semen from the testicles to the urethra for eventual exit.

The vasectomy interrupts the path of the sperm, hence sperm are not transported to the urethra, and are not found in semen.

Though a vasectomy can theoretically be reversed, it is advisable to consider it permanent due to the complexity, cost and the failure rate that is associated with attempts at reversal.

Does having a vasectomy mean no ejaculation?

No, ejaculation is not affected by having a vasectomy, the only difference is that the semen will not contain sperm. Semen is not only composed of sperm, but also of fluids from the glands in the male reproductive system including the seminal vesicles, the prostate and urethral glands, which remain unaffected by a vasectomy.

So what happens to the sperm?

The testes continue producing sperm, which are not transported as usual, but rather are broken down and reabsorbed by the body.

Does the testosterone level reduce with a vasectomy?

Testosterone is a hormone that is produced and released directly into the blood stream, and does not rely on the vas deferens or the urethra for its release.

This is the case with most hormones, which are released directly into the blood stream. The testes continue producing testosterone, which is released into the blood stream as usual.

When I get a vasectomy, does that mean I am castrated?

A vasectomy is NOT the same as castration. Castration is the removal of the testes while a vasectomy is simply the tying of the tubes. Castration would result in a reduction of testosterone while a vasectomy does not change the levels of testosterone.

After how long can one resume normal intercourse?

Depending on the recovery of the individual, one can resume normal intercourse even as early as in a week’s time. However, in the immediate period following a vasectomy, there is still a chance that some sperm will be found in the semen.

Part of the procedure in the months following a vasectomy is an analysis of the semen to confirm absence of sperm. This is usually done after three and four months (unfortunately, up to half of the patients do not return for the semen analysis after a vasectomy.)

Prior to the confirmation of absence of sperm, other means of contraception should be used since there are still chances of pregnancy.

How long does the procedure take?

A vasectomy is done as an outpatient procedure, which takes approximately 30 minutes to one hour, depending on the method. The more current ‘no scalpel’ technique is less invasive, and may take a shorter time. In addition, it is associated with faster recovery and less likelihood of complications.

Is the procedure painful?

Vasectomy is done under local anaesthesia, so the affected area is numb during the procedure, but the anaesthesia may be given using a needle, which may cause slight discomfort.

However, there is a ‘no needle’ option that involves pressure-jet delivery of the anaesthetic into the tissues without a needle; this is comparatively less painful.

What are the possible complications?

There are very few possible complications with a vasectomy, usually in the immediate post-operative period, and include bleeding and formation of a blood clot (haematoma).

Chances of such complications, however, are lower with the ‘no scalpel’ technique. There may also be infection, congestion of the epididymis, and formation of sperm granulomas, which are treated with antibiotics where warranted, anti-inflammatory drugs, rest, ice and heat therapy. In the long term, some pain may persist.

How effective is vasectomy?

The procedure has a lower failure rate than its female equivalent, tubal ligation. Currently, the failure rate documented is 1 in 2,000 cases (for tubal ligation, it’s 1 in every 300-400 cases ).

A large number of the pregnancies occurring after a vasectomy usually occur due to having unprotected intercourse too soon, prior to confirmation of absence of sperm in the semen.

Torooti Mwirigi [email protected]