There are all sorts of ways of preventing babies from being the product of sexual intercourse. I presume I don’t need to run through them - right?
We are all (if you are reading this on-line) at least computer literate – this allows all sorts of assumptions like that you know how to use a condom and if you are on the pill then you know how to use it properly. I know it is a tenuous link (if any) between computers and condoms but you get the point.
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In dealing with long term contraception issues with my patients who are in committed stable relationships, I am struck by how many men are reluctant to accept real responsibility for contraception. I’m not talking about a dislike of condoms. Many couples agree that condoms are not their first choice for long term contraception. That leaves very little doesn’t it? Basically it is over to the women to take the pill or get injected with something to stop the babies coming.
A Sharp Needle? There is talk of a contraceptive injection for men – it is not yet registered for use in humans while tests on its safety are carried out. I’m told that it will involve monthly injections. When I raise this as a future possibility with patients I am left with no uncertainty that this is not acceptable to men. What of those people who have decided that they don’t want any more babies – the final contraception decision if you like? This is where I find men covering their groins with both hands and foisting the responsibility onto their partners
If a couple is really convinced that they will not want more children, and they cannot conceive (excuse the unintended pun) of circumstances in which they would change their minds, I advise against the long-term use of chemicals and hormones. Taking the contraceptive pill for a decade or so seems fine, but for 20 or 30 years just seems a bit extreme. Similarly, having an injection every two or three months for that length of time is probably not wise.This leaves the surgical options.
Surgical sterilisation is a smallish procedure for women. It involves a general anaesthetic and laporoscopy, where a small tube is put through a cut in the muscle of the abdominal wall and the fallopian tubes are tied and a section is cut out. By and large a night in hospital is not required.
It's really not that bad Even though the procedure in women is not a major one, for men the equivalent procedure is almost a non-event. OK, relax, you can take your protective hands away from your groin now, it is really not a big issue. Before I go on to explain the procedure I think as men we need to remember what women go through to have babies. Labour itself is one thing, but the post-natal pain, cracked nipples and other unpleasantries would have most men whingeing from here until Christmas. On the balance of it having an itsy witsy tiny surgical procedure to prevent having further babies hardly seems a big issue.
An afternoon off work will do the trick A vasectomy will take just a couple of hours of your time. Maybe an afternoon off work would seem appropriate – that would still leave you some leisure time to celebrate. Government hospitals do them for free if you don’t have a medical aid but have substantial waiting lists. If you do have a medical aid they are relatively easily convinced that this is an essential surgical procedure and will pay for it.
These days vasectomies are done exclusively by specialist urologists so your GP may have to refer you to one. Mostly they are done under local anaesthetic so you won’t need premedication or to starve yourself prior to the op – check this with the urologist after arriving at the hospital and changing into the sterile clothing you are walked into the theatre – in quite a dignified way, really – and told to lie on the table. You then basically stare at the ceiling for half an hour.
Everything is thoroughly washed and you are draped with surgical towels. A tiny, and I mean really tiny (about 12 millimeters long), cut is made in the scrotum just below the base of the penis.The vas deferens (the tube connected the testes to the urethra) is tied off and a small section cut out. A single, self-dissolving stitch is put in the scrotum and you walk out again. It is your choice as to the wisdom of engaging in idle chitchat with the surgeon and nurses during the procedure. By and large the procedure is probably less distressing than a dental filling.
After the procedure it can get a little painful for a day or two, but most people experience only a slight discomfort. A very small proportion have some bleeding into the scrotum and have a more serious pain – described as being somewhat like the sensation of being kicked in the gonads by a horse. Fortunately this lasts only a day or two. Playing active sport is not advisable for 48 hours after the procedure.
Additional contraception is required for at least three months after the procedure. At three months a semen sample is examined for evidence of new active sperm. If none are present the all-clear is given and that is it. Producing the semen sample is either the most difficult or the most fun part of the whole procedure – it depends on how you look at it.
No change in sex drive There is no change in sex drive or ability to have sex, there is no change in the volume of the ejaculate, no increased risk of cancer or other diseases and vasectomy does not result in a squeaky voice.
Vasectomy is a really simple and safe procedure. I can think of very few reasons why women should be subjected to the bigger, and relatively more dangerous, equivalent procedure when such a simple and safe procedure is available to men. Unless of course it is just good old-fashioned sexism.
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