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Updated 20 May 2014

Shortcut to the future

A vasectomy is the most grown-up thing a man can do. Here’s the honest account on the pros and cons of the “snip”, as experienced and written by a medical journalist.

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A vasectomy is the most grown-up thing a man can do. Here’s the honest account on the pros and cons of the “snip”, as experienced and written by a medical journalist.

You don’t sow wild oats. You’re not in the habit of making babies on a whim or anywhere else. You’re in a long-term relationship and are acutely aware of how much time and money even one child takes.

Your partner dislikes using the pill. Neither of you are wild about using condoms. You don’t want any more kids, but are looking for safe, healthy contraception methods.

Many South African men feel as you do, but just as many are reluctant to accept real responsibility for contraception.

Yes, a pill for men is on the way. But it won’t be ready next month, or even next year, during which time you hope to get up close and personal with your partner at least once.

A few years ago, most men would have considered it inconceivable to be sterilised. The word carried images of asexual beings, robbed of their gender through some hormonal sabotage, reduced to pale androgyny, rather like David Bowie in the early ‘70s.

Not so. A short, simple, safe and painless procedure enables you to retain your bull-like masculinity, while eliminating the risk of making babies. Vasectomy is becoming a popular choice for many South African men – approximately 1 000 vasectomies are done in the Western Cape every year.

Consider that the alternative is spending the rest of your life with some nagging concern that you might be spawning unwanted heirs. The alternative – if you’re in a monogamous relationship – is never having to worry about protection again.

What to expect
In surgical terms the vasectomy is almost a non-event. Take the afternoon off. This will mean around half an hour in a clinic and the rest of the day to celebrate your freedom. Government hospitals do them for free if you don’t have a medical aid but they have waiting lists. And if you do have a medical aid it’s likely that they’ll pay for it.

Nowadays vasectomies are done by specialist urologists, so your GP is likely to refer you to one. They’re done under local anaesthetic, so you won’t need to spend the night in hospital or to starve yourself.

You’ll be washed down gently while staring contemplatively at the ceiling. A tiny – around one centimeter long – cut will be made in your scrotum. You won’t feel a thing.

Yes, it is painless
The vas deferens - the tubes that carry sperm from the testicles - is tied off and a small section cut out. In this way, sperm can no longer enter the seminal fluid but is rather reabsorbed into the body. One self-dissolving stitch is put in the scrotum and you walk out again.

That’s it. You’ll feel a little tender in the trouser department for a day or two, but a vasectomy involves far less pain and discomfort than having a tooth filled. An ice bag or non-aspirin painkiller will provide relief. You should avoid participation in skydiving, all-in wrestling or ice hockey for 48 hours after the procedure, but are welcome to watch any of these on TV.

For three months after the procedure you’ll be required to use some additional form of contraception, until there are no active sperm left that could result in an earnest discussion between you and your partner. You’ll be required to undergo a simple semen analysis to ensure that all is going according to plan.

What about complications?
Vasectomies are very safe. Complications are extremely rare. Those that do occur are usually associated with infection after the operation (in seven percent of cases). Warning signs include a fever, blood or pus oozing from the incision and excessive pain or swelling. Other complications include:

  • Bleeding into the skin during surgery which may cause bruising. This will get better on its own.
  • Fluid around the testes occurs in less than one out of 100 cases and generally clears up within a week.
  • Sperm leak from the tubes may cause a small lump under the skin near the site of the operation in about 18 out of 100 cases.
  • Very rarely, the cut ends of the vas deferens grow back together (recanalisation). If this happens, it is usually within four months of the operation.
  • Decreased sexual desire or inability to maintain an erection can occur in around four in 1000 cases. This is usually an emotional problem since there is no physical reason why this should happen after a vasectomy.

Who should consider a vasectomy?

  • Men who are certain that they do not want any children.
  • Men who are concerned about the side effects of other contraceptive methods.

Don’t consider a vasectomy if:

  • You may want children in the future. Vasectomy is a permanent option. Only around 16 to 19% of men with reversed vasectomies will successfully father a child.
  • Your partner does not agree.
  • You feel pressured into having it done.

Don’t underestimate the benefits to your sex life of not having to worry about an unwanted pregnancy. And if you combine a vasectomy with a smoking cessation programme, you just might discover a revived, turbo-charged sex life.

Theoretically, you could have some of your sperm frozen, so that you can make more babies after your vasectomy.

It’s a win-win situation, as the Americans say: no high-pitched voices, no sprouting of mammalian protuberances. Your legendary bull-like sexuality will remain intact, as will the volume of liquid you ejaculate and the volume of the accompanying chorus.

 
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