WOMEN: MALE STERILISATION. VASECTOMY
This is vasectomy, in which the tube that carries sperm from the testis into the semen – the vas deferens – is cut and tied in the scrotum.
It wasn’t until the invention of the microscope in the late eighteenth century that sperm were seen in semen and identified as the male contribution to pregnancy. At this time sperm were thought to be miniature men, and one scientist of the time even claimed to have seen microscopic horses cantering through semen! The first human vasectomy was performed in England in 1893, but for treatment of a prostate disorder rather than sterilisation. Over the next few decades die operation became disreputable because it was used involuntarily to treat sex offenders, to prevent masturbation and for eugenic purposes. Voluntary vasectomy as a method of birth control didn’t become established until after the Second World War, and even then there were doubts about its legality in some countries. The first nationally promoted vasectomy programme began in India in 1956, but acceptance of male sterilisation worldwide was slow until the 1970s and it is still forbidden by some nations and religions.
How vasectomy is done
A small incision is made in the centre font of the scrotum after injecting a small amount of anaesthetic (some surgeons use an incision on each side). The vas from each side is brought through the opening, cut, folded back on itself and tied. Many surgeons also cauterise the cut end. Each bid is then buried in the tissue beneath the skin. The incision rarely needs a stitch; a small dressing is usually enough. The procedure takes 30 minutes or less and most men say it causes little or no discomfort. Afterwards there may be discomfort, swelling and bruising of the scrotum that usually settle in a week or so. A scrotal support or firm-fitting underpants should be worn until the scrotum returns to normal. Usual activities can be resumed the next day (including sex if the man feels like it), though heavy exertion should be avoided for about a week.
Vasectomy doesn’t immediately result in sterility.
The long spermatic ducts between the site of vasectomy and the prostate are full of sperm-containing semen at the time of the procedure. It takes about 15-20 ejaculations to clear out all these sperm. Couples are advised to continue their usual method of contraception until semen examination has shown that all sperm have disappeared. The first test is usually done two months after vasectomy (or after 15 ejaculations, whichever is sooner), when more than 95 per cent will have zero sperm counts. If any sperm are seen, the check is repeated four weeks later. Checking picks up failure in the operation before there’s any risk of pregnancy.
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