Male vasectomy is a permanent method of conception and highly effective. It is usually chosen by couple who are sure they have completed their families.Vasectomy involves the division of the vas deferens on each side to prevent the release of sperm during ejaculation. It is technically an easier and quicker procedure than female sterilization and is usually performed under local anaesthesia.
Vasectomy differs from female sterilization in that it is not effective immediately. Sperm will still be present higher in the genital tract and azoospermia is therefore achieved more quickly if there is frequent ejaculation. Men should be advised to hand in two samples of semen at 12 and 16 weeks to see if any sperm are still present. If two consecutive samples are free of sperm, the vasectomy can be considered complete. An alternative form of contraception must be used until that time.
Immediate complications such as bleeding,wound infection and haematoma may occur. Occasionally, small lumps may appear at the cut end of the vas as a result of local inflammatory response. These so called ‘sperm granuloma ‘ may need surgical excision. Some men will develop anti-sperm antibodies following vasectomy. These do not cause symptoms but if vasectomy is reversed,pregnancy may not occur because the antibodies inactivate sperm. Chronic scrotal pain following a vasectomy is uncommon -one third of men will have pain at 12weeks post -vasectomy,but only 6-8% of men will still complain of significant discomfort at the end of a year.
Over the years, a possible association between vasectomy and the development of both prostrate and testicular cancers has been raised and received wide spread media interest. In practice, there is insufficient evidence to support any association.
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