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Vasectomy is the voluntary surgical procedure for permanently terminating fertility in men.
Methods
Incisional (1 or 2 small incisions)
No-scalpel technique (NSV) (preferred method)
Mechanisms of Action
By blocking the vas deferens (ejaculatory duct), sperm are not present in the ejaculate.
Benefits
Contraceptive
- Highly effective (0.1–0.15 pregnancies per 100 women during the first year of use)
- Permanent
- Does not affect breastfeeding
- Does not interfere with intercourse
- Good for couples if pregnancy or tubal occlusion would pose a serious health risk to the woman
- Simple surgery done under local anesthesia
- No long-term side effects
- No change in sexual function (no effect on hormone production by the testes)
Limitations
- Must be considered permanent (not reversible)
- May be regretted later
- Delayed effectiveness (requires up to 3 months or 20 ejaculations)
- Risks and side effects of minor surgery, especially if general anesthesia is used
- Short-term discomfort/pain following procedure
- Requires trained physician
- Does not protect against STDs (e.g., HBV, HIV/AIDS)
Clients Issues
- The client has the right to change his mind anytime prior to the procedure.
- No incentives should be given to clients to accept VS.
- A standard consent form must be signed by the client before the procedure.
- Spousal consent is not mandatory.
- In mobile VS programs, counseling and followup should be the same as at fixed sites and all recommended infection prevention practices should be followed.
Who Can Use Vasectomies
- Men of any reproductive age (usually less than or equal to 50)
- Men who want a highly effective, permanent contraceptive method
- Men whose wives have age, parity or health problems that might pose a serious health risk if they become pregnant
- Men who understand and voluntarily consent to the procedure
- Couples who are certain they have achieved their desired family size
Conditions Requiring Precautions
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CONDITION
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RECOMMENDATION
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Single and/or with no living children
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Counsel very carefully and allow additional time to make an informed decision.
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Symptomatic heart disease or clotting disorders, diabetes mellitus, severe anemia
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Clients with significant medical problems may need special surgical and followup management. This procedure may need to be done in a high-level facility, and not in an ambulatory facility. Significant medical problems should be controlled before surgery.
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GTI/Orchitis
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Treat before the procedure.
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Local skin or scrotal infection
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Delay procedure until infection is resolved.
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Other problems: Large varicocele, inguinal hernia, filariasis, scar tissue, previous scrotal surgery, intrascrotal mass, undescended testes and proven fertility, cryptor-chidism (if bilateral and proven fertility), AIDS-related disease
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With any of these conditions, the procedure must be performed by a provider with extensive experience and skill in performing vasectomy.
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(Read More About Vasectomy Below)
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