Vasectomy

Myths:
 
·         Cancer
·         Complications with Method
·         Effectiveness
·         Health Risks and Side Effects
·         Mechanism of Action
·         Return to Fertility
·         Sexual Functioning
·         Sexual Pleasure
 
Myth: Cancer
Some men and women incorrectly believe that vasectomy will cause cancer, such as prostate cancer or cancer of the testes.
 
Fact:
Evidence from large, well-designed studies finds that vasectomy does not increase risks of cancer of the testicles (testicular cancer) or cancer of the prostate (prostate cancer).
 
Counseling Messages:
There was some concern, some years ago, that vasectomy might be associated with an increased risk of heart disease or prostate cancer. However, studies have shown that these things are not increased by having a vasectomy. (Australia)
 
Vasectomy will not cause cancer in the testes or the prostate. Before conducting vasectomy, the doctor will examine you first, to ensure that there are no medical contraindications and no cancer in your sex organ. The World Health Organization has evidence that shows no cancer is caused by vasectomy. [Editor’s note: According to the World Health Organization, there are no medical reasons that permanently restrict a person’s eligibility for vasectomy. However, there are medical conditions that may limit when, where, or how the vasectomy procedure should be performed.] (Indonesia)
 
Unused sperm do not get rotten or eventually cause cancer. The unused sperm get absorbed by the body. Vasectomy does not cause prostate cancer; cancer of the prostate has its own causes. (Swaziland)
 
Vasectomy doesn’t have any bad consequences for your health, and it has been proven that it is a safe method. (Iran)
 
New Zealandhas a high rate of vasectomy. In 2000, a good study was done proving that men who had a vasectomy had no more prostate cancer than men who had not had a vasectomy. Here is a copy of the press release from that study for your information. Vasectomy does not cause testicular cancer, but here is some information to help you keep an eye on abnormal changes in your testicles. (Offer pamphlet about self-checking the testicles.) (New Zealand)
 
 
Myth: Complications With Method
Some men avoid vasectomy because they incorrectly believe that it is very painful or causes men to retain sperm, leading to complications.
 
Fact:
Male sterilization is a safe and simple procedure.All surgical procedures involve some risk, but the chance of serious problems is small with vasectomy. Most postoperative complications of vasectomy such as discomfort in the scrotum and swelling are minor and can be treated with cold compresses andnon-aspirin pain relievers such as ibuprofen (200–400 mg) and paracetamol (325–1000 mg). Other potential complications are generally quite rare, but include bleeding under the skin that might cause swelling or bruising (hematoma), infection at the incision site or inside the incision, and sperm granulomas. Sperm granulomas are small lumps that form when sperm leak from the vas into the surrounding tissue. All of these complications usually can be treated easily.
 
Mortality after a vasectomy operation is extremely rare. Death related to a vasectomy is avoidable if all preventive measures are taken. These include: proper infection-prevention procedures; prompt, proper postoperative management of symptoms of infection; and appropriate follow-up care for any complications.
 
Counseling Messages:
Vasectomy does not cause a hernia or any other complications. Sometimes there is discomfort in the scrotum which usually lasts for two to three days and responds to a pain reliever. It is just a minor incision at the side of the scrotum. Sperm is absorbed by the body. (Fiji)
 
Any operation has some certain degree of pain, though the severity differs. With vasectomy, it is a minor procedure with less pain that goes away after a few days when taking pain tablets. Sperm that are not ejaculated get used (absorbed) by the body, so there is no sickness that results from that. (Swaziland)
 
Usually, the most uncomfortable part of a vasectomy operation is having the local anesthetic injection–not into the testicles, but into the upper part of the scrotum under the base of the penis. Most men report that it is very similar to a dental local anesthetic. We do not want you to experience pain, so we encourage you to let us know if you feel sore during the operation and will give you more local anesthesia. The more common complications are the same as for any surgery—bleeding, discomfort, and infection. All of our methods and pre- and post-operation advice are aimed at keeping complications to a minimum. It helps if you follow the advice. Our doctor is available by phone if you have any complications, and we will give you written information about what to do. (New Zealand)
 
You will just feel the pain of injecting the anesthetic drug and not any pain during the process. After the service you may have a little pain for a few days, which will be relieved by simple analgesics. (Iran)
 
The risk of having any pain after the bruising settles is very low. (Australia)
 
It is not painful because you will be given a local anesthesia injection before the minor operation and oral analgesic to take for discomfort after the vasectomy procedure. There might be slight bruising and swelling for the first few days and you will be advised to call the clinic immediately if you encounter any problems. Normally, follow-up will be in one week. (Malaysia)
 
 
Myth: Effectiveness
Some men and women incorrectly believe that vasectomy protects against pregnancy immediately after the procedure, not knowing they need to use condoms for the first three months.
 
Fact:
While vasectomy is one of the safest and most effective forms of contraception, it is not immediately effective because sperm survive in the man’s reproductive tract for a little while after the procedure. A man must wait three months (12 weeks) before it is fully effective. During this time, he can resume sexual activity, but he and his partner will need to use additional contraceptive protection such as condoms or another effective family planning method. A semen examination is recommended at any time after three months following the procedure, but is not essential. The previously recommended alternative, to wait for 20 ejaculations, has proved less reliable than waiting three months and is therefore no longer recommended.
 
Counseling Messages:
You have to take precaution for three months by either using condoms or having your wife use another effective method such as oral contraceptive pills. This is because sperm may still be present and active in the portion of the duct below the ligation. The sperm stored earlier in the reservoir would still be alive for the next three months, so even after vasectomy, during subsequent ejaculation, the sperm can be found in the seminal fluid for up to three months. (Malaysia)
 
No-scalpel vasectomy (NSV) [and conventional vasectomy procedure]cannot protect your wife against pregnancy immediately after receiving the services. You or your wife should use a reliable method for three months after the procedure and return for a sperm analysis any time after three months if possible. Otherwise you may face unwanted pregnancy. (Iran)
 
Sperm remains present in the vas [the tubes that carry sperm from the testes to the penis], distal to the ligation, and will come with initial ejaculations. So, it is appropriate to use a barrier method like condoms [or another effective family planning method] for at least three months. (India)
 
There is need to use a condom, or other effective means of contraception, for the first three months after the procedure before you can be sure that no pregnancy will occur. The reason is that some sperm [may be] still viable along the tube that transports them. (Swaziland)
 
You have to use another kind of contraception, such as condoms, pills or injectables, to avoid pregnancy until sperm is not present in the ejaculate. It will take three months. (Indonesia)
 
Sperm are generated in the testicle and continuously make their way up the vas [the tubes that carry sperm from the testes to the penis] to be picked up with the seminal fluid at ejaculation. You will have to use condoms or another effective family planning method for three months after the procedure. (New Zealand)
 
Use condoms, or another effective family planning method, after the procedure for three months. A semen analysis is recommended at any time after three months following the procedure, but is not essential. (Barbados)
 
Vasectomy can prevent the emission of new active sperm immediately after the procedure, but fertilization can take place with old retained sperm. (Myanmar)
 
 
Myth: Health Risks and Side Effects
Some men and women have misconceptions about vasectomy causing health risks or side effects, such as impairment of their physical and mental health or causing backaches, weight gain, hair loss, or weakness.
 
Fact:
After vasectomy, a man will look and feel the same as before. The operation will not cause the man to lose strength, so he can work as hard as before. It will not cause weight gain or hair loss, nor will it impair mental functioning.
 
Some men may feel a little uncomfortable about ending the part of their life involved with creating a family. They may feel that they are getting older. These feelings usually pass in time, as men go on to the next stage of life. On the other hand, some men feel relieved that the worry about pregnancy is over. They feel freer and more spontaneous.
 
Counseling Messages:
Sperm that are not ejaculated get used (absorbed) by the body, so there is no sickness that results from that. Illnesses such as asthma and heart disease have their own causes, which are not related to vasectomy. (Swaziland)
 
Vasectomy is safe and does not cause such problems. Many such clients are enjoying their life after their operation. (India)
 
Vasectomy is a safe method of family planning. A man experiences no permanent side effects as a result of undergoing a vasectomy (United States).
 
If a client believes that it will cause weakness, mainly sexual, I always tell the client that it is safe and does not cause such problems. Many such clients are enjoying their life after operation. (India)
 
 
Myth: Mechanism of Action
Some men and women have misconceptions on how vasectomy prevents pregnancy and how vasectomy is performed.
 
Fact:
Vasectomy is a simple and very safe operation in which each vas deferens (the tubes which carry sperm from the testicles to the penis) is either blocked or cut so that sperm cannot enter semen. This is usually done under local anesthesia. It does not involve removal of the testicles or amputation of the penis.
 
During a vasectomy procedure, the man receives an injection of local anesthetic in his scrotum to prevent pain. He stays awake throughout the procedure. Using the no-scalpel procedure, the provider grasps the tube with specially designed forceps and makes a tiny puncture in the skin of the scrotum with a special surgical instrument. The provider lifts out a small loop of each vas from the puncture. The provider will then cut each tube and tie one or both ends closed with thread or close off the tubes by applying heat or electricity. They may also enclose one end of the vas in the thin layer of tissue that surrounds the vas. The puncture is covered with an adhesive bandage, or the incision may be closed with stitches. The man receives instructions on what to do after he leaves the clinic or hospital.
 
With the conventional vasectomy technique, still practiced in many places, the provider makes one or two small incisions in the skin of the scrotum with a scalpel. After the tubes are tied or cut, the incision is closed with stitches.
 
Both no-scalpel and conventional incision procedures are quick, safe, and effective. No-scalpel vasectomy is less traumatic than standard vasectomy and reduces the risk of hematoma, however. Service providers, even those experienced in standard vasectomy, must obtain training before using the no-scalpel technique.
 
Counseling Messages:
Vasectomy is a surgical procedure that blocks the vas deferens [the tubes that carry sperm from the testes to the penis] on both sides, which prevents the sperm from entering the semen. Semen is ejaculated during intercourse, but it cannot cause pregnancy. The penis and testes remain intact and function perfectly normal. Sperm are formed in the testes, which remain untouched. (Tell patients about the normal structure and function of reproductive organs.) (India)
 
Vasectomy is not similar to castration, and the procedure of vasectomy is not to amputate or mutilate the male genitals. The doctor will cut or occlude only the vas deferens or sperm canals [the tubes that carry sperm from the testes to the penis], which prevents the sperm from being released into the ejaculate.
(Indonesia)
 
Vasectomy is a simple method to help men who do not want to have more children. A trained or skilled doctor just occludes or cuts your vas deferens [the tubes that carry sperm from the testes to the penis] with a simple technique, not taking more than 15 minutes. (Indonesia)
 
Using the male reproductive model, explain that by tying the vas deferens tubes [the tubes that carry sperm from the testes to the penis] the sperm will not be able to travel to the seminal vesicle (reservoir). After vasectomy, men will still experience ejaculation of seminal fluid during sexual stimulation or intercourse without a reduction of volume, just minus the sperm. (Malaysia)
 
What happens during this minor operation is that only the tubes that transport the sperm from the testes to the penis are cut. The man continues to have sexual feelings and is able to have an erection and enjoy sex as normal. (Swaziland)
 
Vasectomy does not prevent the production of ejaculatory fluid or sperm. It does stop transmission of sperm from the man to the woman. [Editor’s Note: See Fact for an explanation of the vasectomy procedure.] (Fiji)
 
Ejaculation and orgasm will not change, but the ejaculatory fluid will not contain any sperm. Vasectomy only prevents the sperm from blending with the ejaculate. (Tell the client about the difference between ejaculate fluid and sperm.) (Denmark)
 
The castration process is completely different from vasectomy. With vasectomy, you will ejaculate as before. You cannot feel any difference compared with before the vasectomy period. (Provide client with a picture to show the mechanism of vasectomy.) (Iran)
 
Some men think the ejaculate will be absent after a vasectomy. We reassure them by saying “the river will still flow, but there will be no fish in it.” (Ireland)
 
 
Myth: Return to Fertility
Some men and women incorrectly believe that vasectomy can be easily reversed to allow men to become fertile again.
 
Fact:
Vasectomy is intended to be permanent. People who may want more children should choose a different family planning method. Surgery to reverse vasectomy is possible for only some men and reversal often does not lead to pregnancy. The procedure is difficult and expensive, and providers who are able to perform reversal surgeries are hard to find. Thus, vasectomy should be considered irreversible.
 
Counseling Messages:
While there have been some men who have had a vasectomy successfully reversed, it is not usually very successful. If you think there is any chance that you might want children in the future, I would advise you not to have a vasectomy. It is also very expensive to have it reversed, as Medicare (the health insurance system) does not pay for reversal operations. (Australia)
 
Vasectomy is a permanent contraceptive method. Once you have decided to have a vasectomy you are not expected to have your fertility back. Even though there is a method to re-connect the vas deferens [the tubes that carry sperm from the testes to the penis], it is not easy to reverse your fertility. (Indonesia)
Vasectomy should be considered a permanent method. Reversal surgery is a major operation and is expensive. The chances that it will be successful are very slim. (Singapore)
 
We would like you to approach this operation with the view that you are going to be permanently sterilized. As a man you need to be happy with that. Operations can be reversed, but it is expensive and not always successful. (New Zealand)
 
Having a vasectomy is a permanent method of contraception. (Barbados)
 
 
Myth: Sexual Functioning
Some men and women incorrectly believe that vasectomy impairs sexual functioning by causing impotence, delaying or inhibiting ejaculation, causing the testicles to shrink, or inhibiting men from reaching sexual climax.
 
Fact:
Vasectomy does not affect the sexual drive, nor does it affect a man's ability to get an erection, have sex, or ejaculate.
 
Counseling Messages:
Vasectomy will not impair your sexual function. You still have your sex drive and your sex climax; not a part of your sexual organ will change. It only occludes or blocks your vas deferens [the tubes that carry sperm from the testes to the penis] to keep the sperm from going into the ejaculate, and your sex hormone is still active. (Indonesia)
 
Vasectomy will be done by a qualified and experienced officer and is very unlikely to cause impotency or inability to achieve sexual climax. There will be no changes in sexual desire or function as the man will still produce male hormones as before. (Malaysia)
 
Once any discomfort has settled, which can cause discomfort during sex, there is no impact on sexual function, and your hormones are still produced normally. (Australia)
 
Sexual function will not change. The only difference is that the semen will not contain sperm. (Singapore)
 
Vasectomy is popular in New Zealand. It is a minor operation that in no way affects sexual function, except to take away the fear of pregnancy. Male hormones are not affected. If it affected sexual function even in the most minor negative way, it would not be popular. (New Zealand)
 
Vasectomy doesn’t have any effect in your sexual activities and nothing ill happens in your external genitalia. (Iran)
 
The erection remains the same as it was before the operation. Sexual desire also remains the same. There is no change at all. (Fiji)
 
Some people believe that vasectomy causes impotence or reduces sexual drive. Sexual drive is reduced with aging, chronic diseases (e.g. diabetes) or other psychological problems (e.g. stress). For some men, tubal ligation or vasectomy improves sexual life.
 
Vasectomy never causes impotence because no blood vessels are interfered with. For some people sex becomes even more powerful than ever. (Swaziland)
 
 
Myth: Sexual Pleasure
Some men and women incorrectly believe that vasectomy reduces sexual pleasure because it causes men to lose their sex drive.
 
Fact:
Vasectomy does not change sexual drive. Erections and climaxes will be the same for men after the procedure. The procedure does not affect sexual enjoyment or satisfaction as sexual functioning is not impaired in any way. Some men say that without the worry of accidental pregnancy and the bother of other family planning methods, they and their partners find sex more pleasurable and spontaneous.
 
Counseling Messages:
Vasectomy does not reduce your sexual pleasure, and it also does not cause men to lose their sex drive. Your sex hormone is still produced in your testes, and the testes are not removed by vasectomy. (Indonesia)
 
Vasectomy only involves removing part of the ducts that carry semen. It does not affect penile erection or ejaculation and therefore does not reduce sexual pleasure. Many couples enjoy sexual pleasure more than before as they do not have to worry about unwanted pregnancy or using family planning methods like barrier methods, spermicides, or coitus interruptus [withdrawal]. (Malaysia)
 
No, it never causes loss of libido, but instead makes men perform much better because they are relaxed and have no fear of possible pregnancy. (Swaziland)
 
Once in a while a man might have sexual problems after the operation, but this is emotional because of physical changes. However, these feelings usually will come to pass. (Singapore)
 
It does stop sperm from traveling from man to woman, but sexual pleasure has no change. (Fiji)
 
Vasectomy does not cause any such problems as most people think. Rather, sexuality increases because there is no fear of causing pregnancy. (India)
 
There will be no change in orgasm. (Denmark)
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