Time for a va­sec­tomy?

Sharon Ní Chonchúir finds that un­der­stand­ing of va­sec­tomies is lack­ing — one in ten men think the pro­ce­dure in­volves the re­moval of their tes­ti­cles

Irish Examiner - Feelgood - - Feature - irish­life­health.ie ■

MIL­LIONS of us take the pill, use con­doms, or in­trauter­ine de­vices such as the coil. But how many have con­sid­ered the more per­ma­nent so­lu­tion of va­sec­tomy?

Ac­cord­ing to re­search car­ried out by Ir­ish Life Health in Jan­uary, 8% of Ir­ish men have al­ready un­der­gone va­sec­tomies while a fur­ther 28% would con­sider hav­ing the pro­ce­dure at some point in the fu­ture.

“8% is about av­er­age by in­ter­na­tional stan­dards but that fig­ure could be higher,” says Dr Philip Kieran from RTÉ’sYou Should Re­ally See a Doc­tor.

“The tra­di­tional view is that women look af­ter con­tra­cep­tion but men could take on more of that re­spon­si­bil­ity and there comes a point in most long-term re­la­tion­ships where this can hap­pen.”

The Ir­ish Life Health re­search shows that this time seems to be when a man is 40 years old and al­ready has two chil­dren.

“On av­er­age, this is when they de­cide they have had enough chil­dren and are happy to take re­spon­si­bil­ity for con­tra­cep­tion,” says Dr Kieran.

Fol­low­ing a suc­cess­ful va­sec­tomy, there is a one-in-3,000 chance of a preg­nancy, which makes it the most ef­fec­tive form of con­tra­cep­tion cur­rently avail­able. So why are so few men get­ting va­sec­tomies?

The re­search shows sev­eral rea­sons for this. Some 21% think it’s too per­ma­nent, 19% fear it would af­fect their sex lives, 27% sim­ply don’t un­der­stand what’s in­volved, and 10% think the pro­ce­dure in­volves the re­moval of their tes­ti­cles.

“It’s no wonder there is such a low rate of va­sec­tomy if one in ten men be­lieve it means re­moval of a part of their anatomy,” says Dr Kieran. “We need to dis­pel some of these myths.”

Va­sec­tomy is a mi­nor sur­gi­cal pro­ce­dure, which in­volves a small cut be­ing made in the tube that car­ries sperm from the tes­ti­cles to the pe­nis. That cut is then sealed. This is all car­ried out under a lo­cal anaes­thetic and is over within 15-30 min­utes.

The pro­ce­dure is usu­ally car­ried out in a GP’s of­fice. “It used to be done by urol­o­gists but now trained GPs can do it,” says Dr Kieran. “Men are in and out in a mat­ter of min­utes.”

The idea of the pain in­volved is an­other fac­tor that puts men off hav­ing a va­sec­tomy. “There’s a min­i­mal amount of pain and it’s more dis­com­fort. The vast ma­jor­ity of men are back to nor­mal within 24 to 48 hours.”

Cost shouldn’t be a de­ter­rent ei­ther. The av­er­age cost of the pro­ce­dure is €400 to €600, which com­pares well with the long-term costs of other con­tra­cep­tive meth­ods.

One in five of the men in­ter­viewed by Ir­ish Life Health wor­ried that a va­sec­tomy would have a neg­a­tive im­pact on their viril­ity. Dr Kieran re­as­sures them that this is not the case.

won’t have any ef­fect on your li­bido or your abil­ity to ejac­u­late or main­tain an erec­tion. The ev­i­dence ac­tu­ally shows the op­po­site. All a va­sec­tomy does is stop the sperm from leav­ing the body and see­ing as sperm makes up less than 1% of what a man ejac­u­lates, you shouldn’t no­tice any dif­fer­ence at all.”

In fact, ac­cord­ing to the Eval­u­a­tion of Male Sex­ual Sat­is­fac­tion af­ter Va­sec­tomy study pub­lished in 2010, most men re­port an in­crease in their sex drive as they no longer need to worry about con­tra­cep­tion.

An­other 2010 study looked at 3,390 Aus­tralian men and found that men who had un­der­gone va­sec­tomies were just as sex­u­ally sat­is­fied as men who had not.

In the past, it was claimed that hav­ing a va­sec­tomy in­creased the risk of prostate can­cer. This has also been dis­proven.

A to­tal of 84,753 men from the Euro­pean Prospec­tive In­ves­ti­ga­tion into Can­cer and Nu­tri­tion pro­vided in­for­ma­tion on va­sec­tomy sta­tus and were fol­lowed for 15 years. It found that there was no el­e­vated risk for prostate can­cer in men who had un­der­gone va­sec­tomies com­pared with men who had not.

The only valid rea­son that should pre­vent a man from hav­ing a va­sec­tomy is the pro­ce­dure’s per­ma­nence. “They can be re­versed in the­ory, but the ac­tual suc­cess rates are very low, be“It tween 10% and 19%,” says Dr Kieran. “I tell my clients to con­sider it per­ma­nent. If they have any doubts about whether they have enough chil­dren or whether they might want to have more chil­dren with an­other part­ner in the fu­ture, then a va­sec­tomy is not for them.”

Va­sec­tomies were a pop­u­lar form of con­tra­cep­tion 20 years ago when a cou­ple de­cided their fam­ily was com­plete. “It’s hard to know what has hap­pened to make va­sec­tomies fall out of fash­ion in the mean­time,” says Dr Kieran. “But when you think about it, we didn’t dis­cuss any of this 40 years ago and 20 years ago there was prob­a­bly some­thing of a re­bound ef­fect in that we were just be­gin­ning to dis­cuss sex­ual and con­tra­cep­tive mat­ters. A va­sec­tomy was also a newer pro­ce­dure then. It’s slipped off peo­ple’s radars in the years since then, which is why 62% of Ir­ish men now say there is a low aware­ness of it in Ire­land.”

Dr Kieran be­lieves it’s im­por­tant peo­ple know how quick and easy get­ting a va­sec­tomy can be and how ef­fec­tive it is as a form of con­tra­cep­tion. “Men need to be en­cour­aged to talk about this stuff. A va­sec­tomy could be a good op­tion for a lot of men out there, if only they un­der­stood more about the pro­ce­dure.”

Pic­ture: Ja­son Clarke

NIP TUCK: Dr Phi Kieran at the launch of Ir­ish Life Health’s va­sec­tomy aware­ness cam­paign, in The Grafton Bar­ber, Arnotts depart­ment store, along­side bar­ber Stephen Power.

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