Vasectomy (Male Sterilisation)

Introduction to Vasectomy (Male Sterilisation)

Vasectomy (male sterilisation) is a permanent male contraceptive method, which is a simple, short and safe surgical procedure.
It is carried out by trained surgeons usually under local anaesthesia after careful counselling and informed consent.
Vasectomy is the most effective male family planning method.
Involving males in issues of reproductive health and family planning has several benefits with a positive impact on society.
Vasectomy should be encouraged for appropriate clients. It is less invasive and simpler than female sterilisation.
Reversal of vasectomy is a difficult surgery using loupes/microscope with success rate of 60-80% if done in less than 3 years after vasectomy

Misconceptions about Vasectomy

  • Vasectomy is ligation of the vas deferens and not castration.
  • It does not affect erection
  • It does not affect ejaculation and orgasm. There would be normal ejaculation but the semen does not contain spermatozoa
  • Vasectomy does not work immediately. A back-up method of contraception is necessary for up to 20 ejaculations, 3 months after the procedure or until examination of semen shows no sperm
  • After vasectomy males will still require the use of condoms to prevent sexually transmitted infections including HIV-AIDS

Effectiveness rates of various male contraceptive methods:

Evidence Rating: [B]

  • Vasectomy – 99.85%
  • Male condom – 86%
  • Withdrawal method -81%

Preoperative requirements for casectomy

  • Detailed counselling (ideally both partners must be present) and informed consent
  • Counselling should mention irreversibility of procedure, possible recanalization and risk of chronic scrotal pain postoperative.
  • Medical history
  • Physical examination
  • Laboratory investigations e.g. Hb, sickling, urinalysis
  • Histopathology confirmation of the removed segment of vas deferens may be necessary for medicolegal reasons.

Referral Criteria

Clients should be referred to a Family Planning Unit or Urologist for the procedure.