Thursday, 23 July 2015

VASECTOMY II: AN UNCOMMON REQUEST

After about five seconds of recollection, I began to speak. Fortunately, we had a diagram of the male urogenital system, thus, our discussion was quite illustrative.
Starting from the known, we approached the unknown.





Hanging down between the thighs of our gents is a sac called the scrotum. Inside this are two round structures, the testes. Sperm is produced in the testes and stored in the epididymis where they mature. From there, the vas deferens transports the sperm to mix with seminal fluid produced by the seminal vesicles and prostatic fluid produced by the prostate. The combination of these is known as semen and during ejaculation, semen is ejected through the urethra. Semen is the greyish abi na whitish fluid seen when the male "cums".
Vasectomy is a permanent form of male contraception. Permanent in the sense that it is not easily reversed.
It is a surgical procedure which involves the cutting of the vas deferens and sealing it in such a manner as to prevent sperm from entering the ejaculate. Thereby preventing fertilisation.
When properly done, failure rate is less than 1%(0.10% - 0.15%). It is considered a safe and effective form of contraception.
The procedure is usually performed by a urologist ( a doctor who specializes in the male urogenital system) and is carried out in the clinic with the aid of a local anaesthetic. It takes between twenty to forty-five minutes (usually less) and after observing the patient for about an hour, he is allowed to go home. In cases where the patient is uncoperative or other procedures need to done, a hospital theatre is used.
In vasectomy, the vas deferens are severed. As such, overtime, the ejaculate becomes devoid of sperm cells. The sperm produced by the testes are reabsorbed by the body and the solid component engulfed by macrophages. The procedure is minimally invasive and the male can resume sex using contraceptives within one week of the procedure.
It takes about 15-20 ejaculations or 3-5months to clear the semen of sperm cells. As such, another effective method of contraception is to be used to avoid getting the woman pregnant.
To determine azoospermia (absence of sperm cells in semen), the male is asked to ejaculate into a condom that has no spermicide or a clean container and send the sample to the laboratory within an hour of
collection for semen analysis. Two consecutive samples showing azoospermia indicate the vasectomy procedure was successful.
It is important to highlight that the vasectomy procedure does not provide any form of protection against sexually transmitted infections and as such, barrier contraceptives are encouraged.
Before a vasectomy is done, the male has to be adequately counseled to consider the long term implications of the procedure. This helps to prevent psychological and emotional complications which may arise. Candidates for vasectomy are usually men who have completed their family or who have decided never to have children.
Like every other surgical procedure, vasectomy has some attendant possible risks. These include:
Pain
Bruising of the scrotum
Bleeding
Wound site infection
Epididymitis
Sperm granuloma
Post vasectomy syndrome
Regret

Failure of the procedure is usually due to recanalization of the vas deferens and default in using another effective contraceptive prior to the period of azoospermia.
At this point, Mr Ojah breathed a deep sigh. I knew he had had quite an earful. I anticipated his next question was going to be on the reversibility of a vasectomy and I wasn't disappointed.
"Hmmm... Doctor, can vasectomies be reversed?" He asked.
"Sure they can. But this is an expensive and difficult procedure with no guarantee of success. In fact, the success rate is dependent on the interval between the vasectomy and it's reversal.The earlier the reversal, the higher the chances of success" I replied.
It is pertinent to point out that after a vasectomy there is no significant change in the amount of semen produced. Vasectomy also has no effect on testosterone production by the leydig cells of the testes. Therefore, there is no significant impact on libido, erection or orgasm.
Mr Ojah was adequately counseled and given a two-week appointment inorder to consider his decision carefully. On the appointed day, there was Mr Ojah in the waiting room. Sitting beside him was a very beautiful middle-aged woman, Mrs Ojah. He had discussed his decision with her and to his relief, she was quite supportive. As a couple they were referred to the urologist.
The procedure was successful and judging by their demeanor the last time they visited, I can almost swear their sex life had taken a turn for the ecstatic.
Wewww!!!!!
Dearies, Do Stay Safe And Live Clean With Dr Ib.
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