Contraception: male sterilisation
What is male sterilisation?
Male sterilisation, or vasectomy, is a form of surgical contraception that involves cutting and tying the 2 tubes (each called a vas deferens), that carry sperm from the testes (testicles) to the penis.
How does it work?
A vasectomy works by preventing the sperm from entering the seminal fluid (semen). Semen is produced in the seminal vesicles and prostate, which are unaffected by a vasectomy. The amount of seminal fluid is not affected, as sperm account for only 2-5 per cent of ejaculated fluid. The sperm, which are still produced by the testicles but can’t travel along each of the tied vas deferens, are reabsorbed by the body.
How effective is it?
Male sterilisation is greater than 99 per cent effective at preventing pregnancy. It should be regarded as a permanent form of contraception, as it is difficult to reverse the surgical procedure, and couples where the man has had a reversal of his vasectomy have a success rate of pregnancy of only 45-60 per cent.
What are the advantages?
Some of the advantages of male sterilisation are that:
- it is reliable and permanent;
- it does not interfere with erection, sexual potency, hormone production or ejaculation;
- it does not interfere with spontaneity of sex;
- it is a quick and simple procedure; and
- there should be no long-term side effects.
What are the disadvantages?
Some of the disadvantages of male sterilisation include the following.
- It is not effective immediately, and may take 2-3 months (or 16-20 ejaculations) before all sperm have been cleared from each vas deferens.
- There may be short-term discomfort such as pain, bruising or swelling following the procedure.
- There may be complications such as bleeding, infection or an inflammatory reaction to sperm leakage.
- In about one in 100 to one in 500 cases the tubes may reopen and the man may become fertile again — however, the operation can be repeated.
- It is difficult to reverse.
How is it done?
Vasectomy is a minor surgical procedure that can be carried out under local anaesthetic by specially trained general practitioners, urologists or family planning clinics. The surgeon makes a tiny incision on each side of the scrotum, and then cuts and ties both vas deferentia off. The procedure takes less than 30 minutes.
A couple of months after the operation, the man should give a semen sample which is tested to see if sperm are still present.
Last Reviewed: 27 May 2009
