The Tribune

By DR GREGGORY PINTO

Vasectomies are the subject of many unfounded myths and plagued by numerous negative connotations. Many Bahamian men, like men everywhere, have a fear of the unknown regarding vasectomies.

All children are a blessing, but once you have completed your wanted complement of children, give the children that you have the best without the financial strain and emotional burden of an unplanned child.

Studies have estimated that raising a child to the age of 18 years old in the United States can cost $233,000. The Bahamas has been declared to be the seventh most expensive country in the world to live. So the cost of an unplanned child or children can financially cripple and potentially emotionally devastate a Bahamian family.

Do not have your life, the life of your spouse and those of the children, profoundly affected by an unplanned pregnancy.

The reality is that vasectomies are a quick and highly effective method for family planning. It is reversible, but the procedure should not be undertaken with potentially reversing the procedure in mind.

The vasectomy procedure is minimally invasive and scalpel free, and done as an outpatient procedure in about ten to 15 minutes.

Vasectomy reversals are far more involved. often lengthy procedures that may require the use of a surgical microscope. The success of vasectomy reversals is much higher if done within two years and the success rate is low if done after five years post-procedure.

Vasectomies may be done under local anaesthesia, with or without conscious sedation, or under general anaesthesia. There is minimal to no recovery period and many men often elect to have their vasectomies during an extended lunch break and then go back to work.

Let us address the many myths and misconceptions regarding vasectomies:

1. It is a falsehood that men no longer produce sperm after vasectomies. Men continue to produce sperm after vasectomies; with sperm, a protein, ending up at the end of the tied off vas deferens tubes, where it is simply and harmlessly reabsorbed by the body.
2. Men do not have ejaculate fluid released after vasectomies. Completely untrue. Some 98 percent of the ejaculate is still released after vasectomies. Ejaculate fluid is contributed by four body structures: the testes, the seminal vesicles and the prostate gland and bulbourethral glands. The two percent of the ejaculate fluid containing the sperm is the only component that is no longer present after vasectomies. Men will not notice any change in their ejaculate fluid volume.
3. Female tubal ligation is more or just as effective as a vasectomy. Tubal ligation is far more invasive than a vasectomy and the success rate for tubal ligation is inferior. Vasectomies can be done in approximately ten minutes without the use of a scalpel, as a minimally invasive outpatient procedure. The success rate of vasectomies approaches 100 percent.
4. Vasectomies can negatively affect erectile function and sexual libido. Men experience no difference in sexual prowess or interest or function after vasectomies. The intensity and euphoria of the orgasm is the same after the procedure. Men often actually experience more pleasurable sexual encounters after vasectomies as there is no potential stress related to possible unwanted pregnancy.
5. It is a completely untrue, baseless falsehood that vasectomies can increase a man's risk of prostate cancer or testicular cancer. There is absolutely no truth to this. There are no ill health affects associated with a minimally invasive vasectomy.

The vasectomy procedure step by step:

Men arrive for the quick outpatient vasectomy procedure.

A warm water bottle is often given to the patient to comfortably place for a few minutes on his scrotum to make the vas deferens tubes more prominent and easily felt.

Men are then given a prophylactic antibiotic. There is a choice of local anaesthesia, or local anaesthesia with conscious sedation, or general anaesthesia.

The vas deferens tubes are felt on both sides of the scrotum and brought to the scrotal skin and without the use of a scalpel. A small opening is created in the scrotal skin with gentle instrument pressure. The vas deferens have a segment removed, and both ends are tied off and buried in tissue. The small opening on both sides of the scrotum it usually so small that no suture is required to close it.

The procedure takes ten to 15 minutes. There is minimal recovery required and most men return to their normal routine afterwards. Sperm analysis is done post-vasectomy before the "all clear" is given to proceed without birth control.

Vasectomies are the most effective method of birth control available, other than abstinence. However, they do not prevent the transmission of HIV and other sexually transmitted diseases.

Bahamian men, don't let fear of the unknown prevent you from having a vasectomy. You will be the same man before and after the procedure. Allow your wife to be free of birth control pills or monthly injections that have numerous potential negative health affects.

Fear of unplanned pregnancies does not need to be a constant reality of your existence.

Scalpel-free, minimally invasive, quick, modern vasectomy procedures are readily available locally, and performed in a confidential and compassionate environment.

• Dr Greggory Pinto is a board-certified Bahamian urologist and laparoscopic surgeon trained in South Africa, Germany, and France. He can be reached at Urology Care Bahamas at the Surgical Suite, Centreville Medical Centre, #68 Collins Avenue/Sixth Terrace, Nassau. Call (242) 326-1929, e-mail welcome@urologycarebahamas.com, or visit the website www.urologycarebahamas.com.