As men bear an increasing responsibility for contraception, vasectomy is becoming more popular. Like female contraceptives, the operation has some disturbing side effects.
Research into methods of birth control has for a long time been directed at women; finding methods of preventing the male sperm from fertilizing the female egg.
The only generally available contraceptive for men has been the sheath or condom, but it is not totally reliable.
Much has been written about the prospect of a male Pill, but the only form of contraception currently available to men, other than mechanical devices, is a surgical operation known as vasectomy.
In the operation, a narrow canal called the vas deferens – which transports male seminal fluid from the testes, where it is produced, to seminal vesicles or storage chambers – is blocked off.
The canal may be blocked by simply cutting and tying. Bul some surgeons believe that a segment of the canal – between a half and one centimeter – should actually be removed, and each remaining end closed with ligatures.
This precaution virtually eliminates the already tiny risk of the tubes spontaneously rejoining and restoring potency.
The first sign that this has happened maybe when the female partner becomes pregnant. The domestic and psychological trauma resulting, when it was believed that the male was sterile, would be enormous.
Physically, the operation is minor. The Medical Journal of Australia recently published a description:
The incision is a small and superficial one in the loose skin near the top of the scrotum, an area with such an excellent blood supply that all trace of the scar soon disappears.
It added: “The patient may need to know that the most uncomfortable aspect of the operation is usually the shaving of the pubic hair beforehand. A small percentage of patients have some testicular pain after the operation, but this is usually very mild.”
“In Sydney, the operation is usually done in a hospital or family planning clinic, without an overnight stay.”
Acceptance of vasectomy has grown strongly over the past few years. The Journal of the American Medical Association claimed “there are four million American men with vasectomies.”
Vasectomy removes from a woman the burden. While the Pill is nearly 100 percent reliable if taken as prescribed, and is reversible, there are definite and well-documented medical risks involved.
These range from tumors of the liver (which become cancerous in some women), irreversible blood pressure problems, and blood clots (though this danger has largely been removed with new formulations of the Pill) to depression and loss of libido as well as many other relatively minor effects.
But vasectomy has some problems too. First, it is not an instant contraceptive. It may take months for the man’s seminal vesicles to become free of active sperm. No new sperm can get past the blocked canal, but ones already produced and stored beyond the canal can take a long time to disappear.
The British Medical Journal has quoted figures from a series of tests. They indicate that 40 percent of vasectomy patients still had some sperm in seminal fluid 6 months after the operation. Even after 12 months, 3 percent of cases still showed the presence of sperm.
But perhaps even more important than the physical problems involved in vasectomy are the psychological ones.
In an effort to discover symptoms following a vasectomy, Dr. F. J. Zeigler and colleagues set up a series of studies in California where, incidentally, the proportion of vasectomies is the highest in the United States.
They examined couples who were using oral contraceptives and compared them over a 4-year period with couples where the male had undergone a vasectomy.
“A careful comparison indicated some adverse changes in marital satisfaction two years after vasectomy,” they reported.
Zeigler discovered that some patients looked on the operation as though it may cause a loss of masculinity.
In the period immediately after the operation, Zeigler noted, there was an enormous increase in intercourse in the vasectomy group. The male was consciously or subconsciously endeavoring to establish the fact that his sexual power was as good as before surgery.
But there was often a reaction to this activity. The report stated that “temporary impotence was likely to occur in this high-frequency intercourse group. It is inferred that these men were over-reaching their sexual capacity in order to confirm their masculinity.”
The Medical Journal of Australia summed up the case for vasectomy: “Surgically and physiologically, vasectomy is a minor procedure. The main hazards are psychological.”
Vasectomy, like tubal ligation in women, can be reversed. The British Medical Journal stated that the success rate was about 30 percent with less than 20 percent resulting in pregnancy. But, again as with tubal ligation, the introduction of microsurgery has already begun to improve the rate of success.