रिकामेपणा : पुरुष नसबंदी

Last article we read about female family planning operation.So many of you raised question , which surgery is better ? Male sterilisation or female sterilisation?

I would like to say that in case of family planning, which method is to be adopted is entirely that particular couple’s choice. We as a doctor will explain all the methods available and their pros and cons ...But we can’t advice you to choose particular method. This approach is called ‘cafeteria approach'(like in cafeteria they give entire list and you have to choose yourself what you want)

Male sterilisation can be done by two methods,

• 1. Conventional method
• 2. No scalpel technique - This method is now a days very popular. In this method tube which carries sperm (vas) is cut in such a way that it’s continuity breaks and hence sperms are not mixed in a semen while ejaculation is done. so pregnancy is not possible.
• 3. Preparations - no major preparation is needed for this operation except few basic lab tests. This operation can be done on OPD basis and there is no need for admission in the hospital and stay.

Pre operative counselling -This is very important aspect,

• - This is permanent method of family planning.
• - It is done under local anaesthesia.
• - Millions of men have successfully undergone this operation without any long term side effects
• - It has no effects on masculinity, normal sexual activity and semen volume and general health.
• - Sexual pleasure is not reduced by this operation
• - Reversal of operation is possible and can be done with microsurgery and pregnancy rate after reversal operation is 70%.

• 4. Female partner’s consent is not required for this operation
• 5. This operation is done in government hospitals as well as private hospitals after special training.
• 6. Any healthy male can undergo this surgery; in special conditions like diabetes, hypertension, kidney disease extra precautions are taken and when patient is stable this operation can be done.

Post operative care –

• - Patient can go home after 2 hrs.
• - Use of painkillers if needed
• - Do not wet the dressings and keep the wound dry
• - Avoid cycling and two wheeler driving for 2 weeks.
• - Good scrotal support for 6 to 8 weeks
• - Avoid exercise for 2 days
• - Use another temporary method of family planning after operation for 3 months
• - Sperm count should be checked after 3 months and if it is ‘0’ in two different samples ,it is perfectly safe to keep contact
• - At least 20 ejaculations are needed to become sperm count zero...semen should be taken out and only abstinence from sex doesn’t work.

If comparison is between make and female sterilisation,

• - Female sterilisation needs hospital admission and stay at least 24 hrs ;male sterilisation is done on old basis no hospital stay.
• - Female sterilisation is done under general or spinal anaesthetist; male sterilisation is done under local anaesthetic so more safe than female sterilisation.
• - Female operation is with stitches; male operation is without stitches.

• 7. . Complications – Vasectomy i.e. male sterilisation is very safe and effective . Very rare complications are wound infection, collection of blood around operative site, psychological disturbance...These complications are easily manageable complications.

Inspite of all above mentioned the male sterilisation is not much popular ; the reason behind this is ‘mind-set’ of our society .Whenever patient’s husband comes to us and says “doctor, my wife has tolerated pain of delivery so why should she suffer more? Now it’s my turn and I will undergo family planning operation insted of her ”then I think: the mind-set of our society has started changing. But this change is very slowly progressing. We as a women needs to stand for this change...When mother in law will advice her son to undergo family planning operation then large part of society will be ready to undergo this big change...

I wrote this article as you all inspired me by asking questions....Now you all read, think and share this article, tag your friends so that they will also be involved in this thinking process and who knows these small steps may turn out as the beginning of the big change...