Healthy Living Looks At Male Sterilization

When a couple decides that they have had as many children as they would like, the conversation that follows is often about measures that the woman may take to prevent further pregnancies. Those options include all forms of contraceptives and even tubal ligation or as we call it in Belize: a “tie off.” But if a couple is really convinced that they are done procreating; then there is an option just for men. That’s the focus of tonight’s Healthy Living.

Marleni Cuellar, Reporting
The World Health Organization reports that an estimated two hundred and twenty-two million women in developing countries would like to delay or stop childbearing but are not using any method of contraception. In many cultures, family planning is seen primarily as the woman’s business. Yet, one of the least explored options is a procedure done on the man that is not only minimally invasive, but also highly effective and even reversible.

Dr. Pedro Gonzalez, General Surgeon

Dr. Pedro Gonzalez

“I can count the cases, I probably do about four to six a year. Compared to what we know in Europe, some places in Europe have fifteen thousand to twenty thousand a year.”

General Surgeon, Dr. Pedro Gonzalez, has been performing vasectomies for years. He says it is one of the least sought procedures that he performs. However, this lack of interest is not entirely unique to this region.

Dr. Pedro Gonzalez

“In North America the reception of the technique is changing. It is being accepted more. In Latin America and developing countries it is a lot less, one of the reasons is because of the beliefs the negative beliefs.”

A vasectomy is a procedure that sterilizes men by cutting the tube that transports sperm to the penis for ejaculation. It is a very effective means of preventing pregnancy in a woman.

Dr. Pedro Gonzalez

“The only indication to do a vasectomy is sterilization, male sterilization. It is the counterpart of what is done with the women, in tubal ligation. Of course, tubal ligation is a very, very old known procedure with all its difficulties, its failures because there are so many things that can happen. Tubal ligation requires a number of things that all gynecologists and surgeons know; one is hospitalization, at least a day. It requires entering the abdomen with an incision although today, it is being done macroscopically but either way you still have to get into the abdominal cavity. You have to invade the belly, pain is there. It’s more expensive. You have the risk of infection and worse you can get a long term complication which we call ectopic pregnancies in which a pregnancy still can occur and it sits in the tube and grows there. That’s what you call an ectopic pregnancy. It can even produce mortality. Vasectomy is a whole lot easier, it’s a day case, and we call it an ambulatory service. It’s a minor procedure in fact, it’s one of the smallest procedures that general surgeons and urologists do. Depending on the experience, it takes about fifteen minutes to one hour. If you do it every day, it takes at most fifteen to twenty minutes. It’s a day case. The man comes here to the clinic or hospital. It is done with local anesthesia. It doesn’t go beyond the pain you get for any injection. The incision is small. The pain that you get with the procedure is very little or none. And after the procedure it’s very very mild. But effectiveness; it’s a lot more effective than tubal ligation.”

A ‘tie off’ may cost a woman anywhere from three to five thousand dollars, and a hospital stay, a few weeks recovery and is still less effective than the vasectomy. The vasectomy will cost about seven hundred dollars, little to no recovery, and you can literally be in and out of the clinic in a day. So, the question that begs asking is why aren’t more couples seeking this procedure?

Dr. Pedro Gonzalez

“I think it’s a lack of information. Beliefs- especially in the male. A lot of men simply don’t want to talk about it. Their manly-hood, what we call machismo.  Vasectomy is such a small procedure that you interrupt the tube that facilitates the passage of sperm. Just sperm, not seminal fluid. That comes from a different organ. So having orgasms or ejaculation remains the same. That does not change ever and the erection remains the same way.   The big fear is that once I have a vasectomy I cannot have sex anymore. It is a taboo. It has nothing to do with virility, with the male sex desire or his effectiveness in sex. There is no connection not anatomically or physiologically.”

A vasectomy should have impact on sexual performance or sex drive. But Dr Gonzales’s advice is to seek professional advice to clarify any concerns. He also recommends speaking with directly with persons who have done the procedure.