IT is not reversible. When vasectomy is carried out, the sperms produced later may lose some of the features of a normal sperm so even if the surgery went well and the sperm ducts rejoined, the man may not be able to produce sperm quality enough to make a woman pregnant.

Besides, the reversal is a highly specialized surgical procedure that is mostly carried out in developed countries.

How does one’s sexual life play out after a vasectomy?
A man reaches orgasm when he ejaculates, therefore, since he will continue ejaculating, his sexual drive will not change.

Kapsandui says after a successful vasectomy, the man will still ejaculate, only that there will be no sperms. Hence, his partner would not notice any difference since the semen will reduce by a very minute percentage, around 20%, which would have been the sperm.

Cost of vasectomy
Marie stopes has 17 outreach teams countrywide that carry out the operations in government health facilities for free.

However, when the clients goes to any of the 14 Marie stopes centres located in all the major regions of Uganda, they pay a subsidised fee of sh30,000. At Reproductive Health Uganda, the fee for vasectomy is at most sh35,000.

Reproductive Health Uganda has 17 clinics countrwide that provide short and long-term family planning methods. However, the permanent methods; tubal litigation and vasectomy are provided at a few of these centres.

At the centres where the service is not provided, Reproductive Health Uganda has established partnerships with district hospitals and Marie stopes, to step in.

Which method is more effective?
According to Awudo, there are methods of vasectomy; scalpel, non-scalpel and cauterisation.

Scalpel method
An incision is made using a scalpel (surgical blade) after which another special instrument is used to retrieve the sperm duct before a small segment of it is cut.

Non-scapel method
With non-scalpel, a specific forceps is used. It does both slitting the skin open and retrieving the sperm ducts.
This method has an advantage over the scalpel because unlike the scalpel method, here, the very instrument that cuts the skin open is the very one that cuts the sperm duct.

Cauterisation
This one is mostly used in the developed countries. Here, the sperm duct is blocked by a machine operated blade which uses heat.
“Traditionally the scalpel method was used but currently, although there are those that still use it, the non-scalpel is more common in Uganda,” Awudo notes.

Procedure
Vasectomy is carried out under local anaesthesia. In other words, the person is awake and it is only the area of operation that is anaesthetised.
Before the procedure, local anaesthesia is applied to the area on the scrotum to make it numb so that the client does not feel pain during the operation.

Kapsandui explains that using his fingers, the doctor palpates around the testis for the sperm duct.

Feeling is necessary because alongside the sperm duct tubes are other blood vessels. This is necessary because like the sperm ducts, other tubes in the scrotum carry blood, nerves and hormones for manhood.

After the ducts have been identified, a small cut is made on the scrotal skin and through the cut, the sperm duct is retrieved before it is cut. After the cutting, one of the cut ends is sealed with part of the sheath that covers the sperm ducts.

When covered by the sheath, the chances that the two pieces will rejoin are reduced. When one of the ends is not covered up by the sheath, in extremely rare cases, the cut ends might rejoin.

The skin along the scrotum with the incision made prior, is slid to the next testis and the duct on another side cut as well.

Therefore, for both testicles, the same incision is used. The doctor then looks for signs of bleeding and in case there is none, puts a small plaster on the incision.

However, Because the incision made is so small, it may not even have to be covered with a plaster. Small pain management may be given.

“One can resume sexual intercourse as soon as they feel comfortable,” says Kapsandui .
Pain killers and anti-biotics may be given.


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