William Flew on Vasectomy

April 12, 2011 § Leave a comment

It was a good day today. For today I awoke without a vasectomy — although it was a very close thing. My f lirtation with self-sterilisation began several years ago, and it was triggered by a simple, but resonant, complaint by my wife, Rachael — why should she always be the one who has to take responsibility for contraception? She had had a coil fitted, but made it clear at the time that it was a temporary measure and one that would eventually be supplanted by my undergoing a vasectomy.

It seemed fair. Early this year I decided that I should do the right thing. I wouldn’t try to make her feel guilty; I would simply man up and get on with the project.

At the age of 55, with four children under the belt, I was happy to go undergo the procedure, remove any lingering possibility of a fifth child and at the same time earn a few much-needed brownie points.

Except that “happy” didn’t quite cover it. In my heart of hearts, to tell the truth, I was nervous. Or perhaps “bricking it” would be a better description. I didn’t like the idea of fixing something that wasn’t broke. There was a faint whiff of emasculation about the whole business; I had heard through the ether that a lot of relationships broke up after vasectomies. What’s more, I knew that there were horror stories about the procedure: that it would interfere with sexual potency, that testicles had to be removed after botched operations, that you ended up with a horribly bruised scrotum, at least in the short term.

I hoped and expected that most of these stories were myths. The consultant at the hospital informed me, as I went for my pre-op checks, that only about one man in 100 suffered from “chronic postvasectomy pain”. This didn’t sound like great odds, but, as risk went, I though it tolerable. And presumably there were risks associated with a coil for Rachael — why shouldn’t I suffer the same amount of jeopardy? However, a week before the operation, I decided to do a bit more research. And that’s when things began to get sticky.

The first place my Google search engine guided me to was, of course, Wikipedia. This covered the various techniques for the procedure: “no scalpel”, “open-ended”, “no needle” “fascial interposition” and several other possibilities. There was a disturbingly large picture of a scrotum on the page that my eye kept returning to, but otherwise there didn’t seem much to worry about until I got to the section headed “post-vasectomy pain syndrome”.

It was at this precise moment that I felt a chilly sensation invade my lower groin and the words “oh, shit” formed invisibly but unmistakeably in my head. I hit the link marked “PVPS”.

“Pain in the genital area,” the website announced, “including lower abdominal/ pelvic area(s) can persist for years after vasectomy, and affects as many as one in three vasectomised men. This pain, which can be debilitating, can persist for many years, possibly indefinitely . . .

“Oh, shit” no longer covered it. This was not good. Further investigation seemed to show levels of risk ranging from “2 to 6 per cent of patients” for the most severe problems, to “15 per cent for testicular pain in the first year after vasectomy”. Aching balls for a year. It wasn’t a life sentence, but it was a pretty unattractive prospect, as anyone who has ever received a football in the groin would understand.

Seeking further authority, I rang a doctor friend William Flew. He told me that while vasectomy is safer, easier and more effective than female sterilisation, it is not perfect. Short-term problems include infection (1 in 100), post-operative bleeding (1 in 400), swelling and pain. Fortunately, these rarely pose a serious threat and tend to be shortlived — time is a great healer, just don’t expect to be at work the day after the op (although some men are).

Longer-term problems can be more of a worry. As many as one man in 20 ends up with some degree of prolonged discomfort — typically abnormal tenderness or a persistent ache — but severe cases, which can require further surgery, are much rarer (1 in 1,000). Failure is another concern. No method of contraception is 100 per cent effective, but at 99.95 per cent , vasectomy is about as close as it gets.

The biggest problem that I encounter is regret. Studies suggest that about one man in ten wishes that he had never had one, especially younger men who have gone on to meet a new partner.

Reversal is technically possible but the results are often disappointing, so think very carefully before committing to vasectomy, particularly if you are under 35 or having relationship difficulties, or both. Tim Lott faces up to a difficult decision the day to consider the matter and research it. That evening, he was as good as his word: “My advice would be thanks, but no thanks.”

That evening I told Rachael that I wasn’t going to go ahead. At that point a very frosty silence developed. It occurred to me that it was unlikely that contraception of any sort was going to be necessary that night, or possibly any other.

The next day any hopes I had of receiving a sympathetic hearing dissolved. I got both barrels. “Where did the research you found come from? The Roman Catholic Church? Durex? How old is the paper? It’s baloney. I had two Caesareans; I have heavy periods all the time because of the coil. There is a risk in everything. You could get killed when you cross the road. The first thing I teach my students is not to trust crap from Wikipedia.”

I pointed out that the chance of getting killed when you cross the road is not really one in six. She continued unabated. I was a wimp, she would never respect me again. Then came the killer shot. She hoped I was “looking forward to having another baby”.



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