Vasectomy: permanent contraception for menVasectomy: mardon ke liye hamesha ka khandani mansooba bandi ka tareeqa

Yeh kya hai aur kis ke liye hai

Sperm testicle mein bante hain aur do patli nalion, har testicle se aik, yani vas deferens, ke zariye upar jate hain. Vasectomy mein har nali ko kaat kar seal kiya jata hai. Testicle sperm banate rehte hain, lekin sperm semen tak nahi pohanch sakte aur jism unhein jazb kar leta hai. Testicle mard ka hormone bhi banate rehte hain, is liye vasectomy se jinsi khwahish, khaas hissay ki sakhti ya manyi ke ehsaas par asar nahi hota. Semen waisa hi dikhta hai kyunke sperm us ka sirf bohat chhota hissa hote hain.

Vasectomy un mardon ke liye hai (aam tor par apni biwi ke saath) jo yaqeen se samajhte hon ke unhein koi, ya mazeed, bachay nahi chahiye. Yeh bohat mu'assir tareeqa hai, lekin yeh foran kaam nahi karta (neeche dekhein), aur yeh jinsi taur par muntaqil hone wale infection se nahi bachata.

Ghor se sochein. Vasectomy ko hamesha ke liye samjhna chahiye. Wapas karna mumkin hai, lekin yeh bara operation hai, hamesha kamyab nahi hota, aur aasaani se dastiyab bhi nahi ho sakta. Kuch mard pehle sperm mehfooz karwa lete hain. Biwi ke liye khandani mansooba bandi ke tareeqe aur lambay arsay wale tareeqe mutabadil hain. Mashwara (counselling) is amal ka hissa hai, aur behtar hai ke dono saath jayein.

Procedure se pehle

• Mashwara (counselling): aap se aap ki wajuhaat, khandan ke mansoobon aur operation ke baare mein aap ki samajh ke baare mein poochha jayega. Behtar hai ke aap ki biwi bhi saath aayein. Kisi par dabao nahi hona chahiye.
• Aap se razamandi (consent) maangi jayegi. Kamyabi ki sharah, khatrat aur semen test ke baare mein poochhein.
• Team ko khoon behne ke masail, khoon patla karne wali dawaon, allergies, scrotum ke dard, infection ya hernia ke baare mein batayein. Apne taur par koi dawa band na karein.
• Bay-hoshi: aam tor par local anaesthetic mein, jaagte hue hota hai. Kuch mard sedation ya poori bay-hoshi lete hain.
• Baad ke liye tang, sahara dene wala underwear saath layein aur aik do din aaram ka intezam karein.
• Khandani mansooba bandi ka tareeqa jaari rakhein jab tak aap ko na bataya jaye ke semen test saaf hai.

Procedure ke dauran

Scrotum ki jild saaf ki jati hai aur sunn ki jati hai. Surgeon jild mein aik ya do bohat chhote suraakh (chhota puncture ya chhota cut) lagata hai, har vas nali dhoondta hai aur use baandh kar, garmi se, ya dono tareeqon se kaat kar seal kar deta hai. Suraakh bohat chhote hote hain aur aam tor par taankon ki zaroorat nahi hoti ya sirf aik do ghulne wale taanke lagte hain. Aam tor par taqreeban bees se tees minute lagte hain aur zyadatar mard jald ghar chale jate hain.

Procedure ke baad aur recovery

• Aik do din aaram karein aur tang, sahara dene wala underwear pehnein.
• Scrotum mein neel, soojan aur dard aam hai aur aam tor par aik do haftay mein theek ho jata hai. Aam dard ki dawayein madad karti hain. Kapray mein lipti thandi patti araam de sakti hai.
• Takreeban aik haftay, ya jaisa mashwara ho, bhaari wazan uthane, cycling aur zor wali kasrat se parhez karein.
• Jinsi taluq: jab aaram ho jaye tab dobara shuru kar sakte hain, aam tor par taqreeban aik haftay ke baad. Aap abhi hamal se mehfooz nahi hain. Jab tak test na bataye ke aap saaf hain, khandani mansooba bandi ka tareeqa istemal karein.
• Semen test: taqreeban teen mahinay baad aap se semen ka sample maanga jayega taake dekha jaye ke koi sperm baaqi hain ya nahi. Kuch markaz do samples maangte hain. Poochh lein ke kya chahiye aur kahan dena hai (dekhein semen analysis ki guide).
• Khandani mansooba bandi tab hi chhodein jab aap ko bataya jaye ke test saaf hai. Nateeja khud apne haath mein maangein.

Mumkina khatrat

• Aam: aik do haftay neel, soojan aur takleef.
• Kam aam: zakhm ka infection, scrotum mein khoon jama ho jana (haematoma) jis ki dekh bhaal chahiye, aur kati hui nali se sperm ke reesne se dardnaak gaanth (sperm granuloma).
• Ghair aam: operation ke baad mahinon ya zyada arsay tak scrotum mein dard ya takleef (kuch mardon mein). Aisa ho to doctor ko batayein.
• Yeh kaam na bhi kar sakta hai: shuru ke tests mein sperm ab bhi mojood ho sakte hain, aur phir zyada waqt ya dobara test chahiye hota hai. Bohat kam nalian baad mein dobara jud jati hain (late failure), aur saalon baad bhi hamal ho sakta hai.
• Pachtawa: kuch mard baad mein chahte hain ke unhon ne yeh na karwaya hota, khaas tor par jab zindagi badal jaye. Wapas karna hamesha mumkin ya kamyab nahi hota.

Follow-up aur nateeje

• Semen test hi follow-up hai. Yaqeeni banayein ke aap ko pata ho ke sample kab aur kahan dena hai aur nateeja aap ko kaise bataya jayega.
• Agar sperm ab bhi mojood hon to aap se intezar kar ke test dobara karne ko kaha jayega, ya kabhi procedure ki jaanch ya dobara karwane ko.
• Apna nateeja mehfooz rakhein. Isay likhi hui shakal mein maangein aur mehfooz jagah rakhein.
• Agar baad mein biwi ki mahwari rukk jaye to hamal ka test karein aur doctor ko batayein. Late failure bohat kam hota hai lekin ho sakta hai.

Aam sawalaat

What it is and who it is for

Sperm are made in the testicles and travel up two thin tubes, one from each testicle, called the vas deferens. In a vasectomy, each tube is cut and sealed. The testicles carry on making sperm, but the sperm cannot reach the semen, and the body absorbs them. The testicles also carry on making the male hormone, so a vasectomy does not change your sex drive, erections or the feel of ejaculation. The semen looks the same, as sperm make up only a tiny part of it.

A vasectomy is for men (usually together with their partner) who are sure they do not want any, or any more, children. It is a very effective method, but it is not immediate (see below), and it does not protect against sexually transmitted infections.

Think carefully. A vasectomy should be considered permanent. Reversal is possible, but it is a bigger operation, is not always successful, and may not be easily available. Some men store sperm beforehand. Contraception for your partner, and long-acting contraception, are alternatives. A counselling talk is part of the process, and it is best to attend together.

Before the procedure

• Counselling: you will be asked about your reasons, your family plans and what you understand about the operation. Ideally your partner comes too. Nobody should feel pushed.
• You will be asked for consent. Please ask about the success rate, the risks and the semen test.
• Tell the team about bleeding problems, blood thinners, allergies, any scrotal pain, infection or hernia. Please do not stop any medicine on your own.
• Anaesthetic: it is usually done under local anaesthetic, awake. Some men have sedation or a general anaesthetic.
• Bring snug, supportive underwear for afterwards, and arrange to take it easy for a day or two.
• Keep using contraception until you have been told that the semen test is clear.

During the procedure

The skin of the scrotum is cleaned and numbed. The surgeon makes one or two tiny openings (a small puncture, or a small cut) in the skin, finds each vas tube, and cuts and seals it, by tying it, using heat, or both. The openings are very small, and usually need no stitches or just one or two dissolving stitches. It usually takes about twenty to thirty minutes, and most men go home soon after.

After the procedure and recovery

• Rest for a day or two, and wear snug supportive underwear.
• Bruising, swelling and an ache in the scrotum are common and usually settle within a week or two. Ordinary painkillers help. A cold pack wrapped in cloth can ease it.
• Avoid heavy lifting, cycling and strenuous exercise for about a week, or as advised.
• Sex: you can restart when you are comfortable, usually after about a week. You are not yet protected from pregnancy. Use contraception until the test says you are clear.
• The semen test: you will be asked to provide a semen sample after about three months, to see whether any sperm remain. Some centres ask for two samples. Ask exactly what is needed and where to take it (see the semen analysis guide).
• Only stop contraception once you have been told the test is clear. Ask for the result to be given to you.

Possible risks

• Common: bruising, swelling and discomfort for a week or two.
• Less common: an infection at the wound, bleeding into the scrotum (a haematoma) that needs care, and a tender lump where sperm leak from a cut tube (a sperm granuloma).
• Uncommon: an ache or pain in the scrotum that goes on for months or longer after the operation (a small number of men). Tell your doctor if you have this.
• It may not work: sperm can still be present on the first tests, and then you need more time or a repeat. Very rarely the tubes join up again later (late failure), and a pregnancy can happen even years afterwards.
• Regret: a few men later wish they had not had it, especially if life changes. Reversal is not always possible or successful.

Follow-up and results

• The semen test is the follow-up. Make sure you know when and where to give the sample, and how you will be told the result.
• If sperm are still present, you will be asked to wait and repeat the test, or sometimes to have the procedure checked or repeated.
• Keep your result. Ask for it in writing, and keep it in a safe place.
• If a partner later misses a period, do a pregnancy test, and tell your doctor. A late failure is rare, but it can happen.

Common questions