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Monday 23 October 2017

The snip decision

Not a lot of people know this, but the poet WB Yeats had a vasectomy. So did Sigmund Freud. In the 1920s and '30s it was widely believed that the snip was a boost to the libido.

"It's complete nonsense, of course," says Dr John O'Keeffe of the Morehampton Clinic. "But back then there was this idea that a vasectomy stopped a man from spilling vital fluids, thereby putting more lead in the pencil."

Nowadays, people opt for vasectomies for family-planning reasons, according to Dr O'Keeffe. Actor Jerry O'Connell has said in the past that he considered getting a vasectomy after the birth of his twin daughters with wife Rebecca Romijn.

"I thought it [having kids] was going to be a lot easier than it actually was. I thought I'll just slap some diapers on, throw some food in them and that would be it. I thought it would be like one of our dogs," said O'Connell in a recent interview with website PopEater.

"Will we have more? No, that's it. I took one of my dogs to the vet the other day and I was really considering going in and getting fixed myself," he said.

While you can get a vasectomy on the Medical Card, if you don't fall into that bracket, you have to pay the full cost. Medical insurance will not cover any part of the cost, which is something of a bugbear with John O'Keeffe.

"I write to VHI and Quinn and the various companies every year to recommend it, and every year I get replies in the negative. They should because it's an awful lot cheaper to pay for a vasectomy than an unwanted pregnancy."

While recent statistics show that more and more men are seeking vasectomy reversals in the UK, there are no figures to suggest the same is happening in Ireland.

"The vast majority of men who come back for reversals are those who have split up with the partner they were with when they had the procedure and are now with another woman," says John O'Keeffe.

Richard Kavanagh's experience bears this out. He underwent a vasectomy eight years ago when he was 41 after he and his wife decided they didn't want any more children. A few years later they went through a separation.

"That was the only time I felt doubtful about it," he says. "I was worried about meeting someone new, in case it turned out to be a problem." "The sooner after a vasectomy the reversal is done, the higher the rate of success," says Dr O'Keeffe, "But the nature of it is that it might be five or six years that somebody might ask for a reversal. Marriage split ups take time, deciding to have more children with another partner takes more time. The success rate at this stage is about 50pc."

Ultimately, Richard believes it was the right decision. "Bringing up children isn't easy -- especially when they get to be teenagers. I certainly didn't want to face into having teenagers when I was 60."

According to Dr John O'Keeffe, Ireland and the UK are unusual in that GPs can carry out vasectomies: "In America, for instance, you would have to go to a specialist. But not here.

"It's a tricky operation to start with, but once you get the hang of it, it's pretty straightforward. For the patient, the procedure begins with counselling, which has two aspects to it. One is the doctor talking with the man or the couple about the rationale for doing it. If you think you possibly might like more children, then it's not good. It's for couples who are absolutely 100pc sure they don't want any more kids.

"If there is disagreement between the couple about whether to get a vasectomy, it is probably not a great idea to go through with it."

The doctor then gives the patient a DVD which explains the mechanics of the operation, what can go wrong, what to expect after the procedure and so on.

"A local anaesthetic is usually used," says Dr O'Keeffe. "It's a small injection and not into the testicle. It's a good two inches above. It's exactly the same anaesthetic that dentists use. There's a little discomfort, the same as when you are having a filling done and then the area goes numb and you won't feel anything."

"I was a bit worried about it," says Richard. "Anything that's going to fiddle with you down below is a matter of concern. But I was in and out in 20 minutes and the whole thing was painless. However I did feel a bit tender for a couple of months. It wasn't pain, but more a slight discomfort that was always there."

"There's a bit of discomfort," Dr O'Keeffe agrees. "But we did a survey on this and, very much to my surprise, half of the respondents didn't use painkillers at all."

The doctor warns that just because you've had the procedure, it's not a good idea to start having sex without contraception immediately. "Patients don't get the all-clear until three months afterwards, when a sperm count is taken. Until then, it's not certain whether the sperm is viable or not."

Richard advises any couples who are fully sure they don't want any more children to take the plunge. "I have absolutely no regrets," he says. "Not having to worry about contraception has made our sex life so much easier, and better."

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