herald

Friday 17 August 2018

Going for the snip

Celebrity chef Jamie Oliver has told how he thinks he would have had the snip done by now if he wasn't so squeamish about the operation.

The dad-of-four, who is married to yummy mummy Jools, is probably echoing what a lot of men think about having a vasectomy. Yet hundreds of Irish men who do not want to have any more children decide to have a vasectomy every year.

Dr Catriona Henchion, the medical director of the Irish Family Planning Association (IFPA) explains what is involved: "A detailed evaluation and counselling is given before the procedure. Vasectomy is a convenient and permanent one-time method of contraception suitable for couples or men who want to enjoy sex without fear of pregnancy.

"It's popular for men who want to share the contraceptive burden in their relationship when their family is complete, or single men who want to take control of their own fertility," she says.

She says a vasectomy is a minor surgical procedure that seals the tubes which carry the sperm from the testicles to the penis.

The operation is carried out under local anaesthetic and takes about 10 minutes to complete. After the operation, men will still be able to ejaculate, but their semen will no longer contain any sperm so they cannot make their partner pregnant.

Dr Henchion says two follow-up tests are required to confirm the absence of sperm in the semen. Other forms of contraception must be used until the all-clear is received.

She explains that a vasectomy will not affect ejaculation volume, virility, libido or testosterone levels.

Dr Henchion says the one-time cost of a vasectomy, at €500, compares favourably with the outlay for other forms of contraception.

"Yearly costs for use of the contraceptive pill range from €160 to €244 and use of the Mirena Coil costs €66 every year. For a single man aged 40, assuming fertility up to the age of 70, the yearly cost of a vasectomy works out at around €17 a year."

When asked if there is an age below which the procedure will not be considered, she said: "No, evaluation is done on a case by case basis. However, evidence is that men under 30 are far more likely to seek reversal, so special consideration is given to men in this age profile during evaluation."

The IFPA has noted an increase in the number of men describing themselves as single opting for vasectomy. However, these men would usually already have children.

Nationwide, the procedure tends to be predominately accessed through clinics and GPs who have an expertise in the field, rather than hospitals.

Dublin-based Dr John O'Keeffe (pictured), who has performed about 10,000 vasectomies, notes that the average age of the clients that he sees has gone up to 39.

He has been providing the service for around 28 years, and a vasectomy at the Morehampton Clinic in Donnybook where he is based, costs €500.

This is a total fee and includes the operation and all post-operative management, including all semen analysis.

However, for those who have a medical card, including the doctor-only card, there is no cost for a vasectomy at the clinic on the Morehampton Road and medical card holders from all over the country have attended it.

The vasectomy itself takes about 15 minutes and is done under local anaesthetic. Dr O'Keeffe said that the area goes numb and it works instantly. There is no stitch required.

Dr O'Keeffe says he had a survey done in his own practice in which clients answered a question in relation whether they had taken pain relief following the procedure. "Just over half the guys took absolutely nothing. Not even an aspirin," he says.

Physical

"Most guys go back to work the next day, provided they are not working in a very physical job. If somebody is at a desk or a computer, there is no problem, or with walking around the place or driving."

Contact sports, including football, or any sport where a man might get a knock or injury, must be avoided for three weeks. It's fine to resume non-contact sports like swimming, cycling or running within three or four days.

He said the first sperm sample is taken at three months, and there must be a minimum of two weeks between the first sample and the second. "We send them to a hospital technician. It's quite specalised, and the technician writes to us with the results," he says.

Before anyone has a vasectomy, they need to do counselling, ideally with their own GP, at which the reason for the vasectomy can be discussed, and the implications and information on the procedure.

The experts stress it's a procedure that should be regarded as permanent -- a reversal can only be done by a urologist with a specialty in the area, and even the best clinics in the UK report a success rate of just 60pc.

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