Let’s cut to the chase – three myths about vasectomies busted

Phetelo Fakude (29) is staring at the fluorescent ceiling lights of an operating room in a reproductive health clinic in Tshwane. Through the hospital gown he can feel the cold plastic sheet covering the hospital bed – which is not helping much to calm his nerves. 

After a few minutes, a nurse and a urologist walk through the doors and stand on either side of the bed.

The doctor introduces himself as the one who will be performing Fakude’s vasectomy, a surgical procedure to cut the sperm-carrying tube that runs from each testicle (called the vas deferens) to the glands that make semen and which sit just behind the bladder. Semen is a whitish fluid that keeps sperm cells alive when discharged from the penis when a man has an orgasm.

Fakude turns his head to see the surgeon drawing a clear fluid into a syringe. 

“The injection will numb the area around your scrotum,” the doctor explains, which is a good thing, because the scrotum – a pouch of skin that holds the testes – is full of nerve endings and blood vessels, which makes it a sensitive region.

The nurse (let’s call her Sister H) puts a hand on Fakude’s right shoulder and makes small talk. “Where did you grow up?” she asks to distract him from the brief prick of the needle. 

By the time she gets to the next question, the anaesthetic must have kicked in because Fakude can no longer feel the doctor’s hand on his groin.

The surgeon nods to Sister H, signalling that they’re ready to start the procedure.  

“We’re going to make the main incision now,” the nurse explains. She’s referring to the doctor using a scalpel to make a cut of slightly less than a centimetre along the upper part of the scrotum, just below the penis.

“Breathe,” Fakude tells himself. He doesn’t feel the cut. So far so good, he reckons.

Each vas deferens (there are two, one leading from each testicle) sits on the inside of the scrotum and extends towards the seminal gland, which allows the doctor to lift it up gently with a pair of forceps inserted through the incision.

“We’re going in for the left side first,” says Sister H.

During the prep talk before the procedure, the nurse explained that Fakude might feel discomfort while the doctor is working. This could be because the doctor is pulling the tube somewhat so that he can make the cut.

So he focuses on his breathing to prepare for what’s coming.

The tube is cut and then sealed by passing an electrical current through the tissue briefly. Then the surgeon moves on to the other side and does it all again, before stitching up the cut on the skin. The stitches will dissolve over a couple of days.

The procedure lasts about 10 minutes from start to finish.

Read more in Daily Maverick: “Make love, not babies: Surprising discoveries about South Africans’ popular choice of contraceptives”

Sister H helps Fakude to put on the Speedo he was told to bring with him (tight-fitting underwear stops the skin from stretching too much, which could tear the stitches open). Then she guides him off the bed and leads him to the recovery room. He lies down and gets an ice pack to place on his groin to limit swelling after the surgery. 

You stay in the recovery room for about half an hour so that the nurse can make sure you don’t have any unusual bleeding, Fakude explains. 

“You just relax, maybe have a coffee, and then you drive yourself home. It’s the kind of thing you can literally do during a lunch break.”

Things men don’t talk about

After Fakude, who today calls himself a “vasectomy influencer”, tweeted about having had the snip, saying he realised that men “want to know about these things [vasectomies], but they’re uncomfortable admitting it”.

In a Twitter Spaces event he hosted after his procedure, many men listened, but few joined the conversation. Yet afterwards many sent him direct messages to find out more.

Hearing from friends or family members can influence a man’s views on vasectomy, a study from Ghana found. “If we even get one person who has done it [vasectomy] to come out and tell us that it is good or he does not suffer from all the problems we have heard concerning vasectomy, I believe it will encourage others to also go and do it,” a respondent said. 

But it’s something men don’t talk about easily – because it seems to be wrapped in stigma and misconceptions. “Men do not want to do vasectomy because [they fear] people will make fun of them,” a healthcare worker told researchers in that study. 

So, let’s clear up a few things.

Myth 1: It’s going to hurt too much

Myth 2: It’s easy to undo

The tubes that take sperm from the testicles to the glands that make semen are cut. (Photo: medicalnewstoday.com / Wikipedia)

Myth 3: ‘You’re no longer a man after having a vasectomy’