Vasectomy, the dos and don’ts of the procedure

At the age of 43, Dr Peter Ddungu decided he wanted to give his three children the best in life and the best way to do this was not to have more children thus he decided to undergo a permanent family planning procedure -vasectomy at only Shs30,000.

“My wife is a couple of years younger than me and I did not want to expose her to hormonal contraceptives,” Dr Ddungu says adding that hormonal birth control methods such as pills and the patch, among others regulate the change in hormone levels during a woman’s cycle to avert pregnancy.

After years of using male condoms as a family planning method, which effectively helped to space their children, aged 19, 16 and 13; the public health professional thought of having a lasting method so as to keep a small family. To the Ddungus it is about choice not the number of children they are supposed to have and neither do they care about public opinion.

It is with such confidence that the father of three thought it prudent to directly get involved in planning for his family. Unlike most men, he did not want to leave it to his wife.

Sometimes, he says, “We would have situations where we would not use condoms consistently. My wife would have to take emergency contraceptives the next day because we were not ready to have more children.”

Having stayed in South Africa where he carried out surgical procedures on both men and women as a medical doctor for 14 years until he returned to Uganda in 2009, making a final decision was not that hard.

All the myths and truths about the family planning method and other contraceptives were not in any way a threat when he decided to make a life commitment.

The procedure
“All I asked myself was who does it well,” Dr Ddungu reminisces, saying it was a matter of walking into a Marie Stopes Clinic in Mulago, a Kampala suburb where the procedure was done.

Today, he is an employee at Marie Stopes Inter
national Uganda, a non-government organisation that provides reproductive and sexual health services including family planning methods through their clinics and different community outreach services.

Within 15 minutes after counselling and basic examination by the health worker to make him comfortable, Dr Ddungu walked out of the clinic with his tubes cut and sealed from carrying his sperm to permanently prevent pregnancy.

At the moment, Dr Ddungu felt a lot of freedom that he would have a free sex life without having to worry about having children by mistake. The support from his wife was another morale booster to sway away any thoughts of an incident of losing the few children he had.

“My wife was happy and relieved because sometimes, she would get allergic reactions to condoms plus the freedom of not worrying that she would have to consider taking emergency contraceptives,” Dr Ddungu adds.

Sensitisation
Because most of the men shy away when it comes to family leaving it for the women while others even discourage it, Dr Ddungu says it is the reason he opted for the interview. He wants to encourage men to be open about their sex life.

“I hope this would help the men to know that they have a choice and can play an active role in ensuring that they have the wanted number of children that they can look after,” he states. Adding that vasectomy is a safe method of contraception that should not be feared.

The procedure
Dr Charles Kiggundu, a gynaecologist at Mulago hospital, says having vasectomy means the man does not want to have any more children.
“It is a simple procedure conducted in an outpatient setting where the tubes [in a male reproductive organ] are identified, removed and a section of it is cut and tied,” Dr Kiggundu explains.

He says the person only feels very little pain and discomfort after a 15 minute minor surgery because anaethesia is always applied while one is undergoing the procedure.

The procedure is, however, not recommended if someone is unsure because they are thought to be making the decision out of regret, the expert says.

Similarly, Dr Kiggundu says, people who may be having infections on the scrotum (part of the male reproductive organs containing the testicles) are not supposed to undergo the procedure as it may worsen their condition.
He further warns that: “people who undergo surgery still ejaculate semen which still contain sperms during sexual intercourse that one needs to use protection for the first 20 ejaculations (or about two days) after the procedure.”

Unfortunately, Dr Kiggundu says, the method is considered permanent since it would be very difficult or even impossible in most cases to reverse it for the man to have children again.

“But one can get other artificial ways of having children,” he warns, saying this means anyone taking up the method must be sure before they choose the method not to regret.

The method also has no age-limit when to conduct it or not as long as one has made up his mind especially in cases of polygamous families and other men who have very many children at a tender age.

Family planning uptake
The annual performance Monitoring and Accountability(PMA 2020) survey by Makerere University of Public Health indicated that nearly one in every two Ugandan women of child bearing age say their last pregnancy was unintended.

As a result, researchers also found that the use of emergency pills by unmarried but sexually active women is growing to 9.3 per cent from 7.6 per cent last year and 3.5 per cent in 2016.

Dr Placid Mihayo, the family planning coordinator in the Health ministry, says the current statistics on vasectomy were not readily available, referring us to a later date.

However, data collected from different public health facilities and family planning providers in the country five years ago indicated an increase of men who use the method had increased from 2,099 in 2012 to 2,721 in 2013.

Currently, the number of public health facilities in Uganda which carry out vasectomy is still few with majority of the procedures carried out by non- governmental organisations in the country including Marie stopes.

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