Myths about Vasectomy

Vasectomy is a contraceptive method that has many myths. Caution is still needed when deciding on a vasectomy.

KOMPAS/JUMARTO YULIANUS

Residents who are potential acceptors of Long-Term Contraception Family Planning wash their arms before the installation of implants at the religious tourism site of Kubah Basirih in the Basirih Village, West Banjarmasin, Banjarmasin city, South Kalimantan, on Tuesday (9/5/2023). Vasectomy is one type of contraception method, but it is not widely known among the public.

Apart from the socio-cultural obstacles that make vasectomy less popular among the public, contraception by sterilization has many myths that make men think long and hard. This myth continues to persist because the dissemination of information about vasectomies is very limited.

Since the family planning program was introduced by the Indonesian government in the late 1960s, vasectomies have been promoted.

Although the success rate of vasectomy in preventing pregnancy is 99 percent, this permanent contraceptive method for men is opposed by religious groups because it is considered to permanently alter the body and cause sterility.

In addition, healthcare providers and facilities capable of performing the procedure are more limited compared to other contraceptive methods. Information on vasectomy is also limited, leading to many misconceptions. Moreover, some men who are interested in undergoing vasectomy also face difficulties in accessing the program.

Vasectomy or commonly known as Male Sterilisation Procedure (MSP) is a type of modern, non-hormonal, and long-term contraception. This is one of two modern contraception methods for men, in addition to condoms.

Even though the success rate of condoms in preventing pregnancy can reach 98 percent and they are easily available everywhere, their use requires full awareness.

Also read: Vasectomy, a male contraception option that is rarely seen

Vasectomy is a sterilization procedure for men by cutting and tying the left and right sperm ducts (vas deferens) which carry sperm from the testicles to the penis. Cutting the tube means that sperm cannot mix with semen or semen.

Thus, when a man who has undergone vasectomy experiences ejaculation during intercourse, his semen no longer contains sperm. Consequently, the husband's sperm cannot fertilize the wife's egg, resulting in no pregnancy.

The current vasectomy procedure, as cited from the website of the National Population and Family Planning Agency (BKKBN) on November 18, 2019, is a non-invasive vasectomy. This procedure has fewer risks and complications, and is considered safer and relatively shorter in duration.

Information on vasectomies is limited, leading to many misconceptions. Furthermore, some men who are interested in undergoing vasectomy face difficulties in accessing government programs for it.

After the operation, vasectomy does not automatically function effectively. Therefore, for three months after the procedure, men who undergo vasectomy are advised to use additional contraception. Three months after the operation, he must undergo a laboratory examination to ensure that his semen no longer contains sperm.

Misunderstanding

The relatively complex process compared to other contraceptive methods has led to misunderstandings and myths surrounding vasectomy. The myths that arise are generally related to men's sexual health after vasectomy is performed.

A fundamental misunderstanding regarding vasectomy is generally equating the procedure with castration or what is known in medical terms as castration. In reality, vasectomy and castration are two different things.

If vasectomy is the cutting and tying of the sperm duct, traditional castration is done by removing the testicles. Modern castration is generally done by injecting certain chemicals with the same purpose, which is to render the testicles non-functional.

KOMPAS/AGUS SUSANTO

A child is passing through a mural depicting various contraceptives in Kampung KB, Bintara Jaya, Bekasi City, West Java, on Monday (13/2/2023). The National Population and Family Planning Board has set four priority programs for 2023, including the optimization of Quality Family Village (Kampung KB).

As the testicles are removed or made non-functional, castration will cause the person to lack testosterone hormone, resulting in a drastic decrease in their sexual drive.

As quoted by Kompas, 19 May 2014, the testicles are the main producers of the hormone testosterone, which is a hormone associated with sexual desire and providing masculine characteristics. This hormone is also produced by the kidney glands, but in much smaller quantities.

From that basic misunderstanding, a myth arose that vasectomy could lower a man's libido or sexual desire. As quoted from social media account X BKKBN, vasectomy does not affect a man's libido because the testicles, which produce testosterone hormones, continue to function properly.

In addition, the testosterone hormone is circulated through the body via blood vessels, not the sperm cells canal that is cut and tied in a vasectomy surgery.

A similar sentiment was written on the website of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, which is part of the United States Department of Health and Human Services.

The website mentioned that vasectomy will not decrease men's sexual drive as this procedure does not affect the production of male testosterone hormones.

In fact, a study led by Tobias Engl and published in the Central European Journal of Urology, June 23 2017, found that the sexual satisfaction of men who had a vasectomy actually increased and their female partners did not experience a decrease in sexual satisfaction. So, vasectomy does not have a negative impact on a couple's sexual satisfaction.

Also read: Health Services Are Still Far From Gender Justice

Another myth states that vasectomy renders the husband incapable of ejaculation. In reality, semen is still expelled from the penis during ejaculation, just as before the vasectomy. This is because vasectomy does not affect the seminal vesicles that produce and store semen.

KOMPAS/DEONISIA ARLINTA

Executive Director of the United Nations Population Fund (UNFPA) Natalia Kanem (left) visited contraceptive services at Prima Media Hospital in Denpasar, Bali, on Monday (12/6/2023).

Despite that, vasectomy eliminates sperm from the seminal fluid because sperm from the testes cannot reach the penis. The sperm produced by the testes will be absorbed back by the body.

Vasectomy also does not affect the amount of semen produced by men because the proportion of sperm in semen is very small. According to the Austin Center for Vasectomy and Vasectomy Reversal website in Texas, USA, the ratio of sperm content in semen is only 2 percent, so men will not realize it.

Another misinformation that spreads about vasectomy is that the procedure can trigger impotence or make men unable to have erections. In fact, erections in men are triggered by nerves and blood vessels in the penis.

Meanwhile, the vasectomy procedure only takes place around the testicles and only impacts the sperm duct, without interfering with the nervous system related to erections.

Therefore, vasectomy does not affect a man's ability to have an erection. If someone experiences erectile dysfunction after vasectomy, as stated on the International Society for Sexual Medicine (ISSM) website, it is caused by other issues, not vasectomy.

In addition, vasectomy operations are also considered frightening. In fact, the vasectomy procedure is simpler than sterilization surgery in women, also known as tubal ligation. A trained surgeon, urologist, or general practitioner typically only takes around 15 minutes to perform a vasectomy.

KOMPAS/JUMARTO YULIANUS

The Lanting Pusat souvenir home in the religious tourism site of Kubah Basirih, in the Basirih Village, West Banjarmasin, Banjarmasin City, South Kalimantan, was established on Tuesday (9/5/2023). The Banjarmasin City government has implemented the Yan Dewita program, which is a free Long-Acting Contraceptive Method Family Planning service in tourism destination areas to increase the number of acceptors.

However, more complex measures are needed when attempting to reconnect the severed and tied sperm ducts. Vasektomi reversal or vasovasostomy procedures require more complex surgery, and the success rate for men to be able to impregnate again is 80-90 percent.

Although it does not affect men's sexuality, healthcare providers generally treat vasectomy with caution, especially when there are young married couples who want to undergo the procedure.

The conditions for men who can undergo vasectomy, in accordance with the Ministry of Health, must be obeyed, such as having more than two children and the youngest child being over two years old.

Some healthcare workers generally demand parental consent, especially if couples who want vasectomy are still within their productive age range or are young.

Also read: New contraceptives that are effective and meet gender balance are needed

Due to the relatively greater socio-cultural risk of vasectomy compared to its medical risk, the decision to undergo vasectomy must still be made with a clear mind, without emotions, let alone just following trends.

Even though state laws and regulations allow vasectomies, the socio-cultural specs related to vasectomies still need to be considered.