Dr. Subhash Abrol
Vasectomy is a permanent method of contraception for males for planning the family. It is the most effective contraceptive option available for men till date world wide. More than 40 millions couples use vasectomy as their method of fertility regulation. However this method is popular in only few countries.
Expanding use of vasectomy as a safe and effective method requires overcoming obstacles namely socio-cultural and political barriers, provider bias and inadequate information and communication. Vasectomy may be an incorrective term sanctioned more by usage than science. “Ectomy” normally refers to totalremoval of an organ but in Vas-ectomy only 1cm of Vas is removed & rest of the organ remains untouched so Vas Occlusion is a more accurate word for this procedure.
Traditionally this procedure was done by incisional method using mostly 2cm incisions on both sides in the scrotum. After the procedure these incisions were closed with a silk, a heavy dressing and from the patients point of view required multiple visits to doctor including change of dressings and stitch removal. The complication profile of this incisional vasectomy has also being unacceptable with infections rates ranging between 5-10% and haematoma rates of more than 1%.
To make Vasectomy more acceptable and to reduce the complication No Scalpel Vasectomy (NSV) was devised in China in 1974. NSV is a minimal access and minimally invasive procedure. Minimal access results in no stitches which may be a major concern for the client. Excision of the VAS is meticulous due to the specially designed only two instruments for this procedure. Both sided Vasa are tackled through the single puncture of 4mm only. Since no scalpel (surgical blade) is used in this procedure so is called No Scalpel Vasectomy. The word Scalpel doesnot mean much, so the surgery is also called No cut or No stitch Vasectomy. Complications in this procedure are less than 1%. Failures should not cross 0.3 percent. To reduce failure rate further a new step has been added to this procedure called Fascial Interposition which is an extra 2 minutes to the total procedure. However, after NSV, the precaution of contraception for 3 months remains, as the Vas deference beyond to the site of procedure and the seminal vesicals still harbour sperms and approximately require 20 ejaculations to be free of sperms. This is an average figureand requires confirmation by a mandatory semen analysis after 3 months. NSV is less complicated, less equipment intensive and administratively less demanding then tubectomy. Patient can return to his work the next day.
What is Word Vasectomy Day?
On October 18, 2013 Co-founders Jonathan Stack & Dr. Doug Stein launched World Vasectomy Day. Their hope was to inform people about vasectomies, bring these services to those furthest afield, and to inspire men to engage in the conversation about family planning.
Not only did they achieve the goal to inspire 100 doctors in 25 countries to do 1000 Vasectomies in 24 hours period. They also had 25,000 media impressions, made the evening news in dozens of cities and were written about by bloggers and journalist all around the world.
World Vasectomy Day is not just about the numbers of vasectomies done, but about the quality of conversations our efforts ignites. Thanks to those who choose this option, not for just taking care of theirselves but for making the right choice for their children, their partner and our collective future. Based on overwhelming level of participation in World Vasectomy day, Nov. 2014 has been declared as World Vasectomy Day.
As communicated by the Co-founders this goal cannot be achieved without participation of India. Time has come to announce ourselves loudly to the world that after China we are the best-in NSV but the impact is muffled until we arrive on the World Stage on World Vasectomy Day. This day has been decided by the common consensus by several NSV Surgeons across the World. Originally the date was in October but it has been moved to 7th Nov to suite our convenience so that all our festivals are over. Let us all prove that change has been worthwhile.
(The writer is A Grade Surgeon Specialist (Retd.) and J&K State Trainer in NSV, Health Services, Jammu and Kashmir)
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