Vasectomy: clinical aspects and reversibility
Muangman, V.
Journal of Thai Association for Voluntary Sterilization 1979: 79-83
1979
PMID: 12265371 Document Number: 496628
Sterilization, which was originated in Thailand 35 years ago, was initially performed in Bangkok and in the large up-country towns only. Sterilization acceptors were the minority group of well educated families. Population in Thailand increased rapidly following World War 2, and the demand in sterilization has risen respectively. In 1950 the government decentralized the National Health Program, and both vasectomy and tubal ligation were accepted by the Thai. After the government announced their population policy in 1971, vasectomy was included in the plan and has become popular. During 1967-72 there were only 2588 vasectomy acceptors. After the government launched an intensive program, the numbers were augmented. In 1977 there were 15,000 vasectomy acceptors, and 107,000 tubal ligation acceptors--a ratio of 1:7. At Ramathibodi Hospital in Bangkok there were 536 vasectomy acceptors. In 1967-69 the National Family Planning Division was established and activities were motivated through health centers, i.e., hospitals, provincial health centers, hygiene centers, mother and child care centers, and so forth. The government set up a Mobile Vasectomy Unit in 1975 with the goal of performing vasectomy in the remote areas of the country. The National Family Planning Division, established in 1977, has encouraged private clinics throughout Thailand to perform sterilizations. The aim of vasectomy surgery is to block the passage of spermatozoa through the vas deferens. The standard technic of vasectomy consists of division of the vas at the level of upper scrotum and removal of 1 cm portion of the vas. Both ends of vas are tied with No. 3-0 black silk thread. Currently, there are more than 20 methods of vasectomy. The result of vasectomy can be divided into 4 categories: complication, changes from the obstruction of sperm passage, autoantibody, and result in physical and mental condition. The effects of vasectomy on postvasectomized Thai men were studied in 1976 and 1978. The studies involved 185 men who had a vasectomy performed at Ramathibodi Hospital. The postvasectomized man usually feels scrotal ache or discomfort for a few days. The testicular size will not change. Approximately 50% of vasectomized men showed sperm antibodies in their serum after 6 months to 1 year, which gradually diminished at 1 1/2-2 years. The studies did not reveal any significant changes in psychosexual behavior. With the standard method of vasovasostomy the rate of pregnancy of 30% is acceptable by many. Microsurgery is introduced into this field as there is a high rate of pregnancy requirement after vasectomy reversal.