Myths and fears that stop most men from going for vasectomy

In many parts of the world, family planning is still considered a woman’s responsibility and men will not get deeply involved in birth-control services.

Apart from regular widespread methods such as use of condoms, more effective male birth control techniques such as vasectomy remain highly unpopular among men despite being considered one of the few fertility control methods that allows them to take personal responsibility for contraception.

The World Contraceptive Patterns 2013 show that only 2.2 per cent of the world’s men have had vasectomies. This is compared to female sterilisation and high-risk family planning methods that sit at 18.9 per cent.

 Countries with the highest vasectomy rates include Canada where 22 per cent of men of reproductive age have had the procedure. This compares to the UK with 21 per cent, New Zealand with 19.5 per cent and the US with 11 per cent. In Africa only 0.1 per cent of men have undergone vasectomies.

 Kenya is in step with the trend in Africa. The Kenya Demographic and Health Survey (DHS) 2014 show that only one out of 24,125 married women who were studied said her husband had undergone a vasectomy.

 In Senegal and Nigeria none of the married women surveyed said their husbands had undergone vasectomies. And only 0.01 per cent of the men interviewed in Zimbabwe admitted having a vasectomy.

 The global report says there is misinformation about the non-invasive procedure. Vasectomy (or male sterilisation) remains the most guaranteed form of family planning compared to all other forms of contraceptives, according to experts.

 Dr Charles Ochieng, founder and director at Winam Safe Parenthood Initiative (WISPIVAS), says there is a lot of stigma around vasectomy and people are ignorant about it.

“They say it is castration and all those ill things,” he said.
 Other myths and misconceptions surrounding the procedure include local beliefs that it lowers one’s masculinity, it causes pain during sexual intercourse and triggers weight gain besides lowering sex drive.  The Demographic and Health Survey, 2014 shows that only 38 per cent of women and 48 per cent of men in Kenya knew of vasectomy for family planning.

Most effective

The country is better off compared to Nigeria where only 16 per cent of married women and 27 per cent of men know vasectomy. In Liberia, this figure stood at 20 per cent for both married women and men.

READ: Gel to help men bear family planning burden

Despite the fears, vasectomies could be one of the most effective male birth control methods. They are inexpensive and could therefore have a major impact on sustainable development and population growth. But the procedure is misunderstood and as a result poorly used.

 It is simple and can be done under local anaesthesia. It involves a small incision on the scrotum with only one stab insertion to get the vas deferens then cut out  a small section of it— about one centimetre and tie the ends.

 The vas deferens is the tube that transports sperms from the testicles through the prostate into the urethra. It is determined from the scrotum.
 Dr Ochieng leads by example. He is among the few Kenyan men who have opted for sterilisation, helping carry the burden of birth control.

“My wife was on implants and they were causing her so much trouble. We had already had two kids. We explored options and we settled for vasectomy,” he said.

He said it was a painful investment to put his wife on contraceptives, with managing their side effects costing even more.

He would later undertake a course in Vasectomy Surgery at the US-based Florida Vasectomy and Reversal Center, Tampa City in 2010 to offer same services in Kenya.

Urologist surgeon at Kenyatta National Hospital (KNH), Gitobu Mburugu, says birth control methods among women, including tubal ligation are a high risk, especially if not carried out accurately and could even result in fatality.

 Tubal ligation involves cutting through the abdomen and exposes one to dangers of damages to the appendix, intestines or blood vessels unless done through advanced surgery techniques such as laparoscopy which is still not widely available in Kenya.

“It involves inserting a hook through a small incision and tying the ends of the fallopian tube. It is almost a semi-blind procedure that poses risks of complications,” Dr Mburugu explains.

He said vasectomy procedures are mainly common among young and educated men and widowed or divorced males entering new relations but do not want to father more children.

 These group of men however avoid public hospitals.

“All those that I have performed vasectomy on come to my clinic at Aga Khan Hospital – I am yet to understand why they shun public hospitals,” said Dr Mburugu who is attached to Kenyatta National Hospital.

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