[Films Division presents]
[VasectomyAn Instructional Film for Medical and Para-Medical Personnel]
[Credits]
[Music]
[Dr. Phadke:]Since medical science
has been responsible in lowering the death rate,
it is our prime duty, as members of the medical profession,
to help correct the consequences.
The population of our country is growing at an alarming rate.
And if we wish to improve the standard of living,
we shall have to resort to family planning in a big way.
Among the various methods of family planning,
sterilization in the male has some definite advantages.
It is a permanent method of limiting the family.
The operation is a minor one,
and any physician, with a little practice, can perform it.
But the greatest care should be taken in selecting the patient.
Some of the people are in touch with family planning workers.
They have already got the desired number of children
and have decided for an operation.
Now, who should be operated upon?
The wife, who will have to undergo a major operation,
or the husband, who will not need more than a few days' rest?
An understanding husband generally offers himself.
But in many cases, your client is hesitant and nervous.
[Music]
You have to understand him.
He is full of fears and apprehension.
Will he become impotent after [INAUDIBLE]?
Will it affect his general or sexual health?
If his wife or children were to die,
how can he have children if he wants them later?
He needs all your sympathy and trust.
You have to clear his misgivings.
And the best way to do so is to explain to him
all about sterilization,
better still with the help of the chart.
[Music]
Tell him that the testes are the two important sexual glands in the body.
[Music]
They produce the male hormones,
which are responsible for sexual desire.
[Music]
Hormones are absorbed directly into the bloodstream,
and do not flow through the semen.
[Music]
Testes also produce spermatoza,
which flow through the semen,
and are then themselves responsible for pregnancy.
In a vasectomy,
vast gathering of sperm is trapped inside before it reaches the seminal vesicle.
The sperm thus stops at the site of the obstruction.
They are still being produced, but they accumulate, get older, and die,
and their remains are absorbed in the body.
[Music]
The flow of semen still continues, for most of it
is produced in the seminal vesicle and the prostate gland.
But as the semen is now free of sperm,
no pregnancy is likely to follow.
[Music]
There is no loss of sexual desire,
for the hormones continue to enter the bloodstream as before.
Vasectomy does not mean castration,
as none of the sexual glands is removed.
[Music]
If necessary, vasectomy can be reversed
by an experienced surgeon in an appreciable number of cases.
The cut ends of the vas can be joined.
Sperm starts flowing again through the semen,
and pregnancies do take place.
[Music]
Most of the people will be convinced
if we explain to them properly.
But there may be a few
who are not yet mentally prepared for the operation.
Leave such people alone, for if they are operated upon,
they may later on develop psychical symptoms
suggestive of impotency.
Such people are likely to blame their vasectomy
for every imaginary trouble,
and to create a very undesirable impression upon others
intending to go in for sterilization.
[Music]
When a person decides to have the operation,
he should sign a declaration form, along with his wife.
[Music]
The number of children the family should have
is entirely the choice of the couple.
But three children, with the youngest about three years old,
may be considered ideal.
[Music]
Even otherwise, an operation can be performed
when the health of the wife does not permit for the pregnancy.
Unmarried people must not be operated upon.
[Music]
The patient should be examined before you fix up the date
and time for the operation.
[Music]
Here, a note of caution is not out of place.
Every qualified doctor can undertake these operations.
But before doing so,
he should first carry out a few, but especially
under the direct supervision of an experienced surgeon.
[Music]
Let us now have a look at an operation.
For this operation,
you do not need a well-equipped theater.
It can be carried out even in a remote village
with normal aseptic precaution.
[Music]
The instruments required are few.
These and the sterilization can be carried in a small bag.
[Music]
After shaving, antiseptic is applied to the skin.
[Music]
The area is then draped with sterilized cloth or towel,
secured in place.
[Music]
Now the vas has to be located.
[Music]
The spermatic cord should be held fast by the assistant.
[Music]
The vas is a cord-like, firm structure
quite distinct from the rest of the spermatic cord.
[Music]
Holding the vas firmly,
two CCs of procaine solution are injected around the vas.
[Music]
With a small-bladed knife, a tiny incision
of about a centimeter is made over the vas.
[Music]
Procaine is again injected on either side of the vas
deep in the wound.
[Music]
The vas is separated from the adjacent structure
with the help of mosquito forceps.
[Music]
It is then grasped with Allis's forceps and is pulled out.
[Music]
A few strokes of the knife separate the adherent tissues,
revealing the small white vas.
[Music]
With the help of another Allis's forceps,
an appreciable loop of the vas is pulled out.
[Music]
Be careful in identifying the vas.
Failure of vasectomy
is mostly due to wrong identification.
[Music]
If you felt at it, it feels like a firm cord.
[Music]
The loop is widened, and then two pairs of [INAUDIBLE]
are applied at a distance of about two centimeters.
[Music]
A small portion of the vas in between is cut away.
It is about a centimeter in length.
[Music]
Non-absorbent cotton thread is used to tie the ends of the vas.
[Music]
An extra length of the thread should be kept
and held in Adson forceps.
[Music]
The ends of the vas are now allowed to retract in the wound
to see if there is any bleeding.
[Music]
If there is no bleeding, they are pulled out,
and the sutures are cut.
[Music]
Finally, the vas retracts into the wound.
[Music]
One stitch is enough to close the incision.
[Music]
A similar operation is carried out on the other side,
at the same [INAUDIBLE].
[Music]
The entire procedure is over in about fifteen minutes.
[Music]
Vasectomy is a minor operation,
but great care should be taken while performing it.
Complications, or mishaps, even in one--
can [INAUDIBLE] away a lot of people
wanting to have the operation.
[Music]
A T-bandage, or a suspender,
is used to keep the scrotum firmly supported.
[Music]
No hospitalization is needed,
and the patient can walk off the table.
He's asked to take a rest for two days.
[Music]
After two days,
the patient returns for getting the stitches removed.
[Music]
The scrotal support must be worn for two weeks.
[Music]
The patient should be advised not to indulge in sexual intercourse for the next two months.
But if he desires, he can do so with proper contraception.
[Music]
Every case operated upon should be followed up.
The semen should be checked after two months.
If the sperms are found to be totally absent,
the patient can now lead a normal sexual life.
[Music]
I must repeat in the end that the greatest care should be taken
in selecting the cases, in performing the operation,
and in the post-operative care.
Complications in the vas should be attended to at once,
for the slightest neglect on our part
will give the patient, or his relations,
the wrong impression about sterilization.
Careful attention to these details
will help us in advancing the cause of family planning.
[Music]
[The EndVasectomy]
[Produced by the Films Division,Government of India]