WEBVTT 00:16.500 --> 00:23.166 [Films Division presents] 00:23.166 --> 00:33.566 [Vasectomy An Instructional Film for Medical and Para-Medical Personnel] 00:33.566 --> 00:47.232 [Credits] 00:47.233 --> 00:52.833 [Music] 00:52.833 --> 00:54.899 [Dr. Phadke:]Since medical science 00:54.900 --> 00:58.766 has been responsible in lowering the death rate, 00:58.766 --> 01:02.899 it is our prime duty, as members of the medical profession, 01:02.900 --> 01:06.200 to help correct the consequences. 01:06.200 --> 01:11.666 The population of our country is growing at an alarming rate. 01:11.666 --> 01:15.432 And if we wish to improve the standard of living, 01:15.433 --> 01:19.966 we shall have to resort to family planning in a big way. 01:19.966 --> 01:23.266 Among the various methods of family planning, 01:23.266 --> 01:28.866 sterilization in the male has some definite advantages. 01:28.866 --> 01:32.266 It is a permanent method of limiting the family. 01:32.266 --> 01:34.732 The operation is a minor one, 01:34.733 --> 01:40.666 and any physician, with a little practice, can perform it. 01:40.666 --> 01:46.566 But the greatest care should be taken in selecting the patient. 01:46.566 --> 01:51.332 Some of the people are in touch with family planning workers. 01:51.333 --> 01:55.066 They have already got the desired number of children 01:55.066 --> 01:58.699 and have decided for an operation. 01:58.700 --> 02:02.866 Now, who should be operated upon? 02:02.866 --> 02:06.732 The wife, who will have to undergo a major operation, 02:06.733 --> 02:12.766 or the husband, who will not need more than a few days' rest? 02:12.766 --> 02:18.199 An understanding husband generally offers himself. 02:18.200 --> 02:23.866 But in many cases, your client is hesitant and nervous. 02:23.866 --> 02:26.332 [Music] 02:26.333 --> 02:28.533 You have to understand him. 02:28.533 --> 02:32.199 He is full of fears and apprehension. 02:32.200 --> 02:35.766 Will he become impotent after [INAUDIBLE]? 02:35.766 --> 02:39.999 Will it affect his general or sexual health? 02:40.000 --> 02:43.466 If his wife or children were to die, 02:43.466 --> 02:48.099 how can he have children if he wants them later? 02:48.100 --> 02:51.666 He needs all your sympathy and trust. 02:51.666 --> 02:55.166 You have to clear his misgivings. 02:55.166 --> 02:59.366 And the best way to do so is to explain to him 02:59.366 --> 03:02.466 all about sterilization, 03:02.466 --> 03:05.899 better still with the help of the chart. 03:05.900 --> 03:11.500 [Music] 03:11.500 --> 03:17.266 Tell him that the testes are the two important sexual glands in the body. 03:17.266 --> 03:19.466 [Music] 03:19.466 --> 03:21.499 They produce the male hormones, 03:21.500 --> 03:24.966 which are responsible for sexual desire. 03:24.966 --> 03:27.166 [Music] 03:27.166 --> 03:31.466 Hormones are absorbed directly into the bloodstream, 03:31.466 --> 03:33.832 and do not flow through the semen. 03:33.833 --> 03:36.833 [Music] 03:36.833 --> 03:39.799 Testes also produce spermatoza, 03:39.800 --> 03:41.933 which flow through the semen, 03:41.933 --> 03:47.899 and are then themselves responsible for pregnancy. 03:47.900 --> 03:49.933 In a vasectomy, 03:49.933 --> 03:56.933 vast gathering of sperm is trapped inside before it reaches the seminal vesicle. 03:56.933 --> 04:01.199 The sperm thus stops at the site of the obstruction. 04:01.200 --> 04:07.166 They are still being produced, but they accumulate, get older, and die, 04:07.166 --> 04:10.232 and their remains are absorbed in the body. 04:10.233 --> 04:14.066 [Music] 04:14.066 --> 04:17.966 The flow of semen still continues, for most of it 04:17.966 --> 04:23.299 is produced in the seminal vesicle and the prostate gland. 04:23.300 --> 04:27.966 But as the semen is now free of sperm, 04:27.966 --> 04:30.999 no pregnancy is likely to follow. 04:31.000 --> 04:36.066 [Music] 04:36.066 --> 04:38.799 There is no loss of sexual desire, 04:38.800 --> 04:44.900 for the hormones continue to enter the bloodstream as before. 04:44.900 --> 04:48.300 Vasectomy does not mean castration, 04:48.300 --> 04:51.633 as none of the sexual glands is removed. 04:51.633 --> 04:54.833 [Music] 04:54.833 --> 04:58.999 If necessary, vasectomy can be reversed 04:59.000 --> 05:04.833 by an experienced surgeon in an appreciable number of cases. 05:04.833 --> 05:08.399 The cut ends of the vas can be joined. 05:08.400 --> 05:11.466 Sperm starts flowing again through the semen, 05:11.466 --> 05:14.399 and pregnancies do take place. 05:14.400 --> 05:20.366 [Music] 05:20.366 --> 05:23.032 Most of the people will be convinced 05:23.033 --> 05:26.366 if we explain to them properly. 05:26.366 --> 05:29.032 But there may be a few 05:29.033 --> 05:34.066 who are not yet mentally prepared for the operation. 05:34.066 --> 05:39.666 Leave such people alone, for if they are operated upon, 05:39.666 --> 05:43.599 they may later on develop psychical symptoms 05:43.600 --> 05:46.466 suggestive of impotency. 05:46.466 --> 05:50.132 Such people are likely to blame their vasectomy 05:50.133 --> 05:52.766 for every imaginary trouble, 05:52.766 --> 05:57.966 and to create a very undesirable impression upon others 05:57.966 --> 06:01.399 intending to go in for sterilization. 06:01.400 --> 06:12.733 [Music] 06:12.733 --> 06:16.033 When a person decides to have the operation, 06:16.033 --> 06:20.233 he should sign a declaration form, along with his wife. 06:21.733 --> 06:23.533 [Music] 06:23.533 --> 06:26.166 The number of children the family should have 06:26.166 --> 06:29.666 is entirely the choice of the couple. 06:29.666 --> 06:34.999 But three children, with the youngest about three years old, 06:35.000 --> 06:37.100 may be considered ideal. 06:37.100 --> 06:39.066 [Music] 06:39.066 --> 06:43.032 Even otherwise, an operation can be performed 06:43.033 --> 06:47.599 when the health of the wife does not permit for the pregnancy. 06:51.233 --> 06:54.999 Unmarried people must not be operated upon. 06:55.000 --> 06:57.966 [Music] 06:57.966 --> 07:01.532 The patient should be examined before you fix up the date 07:01.533 --> 07:04.033 and time for the operation. 07:04.033 --> 07:13.766 [Music] 07:13.766 --> 07:18.699 Here, a note of caution is not out of place. 07:18.700 --> 07:23.633 Every qualified doctor can undertake these operations. 07:23.633 --> 07:25.933 But before doing so, 07:25.933 --> 07:29.799 he should first carry out a few, but especially 07:29.800 --> 07:33.500 under the direct supervision of an experienced surgeon. 07:33.500 --> 07:36.533 [Music] 07:36.533 --> 07:39.399 Let us now have a look at an operation. 07:42.466 --> 07:44.166 For this operation, 07:44.166 --> 07:48.499 you do not need a well-equipped theater. 07:48.500 --> 07:52.400 It can be carried out even in a remote village 07:52.400 --> 07:55.233 with normal aseptic precaution. 07:55.233 --> 08:02.466 [Music] 08:02.466 --> 08:05.399 The instruments required are few. 08:05.400 --> 08:10.366 These and the sterilization can be carried in a small bag. 08:10.366 --> 08:42.099 [Music] 08:42.100 --> 08:46.766 After shaving, antiseptic is applied to the skin. 08:46.766 --> 08:49.432 [Music] 08:49.433 --> 08:53.833 The area is then draped with sterilized cloth or towel, 08:53.833 --> 08:55.333 secured in place. 08:55.333 --> 09:05.733 [Music] 09:05.733 --> 09:08.833 Now the vas has to be located. 09:08.833 --> 09:12.866 [Music] 09:12.866 --> 09:16.532 The spermatic cord should be held fast by the assistant. 09:16.533 --> 09:19.399 [Music] 09:19.400 --> 09:22.666 The vas is a cord-like, firm structure 09:22.666 --> 09:26.399 quite distinct from the rest of the spermatic cord. 09:26.400 --> 09:28.566 [Music] 09:28.566 --> 09:30.599 Holding the vas firmly, 09:30.600 --> 09:35.900 two CCs of procaine solution are injected around the vas. 09:35.900 --> 09:46.633 [Music] 09:46.633 --> 09:50.599 With a small-bladed knife, a tiny incision 09:50.600 --> 09:55.033 of about a centimeter is made over the vas. 09:55.033 --> 10:00.766 [Music] 10:00.766 --> 10:05.399 Procaine is again injected on either side of the vas 10:05.400 --> 10:06.866 deep in the wound. 10:06.866 --> 10:16.932 [Music] 10:16.933 --> 10:20.833 The vas is separated from the adjacent structure 10:20.833 --> 10:23.599 with the help of mosquito forceps. 10:23.600 --> 10:36.100 [Music] 10:36.100 --> 10:40.933 It is then grasped with Allis's forceps and is pulled out. 10:40.933 --> 10:53.999 [Music] 10:54.000 --> 10:58.033 A few strokes of the knife separate the adherent tissues, 10:58.033 --> 11:00.066 revealing the small white vas. 11:00.066 --> 11:03.432 [Music] 11:03.433 --> 11:05.999 With the help of another Allis's forceps, 11:06.000 --> 11:09.500 an appreciable loop of the vas is pulled out. 11:09.500 --> 11:21.266 [Music] 11:21.266 --> 11:24.799 Be careful in identifying the vas. 11:24.800 --> 11:26.633 Failure of vasectomy 11:26.633 --> 11:29.899 is mostly due to wrong identification. 11:29.900 --> 11:32.333 [Music] 11:32.333 --> 11:36.233 If you felt at it, it feels like a firm cord. 11:36.233 --> 11:42.466 [Music] 11:42.466 --> 11:46.466 The loop is widened, and then two pairs of [INAUDIBLE] 11:46.466 --> 11:51.432 are applied at a distance of about two centimeters. 11:51.433 --> 11:58.166 [Music] 11:58.166 --> 12:02.366 A small portion of the vas in between is cut away. 12:02.366 --> 12:05.532 It is about a centimeter in length. 12:05.533 --> 12:07.433 [Music] 12:07.433 --> 12:12.399 Non-absorbent cotton thread is used to tie the ends of the vas. 12:12.400 --> 12:23.133 [Music] 12:23.133 --> 12:26.399 An extra length of the thread should be kept 12:26.400 --> 12:28.900 and held in Adson forceps. 12:28.900 --> 13:01.766 [Music] 13:01.766 --> 13:06.032 The ends of the vas are now allowed to retract in the wound 13:06.033 --> 13:09.099 to see if there is any bleeding. 13:09.100 --> 13:11.433 [Music] 13:11.433 --> 13:14.499 If there is no bleeding, they are pulled out, 13:14.500 --> 13:16.900 and the sutures are cut. 13:16.900 --> 13:22.766 [Music] 13:22.766 --> 13:26.732 Finally, the vas retracts into the wound. 13:26.733 --> 13:32.433 [Music] 13:32.433 --> 13:36.099 One stitch is enough to close the incision. 13:36.100 --> 13:55.800 [Music] 13:55.800 --> 13:59.800 A similar operation is carried out on the other side, 13:59.800 --> 14:01.633 at the same [INAUDIBLE]. 14:01.633 --> 14:26.166 [Music] 14:26.166 --> 14:31.332 The entire procedure is over in about fifteen minutes. 14:31.333 --> 14:40.066 [Music] 14:40.066 --> 14:42.766 Vasectomy is a minor operation, 14:42.766 --> 14:48.066 but great care should be taken while performing it. 14:48.066 --> 14:51.432 Complications, or mishaps, even in one-- 14:51.433 --> 14:53.699 can [INAUDIBLE] away a lot of people 14:53.700 --> 14:56.100 wanting to have the operation. 14:56.100 --> 15:10.000 [Music] 15:10.000 --> 15:12.600 A T-bandage, or a suspender, 15:12.600 --> 15:16.033 is used to keep the scrotum firmly supported. 15:16.033 --> 15:26.566 [Music] 15:26.566 --> 15:29.499 No hospitalization is needed, 15:29.500 --> 15:33.800 and the patient can walk off the table. 15:33.800 --> 15:36.833 He's asked to take a rest for two days. 15:36.833 --> 15:40.266 [Music] 15:40.266 --> 15:41.899 After two days, 15:41.900 --> 15:45.366 the patient returns for getting the stitches removed. 15:45.366 --> 16:11.232 [Music] 16:11.233 --> 16:15.166 The scrotal support must be worn for two weeks. 16:15.166 --> 16:20.666 [Music] 16:20.666 --> 16:27.732 The patient should be advised not to indulge in sexual intercourse for the next two months. 16:27.733 --> 16:34.499 But if he desires, he can do so with proper contraception. 16:34.500 --> 16:38.366 [Music] 16:38.366 --> 16:42.932 Every case operated upon should be followed up. 16:42.933 --> 16:46.333 The semen should be checked after two months. 16:46.333 --> 16:49.699 If the sperms are found to be totally absent, 16:49.700 --> 16:53.966 the patient can now lead a normal sexual life. 16:53.966 --> 16:57.399 [Music] 16:57.400 --> 17:02.833 I must repeat in the end that the greatest care should be taken 17:02.833 --> 17:06.166 in selecting the cases, in performing the operation, 17:06.166 --> 17:09.699 and in the post-operative care. 17:09.700 --> 17:15.366 Complications in the vas should be attended to at once, 17:15.366 --> 17:18.866 for the slightest neglect on our part 17:18.866 --> 17:21.566 will give the patient, or his relations, 17:21.566 --> 17:25.932 the wrong impression about sterilization. 17:25.933 --> 17:28.666 Careful attention to these details 17:28.666 --> 17:33.132 will help us in advancing the cause of family planning. 17:33.133 --> 17:37.533 [Music] 17:37.533 --> 17:40.399 [The End Vasectomy] 17:40.400 --> 17:42.933 [Produced by the Films Division, Government of India]