HOW TO IMPROVE VASECTOMIES IN PRIMARY

HEALTH CENTRES

ByDr. S. Sarath kumar

Medical officerPHC, Kusimi

VASECTOMYDefnition: A vasectomy is a surgical procedure

performed on males in which the vas deferens (tubes that carry sperm from the testicles to the seminal vesicles) are cut, tied, cauterized (burned or seared) or otherwise interrupted. The semen no longer contains sperm after the tubes are cut, so conception cannot occur. The testicles continue to produce sperm, but they die and are absorbed by the body.

WHY SHOULD WE ENCOURAGE VASECTOMY?• Responsibility on part of men• Polygamous relations• More advantageous than tubectomy

ADVANTAGES OF VASECTOMY OVER TUBECTOMY Easy technique Short procedure Small incision Less bleeding Less post operative care required Less failure rate

NON SCALPEL VASECTOMY (NSV)No use of surgical bladeVery minute incision Less painNo suturesLess complicationsNo bed rest requiredHeals better

MISBELIEVES IN COMMUNITYMale dominanceFear of impotencyFear of loss of work capacityFear of failure

MOTIVATIONField – Regular IEC

activity and counseling by field workers MPHA and ASHA

Kotha bathuku video played in most villages

PHC – Counseling by Medical officer during routine OP

Organizing special family planning camps

INCENTIVES BY GOVERNMENTRs 1100 will be given to vasectomy beneficiary

while only Rs 580 is given for tubectomy beneficiary

Payment made to beneficiary irrespective of poverty for vasectomy

Special incentives form ITDA

POST OPERATIVE CARE Less postoperative care

required Frequent follow ups gain

confidence Patients are asked to visit PHC

after 1 week to check the scar Patient should be told that he is

not sterile after operations, advised to use condoms for 30 ejaculations

No T bandages required for NSV

STATISTICSSl.no Year Vasectomy

Tubectomy

Vasectomy %

1 2005-06 66 67 49.6

2 2006-07 46 53 46.4

3 2007-08 17 21 44.7

4 2008-09 28 41 40.5

5 2009-10 24 57 30

6 2010-11 19 22 46.3

7 2011-12 53 40 57

8 2012-13(till now) 25 12 67.5

MY SCENARIO Polygamous relations in primitive tribal groups Female domination Avoiding hospital stay Performing NSV

THANK YOU