It's less painful than root canal and simpler than eye surgery, yet many men would rather walk on hot coals than submit themselves to a vasectomy.

However, it's a procedure that some, especially married men with children, consider as a highly effective method of birth control.

During male sexual climax, sperm travel through two tubes (vasa deferentia) and mix with semen. During a vasectomy, these two tubes are cut and blocked.

Although vasectomies are relatively safe, any operation that involves the sexual organs is bound to cause a bit of anxiety -- but much of the fear about vasectomy can be dispelled with a better understanding of the procedure.

"Adam'', who did not wish to be named, is a 40-year-old married Bermudian who had a vasectomy at the age of 35.

He and his wife made a decision not to have any more children so they could afford to properly raise and educate their two daughters.

His wife had a difficult time taking birth control pills because of the side effects, and the couple decided it would be better for him to have a vasectomy rather than she get her tubes tied; the vasectomy is less complex when it comes to surgery.

"I don't think it was a difficult decision,'' Adam said. "My only concern was that everything would work normally after the surgery.'' "I knew there would be some pain involved during the recovery process and I had a general anaesthesia.

"So I got prepped, and while I'm waiting to go to the operating room, I had both feet wrapped close together,'' he laughed.

"Of course you're apprehensive -- even if you're going to get a tooth pulled, you're going to be a little worried.

"Well, they knocked me out and did it -- no stitching was involved, although later my left testicle blew up like a little blue balloon,'' he chuckled.

"Anyway, I agreed to meet my wife at the back entrance of the Emergency Ward.

I decided to be a macho man and refused the wheelchair.

"But I didn't know that my wife had gotten held up at work -- so here I am, looking for her and walking from the front door to the back door looking like John Wayne.'' Adam said he had the vasectomy on a Friday and was able to return to work the following Monday.

"Now, sex is more spontaneous because you're not looking through drawers for condoms,'' he said.

"Everything's the same -- there's still liquid, but no sperm. Where the hell they go, I have no idea.'' Adam said that although there is a stigma attached to vasectomies among men, the procedure for him was very much "a non-event''.

"A lot of immature men couldn't believe I had it done, they couldn't believe I didn't get my wife to have it done instead,'' he said.

"But we sat down and talked about it, and decided if we wanted to give our daughters the education and upbringing we wanted, there was no way we should have a third child.'' According to Dr. Charles Dyer, a vasectomy is a minor operation which usually takes no more than 30 minutes.

"It's certainly become more common than it used to be, although you still have more women getting their tubes tied,'' said Dr. Dyer.

"The number of local men having it done used to be far outnumbered by non-residents. Although local men are still in the minority, more are having it done.

"Men have a very selfish opinion of about themselves when it comes to that area of the body -- they think they'll stop having an erection, that they'll stop producing semen, and a vasectomy doesn't change any of that.'' Dr. Dyer said most of his patients tend to be married men between the ages of 36 and 38 who already have children and no longer wish to use other methods of birth control.

Most of the single men who have the operation tend to be men who already have children and may have been married previously.

And even the rare man in his late 20s will have the operation, although Dr.

Dyer said it tends to be a couple who started having children in their late teens and already have three or four.

Dr. Dyer said the operation is reversible, and is 90 percent effective within the first ten years.

And vasectomies are relatively inexpensive at $214.50, compared with $600 for a woman to get her tubes tied.

With a vasectomy, the doctor makes one or two small cuts in the skin of the scrotum through which the tubes are gently lifted out.

The doctor cuts the tubes and may remove a small piece of each, and the cut ends are tied or sealed with electric current.

There will probably be some soreness for a few days, a bit of swelling around the incision, and the scrotal skin may look bruised.

Many men who have the operation done on a Friday are well enough to return to work by the following Monday, unless their job involves heavy physical labour.

However, there's still the possibility of having active sperm for about six weeks following the operation -- so use some other form of contraception until your doctor confirms that you are sterile.

Your testes will continue to make sperm and when the sperm cells die, your body will absorb them. This is what happens to sperm cells that are not used -- regardless of whether or not a man has had a vasectomy or not.

Male hormones don't change as a result of the operation either, so there will be no change in beard, voice, sex drive or other male traits.

"Jason'' is a single Bermudian man in his mid-40s who doesn't have any children and has never been married.

He had a vasectomy performed shortly before his forty-first birthday. However, his physician was initially hesitant to perform the operation, since most of the men in Bermuda who receive vasectomies are married with children.

But Jason wanted a vasectomy because he considers parenting to be an enormous responsibility that he did not want to shoulder.

And despite his fondness for his friends' and relatives' children, Jason is more comfortable in an `uncle' role rather than becoming a `daddy'.

"For me, it was a matter of taking control of the situation -- I don't want any surprises. A child would completely change my life, and I'm selfish with my time,'' he said.

"Even though I like kids, I don't want to have kids because there's no bigger responsibility.

"You can divorce your wife, but you can't divorce your kids... it's a big commitment and you have to devote a lot of your life to raising them, if you want to do it right,'' he added.

"And I wanted to have the responsibility put on me because I didn't want to leave a decision like that up to someone else.

"There are some girls who get pregnant deliberately -- it doesn't happen a lot, but it does happen and that's appalling.

"They say it takes two to tango and that's true, but once a girl is pregnant, a guy has no say as to what happens. If she wants kids, she does -- if she wants an abortion, she gets one.

"It should come down to her -- it's her body -- but once a girl is pregnant, the guy is completely powerless.'' Jason said a lot of Bermudians attitudes about vasectomies were linked to their notions of manhood -- and claimed that many people, both male and female, were having children for the wrong reasons.

"One guy found out I had it done and said `you still feel like a man?', and I think that's such an ignorant mentality,'' he said.

"A lot of Bermudian men don't want to get it done because of their egos. I don't know of any other single guy who's done it, but I recommend it if you know you don't want kids.

"A lot of girls have kids because their girlfriends have kids -- and a lot of guys have kids to show that they're a man.

"This is a pretty broad statement, but a lot of Bermudian men who aren't married to the mother like to show off their kids at the cricket games -- and then they lose interest after about three years.

"There are so many pathetic fathers out there, it's ridiculous -- and so many Bermudian women don't use any contraceptives, it's really mindblowing. It seems like there's no thought from either party.

"But as far as I'm concerned, if you haven't got time to bring a child up properly, you shouldn't do it just to feed your ego.'' Although vasectomies can be reversed, the reversal operation can't be counted on, and it's more difficult and expensive than a vasectomy.

There are a number of factors that need to be considered before deciding to have a vasectomy.

You need to consider whether you would want to father a child if your family income improves, if one of your children dies, or your current relationship ends and your next partner wants a child.

For more information on vasectomies, take a look at AVSC International's webpage at www.avsc.org/contraception.

Photos by Tony Cordeiro Count down? Sue Smith, senior microbiologist at King Edward VII Memorial hospital, conducts a sperm count following a vasectomy in the hospital's new purpose-built lab.