WHAT IS A VASECTOMY?
If you are thinking about getting a vasectomy, you are not alone. Each year, more than 500,000 men in the U.S. choose vasectomy as permanent birth control. During vasectomy, each vas deferens (the two tubes that move sperm) are sealed off. This blocks sperm from reaching the semen that is ejaculated from the penis. After a vasectomy, the testicles still make sperm but they are absorbed by the body. A vasectomy prevents pregnancy better than any other method of birth control, except abstinence. Only 1 to 2 women out of 1,000 will get pregnant in the first year after their partners have had a vasectomy.
Your doctor can perform a vasectomy in an office or hospital. Vasectomy is a minor surgery that should take about 20 minutes. One urologist who performs vasectomies tells his patients: “take a long hot shower the morning before with a lot of soap. And make sure you have a bag of frozen peas and a couple of rented movies at home.”
Before the vasectomy, your scrotum will be shaved and cleaned. Usually local anesthesia is used. So you will be awake but should not feel any pain. Some patients may also be given medicine to reduce anxiety. With a standard vasectomy, the urologist makes one or two small cuts in the scrotum. One vas deferens tube is cut and tied or sealed with heat. The tube is replaced inside the scrotum. The procedure is then repeated on the other side. Lastly, the skin is closed with stitches that dissolve and do not have to be removed.
Another popular option is a no-scalpel vasectomy. In this procedure, a small clamp with pointed ends is used to puncture the skin. Then each vas deferens is lifted out, cut, sealed and then put back in place. A no-scalpel vasectomy works just as well as a standard vasectomy. Some benefits of a no-scalpel vasectomy are less bleeding, swelling and pain. There is also a smaller hole in the skin.
HOW CAN I BE SURE I NEED A VASECTOMY?
You must be absolutely sure that you don’t want to father a child under any circumstances. Then, talk to your partner; it’s a good idea to make the decision together. Consider other kinds of birth control. Talk to a friend or relative who has had a vasectomy. Think about how you would feel if your partner had an unplanned pregnancy. Talk with a doctor, nurse, or family planning counselor.
A vasectomy might not be right for you if you are very young, your current relationship is not stable, you are having the vasectomy just to please your partner, you are under a lot of stress, or you are counting on being able to reverse the procedure later.
WILL A VASECTOMY CHANGE ME SEXUALLY?
The only thing that will change is that you will not be able to make your partner pregnant. Your body will continue to produce the hormones that make you a man. You will have the same amount of semen. Vasectomy won’t change your beard, your muscles, your sex drive, your erections, or your climaxes. Some men say that without the worry of accidental pregnancy and the bother of other birth control methods, sex is more relaxed and enjoyable than before.
HOW WILL VASECTOMY AFFECT ME?
Vasectomy only interrupts the vas deferens that carry sperm from the testes to where they are added to your semen. It does not alter a man’s sensation of orgasm and pleasure. Your penis and your testes are not altered in any way. The operation has no noticeable impact on the man’s ability to perform sexually, nor does it affect the balance of male hormones, male sex characteristics, or sex drive. As always, testosterone continues to be produced in the testes and delivered into the blood stream. Your body still produces semen, and erections and ejaculations occur normally. As before, the body naturally absorbs unused sperm. The patient will not feel any different physically from the way he felt before. Vasectomy is simply a sterilization procedure; once it has been performed, a man’s semen will no longer contain sperm and he can no longer father a child.
WILL I BE STERILE RIGHT AWAY?
No. After a vasectomy, there are always some active sperm left in your system. It takes about at least 25 ejaculations to clear them. You and your partner should use some other form of birth control until your doctor tests your semen and tells you it is free of sperm.
WILL IT PROTECT ME FROM GETTING OR PASSING ON STDS OR AIDS?
No. It will only prevent you from making your partner pregnant. If you or your partner have a sexual disease, or have more than one sexual partner, the best way to protect yourself and your partner is to use a latex condom.
CAN I DISCONTINUE OTHER BIRTH CONTROL METHODS RIGHT AWAY?
No! Sperm can remain in the vas deferens above the operation site for weeks or even months after vasectomy. You will not be considered sterile until two post-vasectomy semen analyses show that no sperm remain in your ejaculate. Until then, you must continue to use other birth control methods to prevent pregnancy.
HOW SOON CAN I GO BACK TO WORK?
You should not do heavy physical labor for at least 48 hours after your vasectomy. If your job doesn’t involve this kind of work, you can go back sooner. Many men have their vasectomies on Friday so they can take it easy over the weekend and go back to work on Monday.
Sex can usually be resumed 7 days after the procedure, but remember to use some other kind of birth control until the doctor says you are sterile.
ARE THERE LONG-TERM HEALTH RISKS?
Since most men live for a long period of time after a vasectomy, it has been possible to investigate thoroughly, the possibility of long-term health risks associated with vasectomy. Over 10 studies have evaluated more than 20,000 men who have had vasectomies, documenting their progress for up to 25 years after the procedure. The data indicates that men having a vasectomy are no more likely to develop cancer, heart disease or other health problems. In 1993, a panel assembled by the National Institutes of Health, the Association for Voluntary Surgical Contraception (AVSC International), and the National Cancer Institute reaffirmed the conclusion of most medical experts, that vasectomy is a safe and effective means of permanent birth control.
CAN A VASECTOMY BE REVERSED?
An estimated 2% to 6% of men undergoing vasectomy may request a reversal at a later date. In many cases, the cut ends of the vas deferens can be surgically reattached. However, this operation, a microsurgical vasovasostomy, is expensive ($5,000-$10,000) and, for a variety of reasons, does not guarantee a return to fertility. Vasectomy reversal appears to be more successful if performed within 10 years of the vasectomy, but again, there is no guarantee that fertility will be restored. Vasectomy should therefore be considered a permanent procedure. Before you choose to have a vasectomy, make quite sure that you and your partner do not want any more children. If you are thinking about a reversal now, perhaps you should take more time to decide whether vasectomy is right for you.