Vasectomy: A Better Choice for Couples
What is a vasectomy and how does it work?
A vasectomy is a minor surgical procedure used as a permanent form of contraception in males. It is performed in over 500,000 patients annually in the United States and is a safe, reliable, and convenient form of contraception. Patients can enjoy sexual contact without risk of pregnancy. There are no side effects as with other forms of contraception such as birth control pills or diaphragms. Pregnancy results when a man’s sperm meet and penetrates a woman’s egg. The sperm are created in the testicles and exit via a small tube called the vas deferens that passes through the scrotum and eventually into the prostate where it mixes with other seminal fluid to make semen. During a vasectomy, the vas deferens is separated, preventing sperm from entering the prostate and mixing with the remaining seminal fluid. After a vasectomy, the sperm are absorbed by the body.
What permanent alternatives are there to a vasectomy?
A woman can undergo a tubal ligation, which is a procedure to block the fallopian tubes from entering sperm, but a vasectomy is a safer and easier form of sterilization. Tubal ligations are usually performed under general anesthesia while a vasectomy is performed under local anesthesia. A vasectomy is less expensive than a tubal ligation. Recovery with a vasectomy is just a few days but can be a week or longer with a tubal ligation. The success rate of a vasectomy is slightly higher than tubal ligation. Most importantly, the chances of complications are fewer with a vasectomy than tubal ligation and serious complications with a vasectomy are exceedingly rare.
How is a vasectomy performed and does it hurt?
A vasectomy is performed as an outpatient procedure in a doctor’s office or in an ambulatory care center under local anesthetic. A vasectomy takes between 15 and 20 minutes. The procedure requires that a small incision be made, a small segment of the vas deferens be removed, and the separated segments then sealed. The skin may then be closed with a small dissolving suture. A bandage is applied and the patient is able to leave the office. Most men will experience some minor discomfort during a vasectomy while the anesthetic is applied. Afterwards, mild swelling in the area can be expected and resolved within a few days. Tylenol is sufficient for any pain afterwards.
Are there different types of vasectomies?
All vasectomies are performed with the same general principles of a skin incision and separating or occluding the vas deferens. Some doctors prefer a “no-scalpel” technique to perform a vasectomy in which the skin incision is made with a sharp scissor-like instrument instead of a scalpel. Advocates of this technique describe decreased complication rates but it is essentially the same procedure and the differences can be explained by your doctor. There is a new plastic device called a Vasoclip which is used to clamp and occlude the vas deferens without cutting. It does have specific advantages and disadvantages which you should discuss with your doctor.
How successful is a vasectomy?
Avasectomy is successful in over 99.9% of cases. It takes several months for the sperm to be flushed from the vas deferens before sterility can be assured. The absence of sperm does need to be confirmed with a semen analysis prior to abandoning other forms of contraception. It takes approximately 15-20 ejaculates to clear the sperm. Sex can be resumed in about a week for most men, but some men resume sexual activity sooner than others.
Is there a link between prostate cancer and vasectomy?
Though there were some poorly conducted studies early on that suspected a link, the bulk of evidence since has found absolutely no link between prostate cancer and a vasectomy.
Does a vasectomy change sexual functioning and what are the risks?
Sexual functioning is not affected. The testicles have two principal functions: producing testosterone and producing sperm. The testosterone is the male hormone and enters the blood stream and is not affected by vasectomy. Only the production and delivery of sperm are altered. Men will have the same sexual desire, pleasure, functioning, masculinity and erections, and no noticeable change to the ejaculate. The risks are very minor and include bleeding and skin infection at the site of the vasectomy. There is also a small risk of recannulization in which the cut ends of the vas deferens reconnect, though this is very rare and occurs in less than 1 out of a thousand men. Most men experience some mild bruising and swelling at the vasectomy site which usually resolves over 1-2 days
Are men happy with a vasectomy and is it reversible?
Men are very happy with a vasectomy. Almost one out of every ten men in reproductive age in the US has had a vasectomy. Satisfaction with the procedure is very high in men who are sure that they do not wish to have more children. A vasectomy should be considered an irreversible procedure. Though a vasectomy can be reversed, it is not assured. Avasectomy is considered a safe and highly effective procedure with minimal discomfort.
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