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Decision focus: should I have a vasectomy?

Vasectomy is the most common form of male birth control in the U.S. About half a million men have this minor surgical procedure each year. The result is permanent sterilization. © iStockphoto.com/Lilli Day Vasectomy is the most common form of male birth control in the U.S. About half a million men have this minor surgical procedure each year. The result is permanent sterilization. © iStockphoto.com/Lilli Day

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By Howard Seidman, Contributing Writer, myOptumHealth

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Vasectomy is the most common form of male birth control in the U.S. About half a million men have this minor surgical procedure each year. The result is permanent sterilization. It's safe, effective and has no impact on erection, hormone levels or sexual performance. There are also no measurable links between prostate or testicular cancer and vasectomy.

Normally, sperm are produced in the testicles and combine with liquid called semen. Semen is ejaculated during sexual intercourse. With a vasectomy, sperm is blocked from combining with semen and passing out of your body.

Sperm is still produced after a vasectomy, but it can't travel past the blocked path. It becomes reabsorbed by the body instead.

About the procedure

A vasectomy is usually performed in a doctor's office and takes about 15 to 30 minutes. In the traditional vasectomy procedure, the doctor makes small cuts in the skin of the scrotum with a scalpel to reach the vas deferens, a tube that carries sperm from the testicles. There are two vas deferens - one connected to each testicle. This method also involves cutting the vas deferens and then stitching or sealing off the ends.

Other methods include:

Vas-clip method.This method does not require cutting the vas deferens. A clip is used to stop the sperm flow. This may help to reduce pain during recovery, but the success rate may be lower.

No-scalpel vasectomy. Here, the scrotum is opened using a razor-sharp clamp instead of a surgical blade. A section of each vas deferens is removed, but the incisions to reach them are smaller than the traditional method and heal without stitches. A no-scalpel vasectomy may reduce the risk of bleeding and infection. It may also:

  • Shorten the operation
  • Reduce healing time
  • Let you resume sexual relations sooner

Once you have a vasectomy, it takes about two months or about 20 ejaculations to empty sperm already produced. You need to continue to use another birth control method for about three months. At that point, your doctor will ask for sperm samples. If there is no sperm in these samples, the chance of fathering another child is extremely low.

Why you might want the procedure

Vasectomy is much simpler and less costly than female sterilization. It may or may not be covered by your insurance.

If you and your partner don't want to have children (or any more children) a vasectomy can ease your anxiety about pregnancy. This may help you to enjoy sex more and cut down on the cost of other contraceptives. But this form of birth control will not prevent you from getting any sexually transmitted diseases.

Why it might not be for you

Vasectomy is not intended for men who may want to have children later. Doctors advise that men think through this decision completely to consider life changes that could cause a change of mind. Some men regret having a vasectomy if they are with a different partner later who wants children.

Surgery to reverse a vasectomy is possible, but it:

  • Is complicated
  • Is expensive (about $10,000)
  • May not be covered by insurance
  • Fails about half of the time

Vasectomy is a low-risk procedure. Rare complications can include:

  • Bleeding
  • Infections
  • Discomfort lasting up to 12 weeks

In rare instances, an unplanned pregnancy can occur if the vasectomy was unsuccessful. If that happens, a second surgery can be performed.

View the original Decision focus: should i have a vasectomy? article on myOptumHealth.com 

SOURCES:

  • National Institute of Child Health and Human Development. Facts about vasectomy safety. Accessed: 09/09/2009
  • Centers for Disease Control and Prevention (CDC). Unintended Pregnancy Prevention: Vasectomy. Accessed: 09/17/2009
  • Dassow P, Bennett JM. Vasectomy: An update. American Family Physician. 2006;74(12):2069-2074. Accessed: 09/09/2009
  • University of Texas Southwestern Medical Center. Common questions about vasectomy. Accessed: 09/09/2009
  • Cook LA, Pun A, Gallo MF, Lopez LM, Van Vliet HAAM. Scalpel versus no-scalpel incision for vasectomy. Cochrane Database of Systematic Reviews 2007;2:1-22. Accessed: 09/09/2009
  • Art KS, Nangia AK. Techniques of vasectomy. Urologic Clinics of North America. 2009;36(3):307-316. Accessed: 09/09/2010
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