A vasectomy is the most reliable form of permanent birth control, so why aren’t more men having them done?
One of the most common procedures we conduct at Urology Associates is a vasectomy. A vasectomy is a form of permanent male birth control by permanent sterilization that prevents the release of sperm to mix with semen when a man ejaculates.
Compared with the female sterilization process of having the fallopian tubes “tied,” vasectomies are much more reliable, faster and safer. So why do only 9 percent of sexually active men in the United States get vasectomies, while 27 percent of women get tubal ligations?
Well, there’s a lot of fear involved when men think about vasectomy, because they’ve been buying into myths about the V word.
In an attempt to debunk the various myths surrounding vasectomies and get all the facts out in the open, I’ve compiled a list of typical misunderstandings that patients have regarding vasectomies.
A vasectomy murders your sex drive
No way. A vasectomy will not affect your sexual desire, sex drive or your ability to have erections and ejaculate. Everything, including your orgasms, should remain unchanged. Although it’s important to wait until you feel recovered enough to have sex following the procedure. Some men experience mild aching in their testicles when they are sexually aroused, however most of the enjoyable aspects of intercourse won’t be altered.
A vasectomy hurts like the Dickens
I get it, it’s a sensitive area and you are likely anxious about a surgery around this part of your body. While every patient is unique and some discomfort is always possible with any surgery, a vasectomy generally is not painful. Some patients may experience a slight tugging or pulling while the doctor locates the vas deferens during the procedure, as well as a dull ache and mild pain in the scrotum and groin as the anesthesia wears off. In order to reduce pain and swelling you can take over-the-counter anti-inflammatory medication or apply a bag of ice or frozen vegetables to the affected area. If pain lasts for longer than a week and the symptoms aren’t getting any better, it is important to let your physician know.
I’m going to have a long, painful recovery
Not really. Many patients are pleasantly surprised with how quickly they are able to get back in action. Patients usually recover from a vasectomy in about a week. I recommend they wait a few days before having sex or jumping back into strenuous activity.
One of the most important parts of recovery from a vasectomy is rest. Many men, after my own heart, schedule their procedure during March Madness. It’s a great opportunity to grab a bag of frozen peas and post up on the couch for a couple of days while your body recovers.
A vasectomy procedure takes a good while and feels weird
Weird? Maybe the idea can make you feel weird, but the procedure is very quick, lasting about 20-30 minutes from start to finish. Here’s what to expect:
- A local anesthetic to numb the scrotum.
- A small puncture with needle is made on each side of the scrotum.
- The doctor finds, cuts and seals the vas deferens, the small tubes sperm travel in to mix with semen.
- The cut tubes are returned to the scrotum and closed with a few small stitches.
Patients who are considering having a vasectomy should be sure about not wanting to have any more children in the future. By blocking the vas deferens during the procedure, the sperm’s pathway is blocked, it can’t combine with the semen that is ejaculated during sexual climax. Without sperm a woman’s egg cannot become fertilized in order to result in a pregnancy.
Vasectomies fail and men end up getting women pregnant
Here’s where old data might be tripping you up. Over the years, urologists have greatly improved vasectomy success rates. Today, if done properly by a well trained and experienced surgeon, failure rates for vasectomies are around 0 percent. It’s considered the most effective form of birth control.
But, just because you’ve had a vasectomy doesn’t mean that it’s immediately effective. It usually takes 10 to 20 ejaculations to clear sperm completely from the semen. Only 1 to 2 women out of 1,000 will have an unplanned pregnancy in the first year after their partners have had a vasectomy – and that’s typically due to failure to wait until sperm has completely cleared from the semen before having intercourse without birth control. After a vasectomy, sperm produced is absorbed into the body.
It’s a good idea to check back in with your doctor for a sperm count before forgoing other birth control methods. Very rarely, the vas deferens will spontaneously reconnect on their own allowing the sperm to mix with semen.
Having a vasectomy will make my semen look funny
For the most part, your ejaculatory fluid will look exactly the same as it did prior to the vasectomy procedure, because less than 3 percent of the volume of ejaculate is made up of sperm. Because the tubes are blocked before the seminal vesicles and the prostate, you will still ejaculate the same amount of fluid, just without the sperm.
If I change my mind and want children, I’m out of luck
Actually, the “permanent” in permanent sterilization can be reversed by reconnecting the vas deferens in vasectomy reversal. But it’s a difficult procedure.
During a vasectomy reversal, the surgeon will make a small incision on either side of the scrotum and check the vas deferens fluid for sperm. If sperm is present, the physician will reconnect the ends of the vas deferens to the epididymis, thereby allowing sperm to pass through again. If there is no sperm, the surgeon will need to perform a more difficult procedure to bypass the blockage in the epididymis to reconnect the vas deferens.
A vasectomy reversal’s efficacy varies depending on how long it’s been since the initial sterilization, how it was done and the patient’s overall health condition. Another consideration is that a vasectomy reversal is a very delicate process that requires an experienced surgeon. The procedure can take, on average, 4 to 5 hours. About 10,000-30,000 men reverse their vasectomies annually.