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Weighing the Pros and Cons of Vasectomy

When it comes to vasectomy, the most important decision a man will make is not how it will be done—it is a safe, relatively painless, and straightforward procedure—but why it should be done. The choice may seem uncomplicated, but it is tied to lifestyle, perceptions, and values. One thing, though, is clear: If you have a vasectomy, it will be difficult to ever father another child.

What Should You Consider?    TOP

Most men who get vasectomies are in their late thirties and have fathered all of the children they intend to father. Men who are in their twenties who have not yet had children or have decided they do not want to have children, should give the matter serious thought. The procedure is intended as a permanent form of birth control, so the decision should not be made hastily.

In fact, making the decision for the best reasons is the most difficult part about undergoing a vasectomy. As procedures go, it is relatively uncomplicated. Vasectomy is also more than 99% effective. In the majority of cases, it leaves you functioning as well sexually as you did before.

What is not as simple is deciding why you should have a vasectomy. There are very few medical reasons why a man has to have a vasectomy. Contrast this with many middle-aged women who must undergo a hysterectomy for a variety of health concerns or who must undergo a more complicated and riskier surgery in which their fallopian tubes are tied.

What Happens During a Vasectomy?    TOP

Sperm are the reproductive cells in men. They are formed in the testes. During sexual climax, sperm emerge from the testes through two narrow tubes called the vas deferens and mix with semen to form ejaculate. The purpose of vasectomy is to cut and tie the vas deferens, so that sperm cannot get through. Instead, the sperm are harmlessly absorbed by the body. You will still ejaculate semen and it will still feel the same. It just will not be fertile.

During vasectomy, local anesthetic is injected and an incision is made in the scrotum, which is the sac containing the testes. Each of the two vas deferens tubes is cut and tied off. No-scalpel vasectomy, in which a special tool is used to make an opening in the scrotum instead of a scalpel incision, is even simpler. In most cases, you will be awake throughout the 15-20 minute procedure.

After the surgery, there will probably still be some sperm present in your ejaculate for about three months, so you will be asked to have two sperm counts done after approximately 20 ejaculations. Use some form of birth control until these two semen analyses have shown that all is clear.

How About Recovery Time?    TOP

Swelling, bruising, and pain are the most common complaints right after the procedure. However, these usually subside quickly and respond well to ice packs, mild pain relievers, scrotal support, and rest. You should be able to return to work the next day, but it will take about a week to fully resume normal activities.

You should note no change in your libido or sex drive because vasectomy prevents only the escape of sperm, not the release of testosterone, which drives your libido.

Can the Surgery Be Reversed?    TOP

All vasectomies should be considered permanent. A reverse vasectomy can be a risky and expensive proposition, with varying success rates that depend on the type of surgery your doctor does and how much time has passed since the vasectomy. Reversal surgery is also more time consuming and more complicated than a vasectomy. And there are no guarantees that it will work.

A vasectomy is intended to be a permanent procedure. This is important to remember as you begin to decide if a vasectomy is right for you.

RESOURCES:

American Academy of Family Physicians
http://familydoctor.org/online/famdocen/home.html
Planned Parenthood Federation of America
http://www.plannedparenthood.org

CANADIAN RESOURCES:

References:

Barone MA, Nazerali H, Cortes M, et al. A prospective study of time and number of ejaculations to azoospermia after vasectomy by ligation and excision. J Urol. 2003;170:892.
Hendry WF. Vasectomy and vasectomy reversal. Br J Urol. 1994;73:337.
Leavesley JH. A study of vasectomized men and their wives. Aust Fam Physician. 1980 Jan;9(1):8-10.
Microsurgical vasectomy reversal. Johns Hopkins Medicine website. Available at: http://malefertility.jhu.edu/VasectomyReversal.php . Accessed February 28, 2013.
Non scalpel vasectomy. Massachusetts General Hospital website. Available at: http://www.massgen.... Accessed February 28, 2013.
Schwingl PJ, Guess HA. Safety and effectiveness of vasectomy. Fertil Steril. 2000;73:923.
Vasectomy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 6, 2012. Accessed February 28, 2013.
Vasectomy. Planned Parenthood website. Available at: http://www.planned.... Accessed February 28, 2013.
Vasectomy. University of Miami website. Available at: http://urology.med.miami.edu/x64.xml#4. Accessed February 28, 2013.
Vasectomy. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=53. Updated January 2011. Accessed February 28, 2013.
Last reviewed February 2013 by Brian Randall, MD
Last Updated: 2/28/2013
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition. To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebscohost.com.