Snip, snip: all about vasectomies

June 15, 2017 | by Edward-Elmhurst Health
Categories: Healthy Driven Moms

Like many couples, at some point you and your partner may consider a more permanent form of birth control. One option for women is tubal ligation, while men have the option of a vasectomy.

The National Institutes of Health (NIH) says a vasectomy is one of the most effective forms of birth control. It is cheaper, faster and safer than many other options. Getting your tubes tied is permanent and irreversible.

If you’re considering a vasectomy, it could take some coaxing to get your man on board — as many men are apprehensive about the procedure. First, let’s clear up some of the concerns he may have:

  • Libido - A vasectomy does not affect testosterone production or sex drive. In fact, new research suggests a vasectomy can actually improve a man’s sex life.
  • Ejaculate - There will be no noticeable change in the amount of ejaculate, as sperm make up a very small amount of the semen. 
  • Erection and orgasm - A vasectomy will not affect the nerves that are responsible for his ability to get an erection or have an orgasm.

What does the procedure entail? Performed by a urologist (a doctor who specializes in the male urinary tract and reproductive system), a vasectomy usually takes place in a medical office or an outpatient surgery center.

The man is awake for the procedure. He is given a local anesthetic to numb the scrotum. The procedure can be performed in one of two ways on each testicle:

  1. Scrotal incision – One or two small cuts are made in the scrotum. A small section of the vas deferens is cut out and removed, the ends are sealed or tied off, and the scrotum opening is stitched closed.
  2. No-scalpel method – A very small puncture hole is made on one side of the scrotum. Part of the vas deferens is pulled through the holes under the skin, a small section is removed, and the ends are sealed and put back in place.

The procedure takes about 30 minutes, and most men go home the same day. There may be some soreness, bruising and swelling, which usually goes away within two weeks.

After the procedure, a man’s sperm gets reabsorbed by his body rather than ejaculated in semen. Eventually, a man’s testicles will begin making fewer sperm.

Vasectomies are one of the best ways to prevent pregnancy and rarely fail. In the first year after vasectomy, only 15-20 of every 10,000 couples will experience a pregnancy. Compare this number to 500 out of 10,000 couples who experience a pregnancy while on the pill, and a whopping 1,400 out of 10,000 condom-wearing couples who experience a pregnancy.

A common cause of vasectomies failing is if a man doesn’t wait long enough after the procedure before having sex without another form of birth control. Among 1,000 vasectomies, about half of the failures will occur within the first three months (or about 15-20 ejaculations) after surgery — the time it takes after a vasectomy for the remaining sperm to be cleared out of the semen.

After a vasectomy, a man can see his doctor for a semen analysis to determine the success of the procedure and ensure his semen sample is sperm-free.

While a vasectomy is safe and highly effective, there is a small risk of problems, including:

  • Hematoma, or painful swelling from bleeding under the skin
  • Infection (fever and scrotal redness and tenderness)
  • A lump in the scrotum (a granuloma can form from sperm that leak out of the vas deferens into the tissue)
  • Pain in the testicles that doesn’t go away. About 10 percent of men become sensitive to the buildup of pressure in the duct from the sperm that gets reabsorbed. Eventually the pain goes away. If it doesn’t, the vasectomy can be redone or reversed.

Research shows that a vasectomy does not increase a man’s risk of prostate or testicular cancer. Of course, men should still use condoms or another barrier method to protect from STDs.

While a vasectomy is considered a permanent form of birth control, some vasectomies can be reversed if a man later decides he wants to have children. The chance of a successful reversal is highest, though, when the reversal is performed not long after the vasectomy.

Also, a reversal procedure is much more complicated (and costly) than a vasectomy. Instead of 20-30 minutes, it can take 4-5 hours under general anesthesia. Recovery usually takes 1-3 weeks, and it takes an average of one year to achieve a pregnancy after a vasectomy reversal.

The decision to get a vasectomy should be thoughtfully considered by you and your partner. The bottom line: don’t get one unless you’re absolutely sure you don’t want to have children in the future.

But if you do go through with it, the procedure could open up new doors for you and your partner. When you no longer have to worry about an unwanted pregnancy, your sex life could blossom!

Learn more about urologic services at Edward-Elmhurst Health.

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