 | ||
|
| |    Vasectomy by Elisa Ross, MD reviewed and revised by Marjorie Greenfield, M.D. Vasectomy is one of the most popular forms of birth control in the U.S. today, although you'd never know it to hear some men's reactions whenever the topic's brought up! Well, they may laugh nervously or cringe, but roughly 20 percent of American men over 35 years old have had one, about 8 million total. And this number's growing, with about half a million men choosing vasectomy every year. Understanding the procedure Vasectomy is a small surgical procedure that permanently blocks the duct in the scrotum that carries sperm from the testicle. The procedure is usually done by a urologist or family physician in an office or out-patient surgery center. Most men are awake during the procedure, but surgical drapes prevent them from seeing the actual surgery. After numbing the skin of the scrotum with an injection of anesthetic much like the dentist uses, a small cut is made in the scrotal skin. In the "no scalpel" technique, a small hole is made in the skin instead. In both techniques, the tube (vas deferens) is then cut and tied. Usually the procedure takes only half an hour, and the patients can go home shortly after. Most incisions are small and blend in with the wrinkles of the scrotum. Pain afterward is usually minimal, and pain medicine usually works well enough for the men to resume normal activities within days. When does a vasectomy take effect? After the tube is interrupted, there are still a few sperm "downstream" that need to be flushed out since they could still cause a pregnancy. Some kind of effective birth control method should be used until a semen analysis or two have clearly shown that there are no more sperm coming through. So, what are the advantages of vasectomy? If a couple decides that their family is complete, vasectomy is the sterilization method with the lowest cost, fewest side effects, and greatest permanence. Many men enjoy the idea that they are taking some of the physical responsibility for planning their family. And just as with tubal ligation, not having to worry about unplanned pregnancies or using birth control lets many couples feel more spontaneous and free in their lovemaking. What about complications? Even with minor surgical procedures, complications such as bleeding and infection are possible. Sometimes the backed-up sperm can cause pressure or a small lump at the site, but this usually resolves on its own. There is also the possibility that the tube could re-form, allowing sperm to flow through it. This is very rare, occurring once for each thousand operations, making vasectomy one of the most reliable methods of birth control. The long-term effects of a vasectomy After a man has had a vasectomy, he will still continue to make sperm but they no longer have a way to be transported into the semen (the sperm eventually are absorbed by the man's body, just like any other cell that has gone through its life cycle). His testicles will look and feel the same and produce the same amount of male hormones. For men considering vasectomy, it often comes as a great relief to know that sex drive and performance are not affected by the procedure. During intercourse, fluid is still ejaculated; it just doesn't have any sperm in it. Overall, vasectomy is safer than tubal ligation and is not believed to cause any long-term health problems. Some studies published in 1993 noted an association between vasectomy and prostate cancer. Subsequent studies have failed to confirm this association. One theory for the initial findings is that men who already had a urologist (from having had a vasectomy) were more likely to get checked for prostate cancer than men who did not already know one, making it more likely that any cancer would be detected. Deciding to get a vasectomy Vasectomy is a logical option for men who are sure that they have completed their families--or are certain that they don't want to ever start one. But because vasectomy is permanent, men who think they might ever want children (or more children) should consider other birth control methods. Vasectomy also should not be used in the hope of fixing problems within the relationship, or with an expectation of improving sexual performance. That said, there are almost no medical reasons for a man not to have a vasectomy. It is most important that a man talks things over with his partner before making this decision. Many men also have found that they get good information and reassurance from talking with other men who have had the procedure, as well as with their doctors. What are the alternatives? Other than condoms, most methods of birth control primarily involve the woman. They include injectable hormones, tubal ligation (female sterilization), oral contraceptives ("The Pill"), the contraceptive patch, intrauterine device (IUD), diaphragm, spermicide, cervical cap, and timed abstinence ("rhythm method"). How much does it cost? The cost can vary, and usually runs anywhere from $500 to $1,000. Most insurance companies pay for all or most of it. This is less than tubal ligation, and less than many other methods since it is a onetime expense. What about regret afterwards? There is a world of difference, psychologically speaking, between not wanting any more children and not being able to have any. There is a certain amount of wistfulness that accompanies the procedure for many men because it represents the closure of the reproductive chapter of their lives. However, most soon realize that the next chapter is quite attractive, too: the one in which the fear of pregnancy is gone, allowing for different kinds of activities and lifestyle choices. What if I want it reversed? A number of men, especially if they've remarried, truly do regret having a vasectomy and want to have it undone. There are urological fertility specialists who are very good at reconnecting the ducts. Most insurance plans won't pay for it, though, and the procedure costs thousands of dollars. The longer it has been since the vasectomy, the less likely a successful reversal. In one study, three out of four men who had their vasectomies reversed within three years got their partners pregnant, whereas only one in three who had the vasectomy more than fifteen years before were successful. Sometimes sperm can be collected upstream from where the vasectomy was done, and the eggs can be fertilized using a high tech fertility procedure called intercytoplasmic sperm injection, or ICSI. This too, is quite expensive and often not paid for by insurance.
| |  | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| About Us |
Contact Us |
Our Partners Privacy Policy | Ethics | Advertising Policy | Terms of Service © Copyright 2004 The Dr. Spock Company. All Rights Reserved. THIS SITE DOES NOT PROVIDE MEDICAL ADVICE. The information drSpock.com
provides is for educational purposes only and is not a substitute for
professional medical advice. Always seek the advice of your health care
professional if you have a specific health concern. Mention or advertisement
of any product, service, or brand does not constitute endorsement, guarantee,
or recommendation by The Dr. Spock Company. Please read our full
Terms of Service. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
