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Quick Snip: Should You Get a Vasectomy?

Paul J. Turek, MD

If you are thinking about having a vasectomy, you are not alone.

Each year, about 500,000 men in the U.S. choose vasectomy as permanent birth control. During vasectomy, each vas deferens (the two tubes that move sperm) are cut or sealed off. This blocks sperm from reaching the semen ejaculated from the penis. The testicles still make sperm after a vasectomy, but they are absorbed by the body. A vasectomy is more effective than any other method of birth control, besides abstinence. Only one or two women out of 1,000 will get pregnant in the first year after their partners have had a vasectomy.

The Procedure

Your doctor can perform a vasectomy in an office or hospital. Vasectomy is a minor surgery that should take about 20 minutes. We spoke with Urology Care Foundation Outreach Committee member Dr. Paul Turek, who specializes in men’s reproductive health. He tells his patients: “Take a long hot shower the morning before with a lot of soap. And make sure you have a bag of frozen peas and a couple of rented movies at home.”

Before the vasectomy, your scrotum will be shaved and cleaned. Usually local anesthesia is used. So you will be awake but should not feel any pain. Some patients may also be given medicine to reduce anxiety. With a standard vasectomy, the urologist makes one or two small cuts in the scrotum. The vas deferens tube is cut and tied or sealed with heat. The tube is replaced inside the scrotum. The procedure is then repeated on the other vas deferens. Lastly, the skin is closed with stitches that dissolve and do not have to be removed.

Another popular option is a no-scalpel vasectomy. In this procedure, a small clamp with pointed ends is used instead of a scalpel to puncture the skin. Then each vas deferens is lifted out, cut, sealed and then put back in place. A no-scalpel vasectomy works just as well as a standard vasectomy. Some benefits of a no-scalpel vasectomy are less bleeding, swelling and pain, and a smaller hole in the skin.

Risks

Up to one-in-five men may have ongoing pain or discomfort after a vasectomy. Most commonly, it is due to congestion of sperm in the system behind the blockage and eventually resolves with time. This is most often treated with anti-inflammatory drugs, like ibuprofen. One to six percent of men may need additional treatment to relieve their pain. Otherwise, the risk of bad side effects after a vasectomy is very low, but may include:

  • Bleeding under the skin, which may cause swelling or bruising. (Contact your doctor if your scrotum swells significantly soon after your surgery.)
  • Infection at the site of the cut. It is rare for an infection to occur inside the scrotum.
  • A small lump forming because sperm leaks from a vas deferens into nearby tissue. This is usually not painful. If it is painful, it can be treated with rest and pain medicine. Sometimes surgery may be needed to remove the lump.
  • Swelling of the vas deferens.
  • In rare cases, the vas deferens may grow back together, which would enable the man to have children again.

Older studies showed a risk of prostate cancer in men who have had vasectomies. But many years of research since then have found that no clear link exists between a vasectomy and prostate cancer.

Recovery

Your scrotum will be numb for one-to-two hours after a vasectomy. Put cold packs on the area. (The bag of frozen peas Dr. Turek mentioned above works well.) Lie on your back as much as possible for the rest of the day. Mild discomfort or pain is normal after a vasectomy, and should be treated with pain relievers. Wearing snug underwear or a jockstrap will help ease discomfort and support the area.

You may have some swelling and minor pain in your scrotum for several days after the surgery. According to Dr. Turek, “If you are feeling up to it, you may be able to return to work in one or two days, but should avoid heavy lifting for a week. You can resume sexual activity as soon as you are comfortable, usually in about a week. But do not assume the vasectomy is effective from day one.” Sperm may still be in the semen for many months after a vasectomy. It takes about 20 ejaculations or three months to clear the sperm from the tubes. However, results vary for different men. Usually three months later, your urologist will test your sperm count to make sure your semen is clear of sperm. Until the sperm count is zero, sex without some other method of birth control may lead to pregnancy.

After recovering from a vasectomy, “a man and his partner should notice no difference during sexual activity,” said Dr. Turek. The ejaculation and orgasm are generally not changed. The amount of semen does not decrease more than 5 percent. Still, your partner may be able to feel the vasectomy site, especially if a lump has formed. An uncomplicated vasectomy does not cause erection problems.

What to Consider

Choosing to have a vasectomy is a very personal choice. Talk with your partner, and think about what is best for you and your family. Be sure to bring up any questions you may have with your health care provider.

Below are some things to keep in mind:

  • Vasectomy is safer and cheaper than tubal ligation (blocking the fallopian tubes to prevent pregnancy) in women.
  • The one-time cost of a vasectomy may be cheaper over time than the cost of other birth control methods, such as condoms or medication.
  • A vasectomy does not protect against sexually transmitted diseases (STDs). Use condoms to protect against STDs.

Lastly, it is important to note vasectomy is a permanent method of birth control. This may be a plus or a minus based on your own situation. You should not have a vasectomy if you may want to father children in the future. While it is possible to have a vasectomy reversed, this can be a difficult and costly procedure. Also, reversing or “undoing” a vasectomy does not always result in pregnancy. So it is important to think through all your choices carefully before deciding to have a vasectomy.

The following was submitted by Dr. Turek and taken directly from his blog.

Why Do Men Get Vasectomies?

I ask most patients why they are considering a vasectomy. The responses vary, but can be very amusing. Here are a dozen of the funniest answers I’ve heard in my practice:

  1. My wife said: “the factory is closed,” so I’m here.
  2. I was told that they broke the mold after they made me, but I want to make sure of it.
  3. My wife said: “It’s your turn now.”
  4. After this, I won’t ever have to say I’m sorry again.
  5. I’m married! Condoms are sooo high school!
  6. Have you seen the movie ‘One Fine Day?’ That’s why I’m here!
  7. Every time I look at my wife, she gets pregnant.
  8. Apparently, sacrificing some limbs just isn’t the same…
  9. She told me: “Enough, get your wings clipped already!”
  10. I was told that I can shoot the gun all I want and no one will get hit.
  11. I heard that it’s easier than getting your teeth pulled out…
  12. My wife told me that it’s time for juice without seeds.

So, hats off to those men who chose the “emission impossible” way to an unburdened and unbridled sex life.

To access Dr. Turek’s blog, visit theturekclinic.com/blog.

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