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A vasectomy is an operation that blocks the vas deferens, the tubes that carry a man's sperm to the penis.
It is a common procedure used by men as a form of permanent contraception by making the man sterile (unable to deliver sperm to the egg for fertilization). It is often referred to as male sterilization.
Every year, more than 500,000 men in the United States are choosing sterilization by vasectomy as their method of birth control. Vasectomy is a simple, safe, and effective surgical procedure that blocks the flow of sperm by cutting the tube in the scrotum.
The only aspect of your life that is changed by having a vasectomy is your ability to father a child. It does not effect the ability to obtain or maintain and erection of the penis or achieve orgasm. The man will still ejaculate seminal fluid. The only difference is that there will be no sperm in the ejaculate. The testes still produce sperm cells, but they die and are absorbed by your body. Your male hormone level remains the same, and your secondary sexual characteristics - such as hair distributions and the pitch in your voice - are not affected. A vasectomy beside it not effecting your ability to have an erection, it does not interfere with urinating. In short, life seems just the same as before. The only difference being, you will not be able to reproduce and have more children.
However, because a vasectomy must be viewed as an irreversible procedure, it is a serious step to take and your decision should be a shared one with your partner.
Before deciding to have a vasectomy, make sure you and your partner understand all the facts. Above all, be clear and comfortable in your reasons for having a vasectomy, and bear in mind that sterilization should not be viewed as a solution for sexual or marital problems.
There are many questions you and your partner will need to think about. You must be certain that you do not wish to have any more children. You will also have to consider the possibility of divorce and remarriage; if you were to marry again, you might want to have children. You should not have any doubts about such issues if you are going to have a vasectomy.
It is important to keep in mind that, if you should change your mind about wanting another child after you've had a vasectomy, you'll have to undergo a major operation that is not guaranteed to restore your ability to father a child.
If you choose to have a vasectomy, your health care provider will ask you to sign a consent form beforehand which states that you are aware of the risks involved. Be certain all your questions have been answered before you sign the consent form. Your health care provider may want to discuss the procedure with both you and your partner before proceeding with the operation.
DESCRIPTION
A vasectomy involves cutting and tying the vas deferens (sperm channels inside the scrotum). The surgery stops the flow of sperm, and provides a safe, effective form of birth control without affecting sexual desire or ability. Sperm is made in the testes. They travel through the epididymis, where they mature to fully functional sperm. Mature sperm travel through the two Vas Deferens, to the Seminal Vesicles where they are stored for ejaculation. A Vasectomy interrupts the travel through the Vas Deferens by blocking it. Thus, if sperm cannot reach the egg, there is no pregnancy.
All vasectomy methods involve first accessing each vas and then using special techniques to block (occlude) it. Worldwide, the most common occlusion technique is tying (ligation) and cutting (excision), which involves tying the vas closed in two places and removing the short segment between the two ties. Cautery is an alternative, highly effective occlusion technique. When performing cautery, a surgeon uses either an electrode or a hot wire to block about 1 cm of the inside of each end of the vas, producing scars that prevent the transport of sperm through the tube. Thermal cautery, in which a hot wire is used, may be an appropriate occlusion technique in many parts of the world, although more research is needed to confirm its effectiveness in low-resource settings.
Most occlusion techniques can also be performed with fascial interposition, a technique in which the sheath covering the vas is pulled over one of the cut ends of the vas and the end is sewn shut, creating a natural tissue barrier. Research from seven countries in Latin America, Asia, and North America has shown that adding fascial interposition to ligation and excision significantly improves vasectomy effectiveness. Although fewer data are available on the benefits of adding fascial interposition to cautery, combining the two techniques could further maximize their effectiveness.
COUNSELING & MAKING A DECISION ABOUT VASECTOMY
Personal counseling prior to the procedure is important to be sure the man obtaining the sterilization and his partner understand all aspects of a vasectomy. Techniques such as cautery and fascial interposition may further improve the effectiveness of vasectomy, making it one of the safest, least invasive, and most effective forms of permanent contraception. Remember: Sterilization IS NOT castration. Castration is the removal of the testicles.
So that you can better understand what a vasectomy is, you need to understand how your reproductive system works.1. Tiny Sperm Cells and male hormones are produced by separate systems in the testes.
2. Sperm are stored in the epididymis where they mature.
3. The sperm are moved up the vas deferens within the spermatic cord.
4. Sperm can be stored along the upper part of the vas deferens for many weeks.
5. The seminal vesicles and the prostate secret sticky, white fluids which nourish and carry the sperm along.
6. When you have an orgasm, semen (98 percent fluid, 2 percent sperm) is ejaculated through the urethra.
REASONS FOR CONSIDERING VASECTOMY
You want to enjoy having sex without causing pregnancy.
You don't want to have a child biologically in the future.
Your partner agrees that your family is complete, and no more children are wanted.
You and your partner have concerns about the side effects of other methods.
Other methods are unacceptable.
Your partner's health would be threatened by a future pregnancy.
You don't want to pass on a hereditary illness or disability.
You want to spare your partner the surgery and expense of tubal sterilization sterilization for women is more complicated and costly.
DO NOT CONSIDER A VASECTOMY IF...
You want to have a child biologically in the future.
You are being pressured by your partner, friends, or family you must want the operation.
You have marriage or sexual problems, short-term mental or physical illnesses, financial worries, or you are out of work vasectomy is not a good solution for temporary problems.
You have not considered possible changes in your life, such as divorce, remarriage, or death of children.
You have not discussed it fully with your partner.
You plan to bank sperm in case you change your mind sperm banks collect, freeze, and thaw sperm for alternative insemination. However, some men's sperm does not survive freezing. And after six months, frozen sperm may begin to lose the ability to fertilize an egg.
OTHER OPTIONS BESIDES VASECTOMY
Consider all other methods before you choose vasectomy. The pill, the patch, the ring, the shot, and IUDs are more than 97 percent effective. Most women can use them with little risk of serious complications. Other methods that have little or no side effects are condoms, female condoms, diaphragms, caps, shields, periodic abstinence, and contraceptive foams, jellies, and suppositories.
Your partner also may want to consider sterilization. There are new sterilization procedures for women that reduce the cost, recovery time, and risks of the procedure. But vasectomy is simpler, costs less, and has fewer risks. In all cases, the results must be considered permanent. So, think carefully about what sterilization will mean for both of you and your futures.
THE EFFECTS OF A VASECTOMY
A vasectomy leaves your reproductive system essentially unchanged. The only difference is that sperm cells are blocked from traveling through the vas deferens.
VASECTOMY REVERSAL
Sometimes it is possible to reverse the operation, but there are no guarantees. Some sterilized men regret their decision at some point in their lives, mostly due to a change in marital status, the death of a child, or a renewed desire to have children. While many people are under the impression that sterilization is easily undone, sterilization should be considered permanent. Reversals can be very expensive and may not be successful. Although sperm can be found in the ejaculate of most men who have their vasectomies reversed, only 50 percent are successful at fathering children.
Reversal costs from $4,000 to $13,000 and involves intricate surgery. Success in restoring fertility is uncertain. From 38 to 82 percent of men with reversed vasectomies are able to cause pregnancy. The factors in this wide range include:
- The length of time since the vasectomy was performed.
- Whether or not antibodies to sperm have developed. Antibodies are molecules produced by the immune system to fight off anything that the immune system perceives as being foreign. After a vasectomy many men begin making antibodies to their sperm that can be detected in their bloodstream. When present, antibodies can attach to the sperm and prevent them from moving (decrease motility) or from penetrating an egg. It has become clear that only antibodies present on the sperm may cause a problem in certain situations. Very few men actually have antibodies detected on their sperm after vasectomy reversal.
- Age of the woman partner.
- The method used for vasectomy and the length and location of the segments of vas deferens that were removed or blocked.
SPECIAL REQUIREMENTS PRIOR TO SURGERY
You may or may not, depending upon the state you reside in, be required to have the consent of your wife or partner (In Idaho where my husband had his vasectomy, I also had to sign the consent form and we both had to have pre-surgery counseling by the health care provider that did the surgery). Whether or not you and your partner are both required to sign a consent form, it is important that you should discuss the operation with her beforehand. Sometimes waiting periods are required to allow more time for thought before the operation. For federally funded vasectomies, you must:
- Be at least 21 years old.
- Observe a 30-day waiting period after signing a statement of informed consent.
- Be free of the influence of alcohol or other drugs at the time of consent.
- Reapply if the procedure is postponed for more than 180 days.
Mentally competent adults can legally choose sterilization in all 50 states. No one who is mentally competent can be forced to have the operation. You cannot be denied welfare benefits if you do not want to have a vasectomy. Even threats to do so are against federal law.
Policies and practices vary with individual health care providers, hospitals, and health centers. Sterilization may be difficult to arrange under some circumstances for instance, if a person is single or childless.
REASONS FOR PROCEDURE
Voluntary sterilization.
Recurrent epididymitis when caused by chronic prostate infection.
RISKS
As with any surgical procedure a vasectomy carries with it the potential for risks and complications. You need to be aware of these to help you consider the choice you are about to make. Any time a surgeon makes a cut or poke anywhere on the body, there exists the possibility for pain, bleeding, swelling or infection. The complications specific to vasectomy include failure of the procedure, sperm granuloma formation, injury to the blood supply of the testicle resulting in the testicle getting smaller (atrophy) and chronic testicular or epididymal pain (post vasectomy pain syndrome). Fortunately these complications are rare when the health care provider performs the no-scalpel vasectomy. While the reported complication rates for vasectomy vary between 5%-10%, the complication rate is usually lower for the no-scalpel method and some health care providers report it being under 1 percent.
Risk increases with:
Emotional instability.
Recent illness, especially one with fever.
DESCRIPTION OF PROCEDURE
Two methods are used for vasectomies: Scalpel and No-Scalpel.
Scalpel Method: Two small cuts are made in the scrotum and the tubes (Vas Deferens) are very gently lifted out through the cuts. If surgical clips are to be used, two clips are placed closely together on each tube. The tube is then cut. If bleeding occurs, cautery (electric current) is used to stop it. If tying is done, each tube is tied with surgical thread in two places close together. The tubes are then cut. If cautery (electric current) is to be used, the tubes are cut and the ends sealed with the cautery, thus closing both ends of each tube. The tubes are then placed back into the scrotum and the surgical cut is closed with a few stitches.
No-Scalpel Method: The skin of the scrotum is punctured with a sharp instrument. The skin is then stretched so that the tubes can be reached with the instruments that will be used. Each tube is blocked the same ways as with the scalpel method. After the tubes are blocked, the procedure is finished because no stitches are needed to close the puncture. First developed in China, this method is becoming more and more popular as a way of doing vasectomies. There is little blood loss and fewer complications. About 1/3 of all vasectomies in the US are done this way.
The entire procedure usually takes 20 - 40 minutes for both methods.
HAVING A VASECTOMY - PROCEDURE
The procedure may be performed in the health care provider's office, outpatient surgical facility or hospital. You will be asked to sign a consent form beforehand which states that you understand that there can be certain risks involved and that the procedure cannot be guaranteed to make you sterile.
Preparing for surgery
Before coming in for surgery, you will need to shower, making sure to bathe your scrotum thoroughly. You should wear clean underwear to the health care provider's office or hospital.
What Happens During A Vasectomy
After you undress completely, the area around the incision will be washed and shaved (you may be asked by the surgical urologist to shave the area before coming in to his/her office for the surgery.
Instructions for the man's partner if you have to shave-prep him at home prior to the surgery:I had the pleasure of shaving and preparing my husband for his vasectomy (not to mention the surgeon was very nice to let me be there for the surgery so I could watch it - which I found absolutely fascinating, by the way, as he explained step by step what he was doing. It is a very easy procedure!).
If you need to do this shaving prep at home, do not worry. After your husband has showered, have him lay down on a towel on your bed. Apply shaving cream or lotion to help the razor glide smoothly. I recommend using a brand new disposable razor (clean with no prior use) for hygienic purposes and lots of shaving cream or lotion to help prevent cuts or nicks. Take it slow and easy. There is no hurry with this procedure. A little humor helps the tension your partner may feel as you are taking a razor to his most valued commodities, his testicles. You will want to make sure the entire scrotum (balls) and near-by region is shaved clean. You want it as clean and bare as a new born baby. After shaving, wash off excess hair with warm soapy water and towel dry. He may want to take another quick shower to remove any left over stray cut hair. Do this the night before or the day of the surgery.
In the health care provider's office the your scrotal area will then be washed with antibacterial solution and you will be draped with surgical sheets.
You and your health care provider will discuss which type of anesthetic to use. Local anesthetic is most usual. Sometimes a general anesthetic is called for. No pain is felt under general anesthesia because you are asleep. Some discomfort may be felt when the local anesthetic is injected or when the tubes are brought out through the incision.
Usually a local anesthetic by injection is administered. This will prevent you from feeling pain as your surgeon does the incisions. The local anesthetic is much like one the dentist uses to fill a cavity. The anesthetic is injected into the skin and the vas, not the testicle as many people incorrectly think. The injection lasts for 10 seconds and works immediately. Patients are offered valium prior to the procedure but many men chose not to take the valium. The valium is not for pain control but rather to take the nervous edge off that most men have prior to the vasectomy.
CONVENTIONAL METHOD
One or two incisions, about 1/4 to 1/2 inch long are made on both sides of the scrotum. The vas deferens, which lies just below the skin, is identified, tied in two places and cut between the ties. A section of the tube is removed and sent to the pathology laboratory for inspection. The two ends are tied or clipped close, or they may be cauterized (sealed by heat). You may feel a sensation of pulling while the tube is being lifted out and cut.
The divided vas deferens is returned to the scrotum.
The edges of incised skin are reconstructed with fine sutures, which usually fall out in about 7 days or the incision may be closed using a small bandage.
After The Surgery
After the surgical operation, you will probably rest on the operating table for a few minutes. When you first get up, you might feel a bit wobbly, but you won't experience pain since the anesthetic is still working and probably won't wear off for an hour or two. Your health care provider can prescribe pain medication if you need one, but the discomfort is usually not severe. Any discomfort will be greatest during the first 24 hours. You will need to have someone take you home following the surgery.
NO-SCALPEL TECHNIQUE
Another method utilized for vasectomy is called no-scalpel technique. It requires 2 specialized instruments and avoids the usual surgical incision. It requires no sutures to close the surgical site and may result in fewer complications. Some men may not be appropriate candidates for this procedure because of differences in scrotal anatomy.
No scalpel-vasectomy is different from a conventional vasectomy in the way that we get to the tubes or vas to block them from passing sperm out of the testicles. An improved method of anesthesia helps make the procedure less painful. In a conventional vasectomy, the physician may make one or two small cuts in the skin with a knife, and the doctor would then use sutures or stitches to close these cuts at the end of the procedure. In the no-scalpel vasectomy, instead of making two incisions, the doctor makes only one tiny puncture into the skin with a special instrument. This same instrument is used to gently stretch the skin opening so that the tubes can be reached easily. The tubes are then blocked, using the same methods as conventional vasectomy, but because of the lack of scalpel technique there is very little bleeding and no stitches are needed to close the tiny opening. This opening will heal quickly with little or no scarring.
Non-Surgical Procedures:
CONVENTIONAL VERSUS NO-SCALPEL METHODS
The standard technique of performing a vasectomy required the doctor to make an incision (cut) in the scrotal skin, find the vas and separate it from the other structures in the spermatic cord. The vas was then tied off with sutures, cut and the ends separated. The skin incision was then stitched back together. This procedure took longer, was more painful and resulted in a longer recovery time and more complications then the no-scalpel vasectomy. So what is a no-scalpel vasectomy? This is a technique developed in China approximately 20 years ago. In China, men must be sterilized after they father a child in order to qualify for government assistance. This led to a need for a quick and simple method of vasectomy with a short recovery time since almost every man gets sterilized at some point for population control.
The technique of no-scalpel vasectomy uses a special instrument to grasp the vas through the scrotal skin and hold it in place directly under the skin. Another instrument is used to make a small puncture in the skin over the vas and spread the tissue. The vas is then pulled up and all the tissue around it is cleaned off. This is an important step because all the nerves must be moved away from the vas before it is clipped. Once the vas is clear then titanium clips are placed to block the vas. The vas is cut and cauterized between the clips and then separated. A small segment is removed to prevent the vas from growing back together. The vas is then dunked back into the scrotum and the poke hole is sealed without the need for sutures. A sterile dressing, ice pack and jock strap are then placed on the scrotum.
Note: Nationwide, the cost of a vasectomy ranges from $350-$1,000 for an interview, counseling, examination, operation, and follow-up sperm count. (Sterilization for women costs up to six times as much.) Some clinics and health care providers use a sliding scale according to income. Costs vary from community to community, based on regional and local expenses.
Contact your nearest Planned Parenthood health center 1-800-230-PLAN for information about costs in your area.
Many insurance policies will pay for or reimburse you for a vasectomy. Make sure you check your insurance policy. Blue Cross and Blue Shield and some private health insurance policies may pay some or most of the cost. In nearly all states, Medicaid pays but puts some restrictions on patient eligibility. Check with your local department of social services to see if you are covered.
EXPECTED OUTCOME
Expect sterility without complications. You may have up to 30 ejaculations before sperm completely disappear from semen. Allow 2 to 3 days for full recovery from surgery.
YOU ARE NOT IMMEDIATELY STERILE AFTER A VASECTOMY. Because some live sperm are still in the ducts, you must have two consecutive negative counts (no sperm found under a microscope from a specimen). Your testes will continue to make sperm. They are absorbed by your body. This is true whether or not you have a vasectomy. The body absorbs unused sperm cells. Sperm kept in a sperm bank is no guarantee that it can be used later. (Vasectomy may not be right for you if this is what you are thinking about.)
A second contraceptive method should be used for 12 weeks following vasectomy: Because it takes time for the vas to become completely clear of sperm, men should be counseled to use a second contraceptive method for 12 weeks (3 months) following vasectomy. Although guidelines have typically recommended a waiting period of 12 weeks or 20 to 30 ejaculations, recent research has shown that the 12-week waiting period is significantly more reliable. The best approach for determining vasectomy success is semen analysis. Where semen analysis is not available, it is especially critical that men and their partners be counseled to use a second contraceptive method for the first 12 weeks after surgery.
Since a vasectomy does not involve the nerve or blood supply to the penis, there is no reason for impotency after the surgery.
Vasectomies CAN fail - 1 percent of the time. Although uncommon, re-canalization may cause vasectomy failure in a small percentage of cases: Surgical error, infidelity, and not using a back-up method of contraception for at least 12 weeks following a vasectomy are all possible reasons for pregnancy after the procedure. But most of the few vasectomy failures that happen are caused by re-canalization, a spontaneous reconnection of the two ends of the vas, most often occurring within a month or two of a vasectomy. The risk of re-canalization appears to be related to the surgical techniques used during the procedure. Fascial interposition can reduce the risk of failure, as defined by semen analysis, by about 50 percent when performed with ligation and excision. Using cautery instead of ligation and excision may further reduce the risk of failure, making vasectomy an even more effective contraceptive method. Still, couples should be counseled about the possibility of vasectomy failure so that an unexpected pregnancy is not automatically assumed to be the result of infidelity.
POSSIBLE COMPLICATIONS
HEALING AFTER SURGERY:
For a period after surgery you may have a dark discoloration around the genital area (some bruising), and there may be a small amount of bloody discharge from your incision. These are considered normal, and they may be accompanied by slight pain and a little swelling.
As with all surgery, even a minor operation like vasectomy carries with it the possibility of complications. Those that may occur soon after your vasectomy are the following:
- Internal bleeding and collection of blood in the scrotum may cause increasing pain, great swelling, or an enlarging mass. If you have these symptoms, which usually occur within 2 days after surgery, call your health care provider.
- Infection. Surgical wound infection in the incision very rarely occurs a short time after surgery. If you suspect or have symptoms of infection, such as blood or pus oozing from the site of the incision, excessive pain or swelling, a fever over 100°F - call your health care provider.
- Sperm granuloma (benign lump in the surgical area). This occurs in 3-5 percent of all vasectomies and is a painful lump at the site where the vas deferens is tied off, and is caused by a leakage of sperm. Although the lump usually dissolves by itself, surgery is rarely necessary to remove it.
- Congestion caused by sperm left in the epididymis may cause some pain about 3 to 12 weeks after surgery. The congestion usually disappears without the need for treatment.
- Sperm antibodies in the blood are a normal response of the body to proteins formed from absorbed sperm. As of this time, these antibodies have not been found to be harmful.
- Spontaneous formation of a new vas deferens through the scar tissue left by the vasectomy very rarely occurs resulting in a small possibility of re-establishing fertility. This can usually be detected within the first few months after surgery by a semen test. Until your health care provider has done this test, you cannot be certain that you are sterile.
- Pregnancy may still occur in about 1 percent of cases (often as a result of unprotected intercourse too soon after the procedure).
TREATMENT
GENERAL MEASURES - POST SURGERY
WHEN YOU GET HOME:
Arrange for a ride home. Once you are at home, there are several things you can do to aid your recovery and to help prevent complications.
Wear an athletic support for 24 hours (or longer), but some men may find a supporter too tight and confining. If this is the case for you, you will probably find it more comfortable if you wear a pair of cotton, jockey-type under shorts that provide you with some support.
Rest in bed for 24 hours, or at least try to stay off your feet as much as possible for the next 2 days. This will reduce the chances of swelling.
Apply ice bags to both sides of the scrotum (outside of the athletic support) for 20 minutes per hour for the first 6 to 8 hours.
Hard blunt ridges should form along the incisions. While healing, the ridges will recede gradually. Keep the incision area clean and dry.
Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain (beginning 24 hours after surgery).
Shower as usual (avoid hot baths or showers for 24 to 48 hours following surgery to protect your incision).
Avoid any heavy lifting or vigorous exercise for 5 days after surgery. If your job is not a strenuous one, you can usually return to work on the third day after your surgery.
Sexual activity can be resumed in about a week. However, it is absolutely essential that you use another form of birth control until your sterility is confirmed by the health care provider with a zero sperm count result. To make sure no sperm are left in your semen, you will be asked to collect a sample (usually at home and put in a clean pill bottle or small jar) and bring the semen sample to the health care provider's office for testing. Your health care provider will examine your semen under a microscope, and will tell you when there is no longer any evidence of sperm. Then - and only then - can you be considered sterile. You first test will usually be about 6 weeks after surgery and another test is given about 4 months after surgery. Remember, until you have been told that you can stop, continue using other methods of birth control! One sperm can be too many and result in an unwanted pregnancy.
Your health care provider may want to see you in 2 or 3 days to check your progress.
NOTE: As your shaved pubic hair grows back in, resist the urge to scratch the itchiness caused the growth stubble in the testicle region where the surgery has been performed. As the hair grows, it will become less itchy. Applying lotion on the new hair growth may help to relieve some of the itchiness. You might try something with vitamin E and aloe. Both of these are also beneficial to healing scars. Take it from us women who have had our hair removed for childbirth (not so common as it used to be), it does grow back and it does feel better after a while.
MEDICATION
Prescription pain medication should generally only be required for 2 to 7 days following the procedure.
Non-prescription drugs, such as acetaminophen, may be used for minor pain. Avoid aspirin because of increased bleeding risk.
Antibiotics, if needed to fight or prevent infection.
ACTIVITY
Return to daily activities and work as soon as possible (usually 2 to 3 days after surgery.
Avoid strenuous activity for 5 to 7 days. Don't swim until the incision is healed.
Sexual relations may be resumed 1 week after surgery. Use birth control measures until laboratory studies confirm sterility (about 12 weeks) and/or at least 30 ejaculations.
DIET
No special diet. However, putting vitamin E oil (from a capsule) on the scar will help the scar to heal faster, better with less scar tissue.
NOTIFY YOUR HEALTH CARE PROVIDER WHO PERFORMED THE SURGERY IF...
Pain, swelling, redness, drainage or bleeding increases in the surgical area. Most men who undergo vasectomy have no difficulties but a small group of men develop chronic testicular or epididymal pain after the procedure. This pain can start immediately after surgery and is usually due to a sperm granuloma (inflammation at the vasectomy site) or infection and most cases resolve with the appropriate medical therapy. Occasionally, pain may develop years after the vasectomy and be exacerbated by ejaculation. This pain is thought to be the result of back pressure building up in the epididymis and is known as an "epididymal blowout" or "post vasectomy pain syndrome" While it must be stressed that these are fairly uncommon occurrences after vasectomy, they are frustrating and difficult to deal with for both the patient and the health care provider. A range of treatments for these syndromes including non-surgical treatments, vasectomy reversal, open-ended vasectomy, and chemical sterilization. Most patients with this problem, which has been ignored for so long, need not suffer.
Signs of infection develop: headache, muscle aches, dizziness or a general ill feeling and fever.
LIVING WITH A VASECTOMY
A vasectomy will not affect your manliness in any way because it has no effect on the male hormones produced by the testes. Nor will it alter your sexual functioning. You will still have the ability to have an erection and an orgasm, and the amount of semen ejaculated will not decrease noticeably.
Sexual relations will have the same sensations and excitability as before. If you had a good relationship before a vasectomy, it will be the same afterwards. Your mutual enjoyment may actually improve because you will no longer be afraid of unwanted pregnancy, and sex may be more spontaneous because birth control is no longer necessary.
A CHANGE OF HEART
Sometimes an unforeseen event in your life may cause you to seek to have a reversal of your vasectomy. Although vasectomy must be considered irreversible, there is a surgical procedure called a vasovasostomy that may work to restore your fertility. In a vasovasostomy, the cut vas deferens are reconnected to reestablish the flow of sperm. It is a major operation that is quite expensive and it is usually not reimbursable by health insurances. Most important, though, a vasovasostomy cannot guarantee to restore your ability to father a child.
SPERM BANKS
Another possibility that might enable you to have children after your vasectomy is a sperm bank. Before your vasectomy, your sperm is collected, then frozen and stored until you want to have a child.
Sperm Banking: An option to consider prior to having your vasectomy is sperm banking. Some men chose to have their sperm frozen and stored just in case they change their mind and want more children in the future. Having frozen sperm would mean that they would not necessarily need a vasectomy reversal or have to do in-vitro fertilization both of which can be costly. Sperm can be stored indefinitely and used at any time with an artificial insemination procedure. Sperm banks are available only in certain areas of the country, though, and success in achieving pregnancy with "frozen sperm" can be uncertain. You must choose a reliable sperm bank if you opt for storage, such as The California Cryobank, the world's largest and most reputable sperm banks. You health care provider may be able to help you make all the arrangements should you chose this option.
ALTERNATIVE METHODS OF BIRTH CONTROL
After reviewing the benefits and risks of vasectomy, you may want to consider alternative methods of birth control. Before deciding on a vasectomy, you should be familiar with these methods. Discuss them with your partner so that you both understand the choices.
Remember no form of birth control is 100 percent effective, and the effectiveness of any non-permanent method depends largely on your using that method correctly.
MoonDragon's Contraception Methods Compared
NON-PERMANENT METHODS FOR MEN
As a man, you can assume responsibility for birth control with these methods:
THE CONDOM
The condom is a thin, rubber sheath that fits over the penis. It is put on before sexual intercourse and also helps to protect against venereal disease. Its actual use effectiveness is about 90% or so. For more information about condoms, see these web pages:
Male Condom Products:
WITHDRAWAL
Withdrawal of the penis from the vagina before the semen is ejaculated is probably the least effective form of birth control. Semen leakage sometimes occurs before ejaculation and it may be very difficult for a man that has little or no control over his orgasm, in which case he may not be able to remove the penis from the vagina in time to prevent some semen spillage into the vagina.
NATURAL FAMILY PLANNING (MUTUAL CONTROL - BOTH PARTNERS)
This method, often called the "rhythm method", requires participation by you and your partner together, and is about 75 to 85 percent effective for most couples who use it. You'll have to abstain from sex during her fertile period, which lasts from 5 to 15 days during each menstrual cycle. For this method to be successful, your partner must know when she will probably ovulate. You'll need to learn about this method from your midwife, your health care provider, or a family planning clinic.
Natural Family Planning Products:
BIRTH CONTROL FOR WOMEN
These are the birth control methods used by women. Your partner should consult her health care provider first to find out which method may be best for her.
FEMALE STERILIZATION (TUBAL LIGATION)
Permanent contraception for women.
HORMONE CONTRACEPTIVES
Birth control pills are a widely used method of contraception. Oral contraception is 90 to 95% effective for most women. There can be many side effects, some may be significant. A prescription is required.
Other hormone-based contraception besides oral contraception are available. Many of these have the same risks and contraindications as the oral method.
The IUD (INTRAUTERINE DEVICE)
The IUD is a small metal or plastic device that is placed in the uterus to prevent a fertilized egg from attaching to the uterine wall. There can be some risks and side effects. Its effectiveness is about 95 percent. A prescription is required.
SPERMICIDES
Vaginal spermicides come in several forms such as gel, foam, cream, film, suppository, or tablet. They can be used alone or with a barrier-type of contraceptive device.
Spermicide Products:
BARRIER METHODS (DIAPHRAGM, CERVICAL CAP, FEMALE CONDOM, SPONGE)
All of these methods are barrier methods of contraception that covers the cervix and prevents sperm from entering the uterus. They are generally is used with a spermicidal foam, jelly, or cream and it's effectiveness varies depending on frequency and correct usage. A prescription may be needed for some methods and a fitting may be required by your midwife, clinic, or health care provider, depending upon the method chosen.
Female Condom Products:
For more detailed information about contraceptive methods see:
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HELPFUL PRODUCTS & FURTHER EDUCATION
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
-- by Phyllis A. Balch
The Complete Guide to Natural Healing
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