Birth control can be a “testy” subject amongst many couples, especially since it’s everyone’s responsibility, but it often falls more on one person in the relationship. When a couple is planning a family often temporary measures of birth control are put into place.
In the United States, 67 percent of women who use contraceptives rely on non-permanent measures. This means reliance on items including condoms, the pill, the patch, IUDs, and other measures to prevent pregnancies (or less reliable ones like the rhythm method).
Often families will reach a time when they know that they don’t want to expand their wolf pack any further, or start a family at all, and decree their time spent procreating is complete. This is when many seek a permanent birth control solution.
In the United States roughly eight percent of men receive vasectomies as their means of permanent birth control, compared to their neighbors to the north, in Canada, where roughly a third of men no longer wishing to expand their family undergo the procedure.
The choice for a vasectomy (or for tube tying for a woman) is a very personal decision, and something a couple shouldn’t take lightly. A permanent measure of birth control is a huge decision, and everyone involved needs to ensure they are prepared for this to be a final solution.
There are a lot of factors that need to be considered before taking the big step towards the big snip. Here are 15 things couples should know about a vasectomy.
15 It’s Critical To Talk It Out
This is an important decision and the feelings of all parties involved must be considered. Sometimes it can take couples days, weeks, or even years to make a final decision surrounding a vasectomy. Ben said, “There were two primary reasons I opted for a vasectomy; after talking it over with my partner we both agreed that we didn't want any more children.
Also, it is one of the few more permanent ways someone who is male can contribute to birth control in a relationships, which was a bonus. During researching the procedure it became clear that it was one of the safest and most effective forms of birth control.”
Morgan and his partner had a clear sense of when their family was complete, which helped guide their final decision for a vasectomy.
“After having our first child, my wife and I experienced an ectopic pregnancy, which left us with an overwhelming feeling that our family was not yet ‘complete’. After having a second child, that feeling evaporated completely. We both felt we were done. The way we saw it, birth control was mostly her responsibility before kids, and mostly mine after.”
Ben added, “I spoke with my family doctor who recommended a urologist for the procedure. I did digging on the doctor and was pretty happy with what I found, so I felt really comfortable setting up the procedure.”
14 It Will Not Impact Sexual Appetite
Everyone has a different definition of masculinity, or their own sexuality. This is very important to both self-esteem and how someone relates to their partner(s). Let’s squash any concerns surrounding sex drive, ability, or appetite post-surgery right now. A vasectomy will not impact a man’s level of desire, ability to achieve and maintain an erection, or the quality of orgasms, period.
A man’s drive the week before the vasectomy will be no different than it is one year post-surgery (barring other medical issues unrelated to the vasectomy). Testicles will continue to produce both testosterone and sperm, however the sperm will be absorbed into the man’s body, leaving “blanks” or “empty” semen in ejaculation.
Some studies have revealed that many men who have had vasectomies are happier in their relationships, and this is said to be because the procedure can decrease anxiety over pregnancy and potential conflict surrounding contraception.
13 Some Grief Is Natural
The choice to have a vasectomy is a very final decision. It is very natural to feel some sadness and anxiety, or some “what if” moments in the time leading up to, and following a procedure.
Morgan said, “Be prepared to be emotional. Even if you are absolutely, 100 percent sure you don't want kids again (and you should be!), it's still an emotional thing to go through, officially closing this chapter of your life is not nothing. Be ready to feel things you might not expect, and know that it's normal.”
Time spent with family and friends’ infants, or added involvement in existing children’s activities can help mitigate this feeling. However it is very important to make sure this decision is the right long term decision for everyone involved, today, tomorrow, and ten years down the road.
Morgan adds, “Both my wife and I had a few hesitations leading up to the procedure, but in the end we both agree it was the right decision for our family.”
12 Getting It Reversed
Reversals are much more costly, and significantly less effective than vasectomies. An undo is much harder than many people initially believe, since a vasectomy after-all is considered a permanent method of birth control. Vasectomy reversal is standardly an outpatient procedure.
The chances of a reversal being successful can depend on how much time has passed since the initial procedure, and is most successful during the first three years post vasectomy, leading to pregnancy 50 percent of the time. Pregnancy occurs as a result around 30 percent of the time if the reversal is completed within ten years of the vasectomy.
The reversal can take between two to four hours. In Canada (where there is no cost to the vasectomy patient) a reversal generally costs around $5000, with no real guaranteed results on future fertility. This means surety that this is the correct procedure is extra important before reaching the point of no return.
11 The Basics – Health Class 101
To understand how a vasectomy works, it’s best for a brief health education class, so let’s go back to Physical Education class and get the basics on how things work beneath the boxers or briefs. Sperm are produced in the testes and stored in a neighboring sac (the epididymis). In “action” they move through a 15 inch thin tube called the vas deferens.
Within the abdomen the vas deferens is connected to both the semen producing prostate gland and the seminal vesicles. This is where the male “magic” happens in terms of reproduction. Men with normally functioning reproductive systems will release 200 to 300 sperm per ejaculation.
Along with sperm, this secretion includes other liquids which include liquid secretions from the seminal vesicles, Cowper’s gland, and prostate gland. When the sperm’s path is cut off (so to speak) they won’t be able to abracadabra the way they would otherwise.
10 The Procedure
Here are the basics of the procedure: First a local anesthetic will be used to freeze or numb the area (some even use a topical spray instead of a needle). Next the surgeon will knead the scrotum in order to locate the vas deferens. Once the vas is located the doctor will use a needle or scalpel to poke a hole.
Next they will use tiny clamps to pull out a small length of the vas deferens, with a number of different methods used to cut, deactivate, and close both ends of the vas deferens.
The method considered “best” according to a number of surveys is “intraluminal cauterization with fascial interposition” where the surgeon will slice the vas in two and scar the inside of one tube using a heated needle, next they will pull up the tissue surrounding the tube and clamp it over top of the end of the tube.
9 Financial Considerations
Costs for a vasectomy will vary depending on location and health care coverage. Some insurance plans cover it, some governments cover it, and at the end of the day the cost is going to be significantly less than raising a child. In Canada OHIP covers the cost of a vasectomy, and this has made it a popular birth control choice within the country.
According to a Canadian Contraceptive study 13 percent of women under the age of 44 said a vasectomy was the form of birth control they could truly rely on, with around one third of the male population opting to get snipped during their lifetime.
In the US around 500,000 vasectomies are performed every year, and even though the procedure is cheaper, safer and reliable only nine percent of sexually active men get vasectomies, whereas 27 percent of women opt for the more complicated method of tubal ligation.
High end US urologists can charge up to around $1200.00 US for the procedure, although those who want to save some money can go to Planned Parenthood who charge around $100.
People need to wait at least two to three months (while using backup contraceptives) to ensure all remaining sperm is cleared from their system before “pulling the goalie” so to speak. It generally takes 10 to 20 ejaculations for all sperm to clear the urethra. Men will need to provide a sample of their “seed” and have it analysed to ensure there is no viable swimmers left.
The entire point of the procedure is to stop the production of sperm, so due diligence said that testing is essential for success. Ben said following his vasectomy, “Since most labs (in my area) had merged under one conglomerate who didn't seem to know how to handle post-vasectomy tests, I ended up having to go back twice to provide samples since apparently a sample of my semen just disappeared. Sorry world.”
Even if a person is assured there are no sperm in their sample there is a 1 in 2,000 chance a person will become fertile again, just like in Jurassic Park, “Life finds a way.”
7 Anxiety Surrounding Surgery
It’s perfectly natural, and normal to be tense about surgery, particularly in the nether regions. Morgan said, “The procedure itself was more harrowing than I expected. I had no barrier between my eyes and my junk, and I was fairly terrified of looking down and seeing blood and a scalpel around my most sensitive spot.
While it is often described as a routine procedure, it’s still surgery, and surgery in a particularly sensitive area (pun intended).” Ben adds, “The procedure was impressively smooth, but very weird to experience. You are awake for the entire thing and only given local anesthetic.
It was interesting having a discussion with the surgeon as they were rooting around in my testicles and a little disconcerting to see smoke drift upwards during cauterization.” People should ensure they fully understand the procedure and carefully follow any instructions following to ensure the smoothest possible post-surgery experience.
6 Pain Of Surgery
This is a big concern and source of stress for a lot of men. The procedure itself, if done correctly, is relatively painless with some soreness for several days following. It is recommended that sports, lifting of anything heavy, and sexual intercourse are avoided for a few days to a week post-surgery.
Surveys on pain post-surgery vary wildly, with anywhere from one percent to 50 percent of men complaining of sore testicles for up to a year following the surgery (although some men randomly experience soreness of the testicles whether they’ve had the procedure or not).
Morgan said of his vasectomy, “It wasn’t that bad. Within 48 hours I felt fine, within 72 hours I told my family I was feeling fine.” Ben said of his experience, “Post-surgery recovery was a breeze. A few painkillers, a good bit of sitting around on the couch and avoiding heavy lifting. After a week I wouldn't have known I'd had surgery at all.”
5 Sometimes There Is Pain, And Scars
This is surgery and there will be after-effects. There may be bruising and swelling for a few days or even a few weeks. Nils said of his surgery, “There was bruising, and swelling, it was quite tender and sore for about two weeks post-surgery, but the relief I felt after getting my sperm analysed, it was totally worth it.”
Localized swelling can flare up during the first year after surgery, but most of this is (and can be) controlled by using anti-inflammation medication following the procedure. Morgan said, “The first vas was snipped and clamped without any issue, however the second one gave my surgeon trouble.
After spending a significant amount of time he needed to make an incision on the base of my shaft for the second vas. That incision point took the longest to heal, and there is still a scar, but it’s a small one.”
4 Recovery Time
Like any surgery recovery time will vary from person to person. Advice from those who have been there include remembering that there is nothing to prove and no need to be a hero. Take it easy and do what your doctor recommends. Accept help when you need it.
Morgan said, “Don’t be that hero guy who drives himself home and goes into work the very next day. Prepare for the recovery ahead of time; buy loose comfy sweatpants and avoid stairs if you can. If you have children warn them to take it easy around you (i.e. no roughhousing).
Clear your calendar of work and personal obligations that require absolutely anything physical from you.” He also adds, “This is a great time to binge watch that favorite show, or check out albums you haven’t had a chance to.”
3 There Are Surgical Risks
Before making a final decision it’s a good idea to look at the risks of the surgery itself. Standard Literature suggests that around 20 percent of men will have “chronic pain” post-surgery (this means pain that lasts for three months or longer post snip).
Most early complications stem from people not following the doctor’s recommendations and trying to be too tough, too soon (i.e. lifting heavy objects, exercising, or engaging in sexual activity before 72 hours or a week post-surgery). Again by following the doctor’s instructions to the letter a lot of complications can be avoided.
Post-surgery Pete should just put his feet up, seriously there is nothing to prove. In 1 percent of vasectomies a small blood vessel will bleed into the scrotum and form a clot of blood known as a hematoma. Smaller clots are re-absorbed into the body with time, whereas larger ones need to be drained through surgery (this surgery usually requires general anesthetic to drain the blood clot).
2 There Are Some Post-Surgery Factors To Consider
There have been a few studies that have linked the vasectomy to various illnesses, however there is not a ton of data on many of the longer term negative side-effects. There have been a number of studies that have linked vasectomies and prostate cancer.
A study completed at the Harvard School of Public Health of over 50,000 men revealed that those who had undergone a vasectomy had an increased risk of developing prostate cancer in later life, by one and a half times (compared to those who had not undergone the procedure).
Research has also shown that following a vasectomy particular barriers are breached and some men may begin to produce antisperm antibodies. This worries researchers as when the body is defending itself it can cause reactions including: a clogging of the arteries leading to heart attacks, rheumatoid arthritis, and other immune reactions.
A 2006 Northwestern University study appeared to link vasectomy and dementia, and was prompted when a patient at an Alzheimer’s disease clinic informed doctors that his problems with speech began immediately following his vasectomy; a small survey sampling 47 patients with early speech issues revealed 19 of the group had undergone a vasectomy.
The Northwestern study has not been replicated at this point and there is not enough information to see the dementia as anything beyond a hypothetical risk.
1 Celebrate World Vasectomy Day
World Vasectomy Day was an event launched just a few years ago to help increase the global awareness about vasectomies and better involve men with family planning choices. The hope is that this awareness will make the prospect of the procedure more appealing on an international scale.
The goal for the first day in 2013 was for doctors all around the world to perform 1000 vasectomies, connecting the event over Skype and social media. World renowned vasectomist Dr. Doug Stein has performed vasectomies in front of an audience at the Royal Institution of Australia to launch the inaugural Vasectomy Day, and performed the first ever live-streamed vasectomy.
He also answered audience questions. By 2014, event founders Doug Stein and Jonathan Stack had over 250 doctors supporting the cause. To celebrate Stein live streamed 28 vasectomies. This year’s World Vasectomy Day is on November 18, 2016, so, Snip, Snip Hooray!