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Vasectomy at a Glance

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For those who want a permanent form of birth control, vasectomy is one of the best choices because of its reliability, cost, effectiveness, safety and ease of the procedure. The procedure can be done in the office as an outpatient basis. The procedure itself can take as little as twenty minutes under local anesthesia. All methods of the procedure accomplish the same result to cut, tie, or cauterize the sperm tubes (vas deferens) in the scrotum. The procedure is very effective with low risk of adverse effects. The cost may vary from $350 to $1,000 but is usually covered by insurance. Although reversing a vasectomy is available, it is expensive, usually requires a procedure in the hospital, is much more expensive and typically is not covered by insurance. The success rate of re-establishing fertility is 35-45%. Hence due consideration should be given to vasectomy as not only a very effective option, but also a permanent one.

There are different techniques and availability may vary depending on your area of the country. The conventional method involves injection of local anesthesia into the scrotum, and using a scalpel to make small incision and remove or cut the two sperm tubes. A newer technique known as “no scalpel” still requires local anesthesia. A small hole is made in the scrotum to retrieve the sperm tube. The cutting or cauterization is carried out and then the sperm tube is gently returned through the small hole. The holes usually heal without any stitches as they are so small. Advocates feel there is less swelling and post-operative discomfort. Use of a pressure gun to provide anesthetic through the skin without a needle is an old device used for a new purpose at some facilities. All in all, results for any of the techniques are very good and carry low risk of side effects.

There are some common misconceptions about vasectomies. It does not reduce a man’s sex drive, ability to have an erection or ejaculate. Male hormones produced by the testes remain unaffected. Post-operative soreness may persist for a few days to a week. Since sperm in the vas deferens will remain for a while, waiting six weeks and having a repeat sperm count to be sure sperm are no longer ejaculated is recommended for completeness. Sperm comprise only a small part of the ejaculate fluid, so there is usually little or no noticeable difference in the fluid.

Serious consideration should be given to this choice prior to undertaking this as a permanent solution. One option could be donating some sperm to a sperm bank for use if you are uncertain about future plans to have children. On the other hand eliminating the risks and pressure of preventing pregnancy for many couples is a great relief. Compared to the tubal ligation for women, vasectomy is a much more convenient, safer and cost effective option for permanent birth control.

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About Bruce Kaler M.D.

  • RJ

    Local anesthetic, eh? I wonder how many patients reflexively attack the doctor performing this “procedure” the moment the cold scalpel comes into contact with the scrotum.