Ready for a Vasectomy?
Are there any negative side effects to a vasectomy? Is it easy to reverse the process?
I applaud you for considering a vasectomy as a birth-control option. Vasectomies are an extremely effective, inexpensive, and safe method of birth control, but they're rarely performed. Interestingly, the female counterpart to the procedure, tubal ligation, which is used much more often, costs seven times as much and is a far more risky operation.
In a vasectomy, a surgeon seals off the vas deferens, the tube by which the spermatozoa travel on their way out of the body during ejaculation. Complications are far less likely if you find a surgeon who will perform what's called a no-scalpel vasectomy." This technique originated in China in 1974, but US doctors are still learning how to do it. It involves making just a tiny puncture in the scrotum to get to the vas deferens, instead of making a couple of incisions. The procedure can be done in a doctor's office in about 10 minutes, compared to the standard 20-minute vasectomy. After the surgery, a man will feel the usual discomfort that follows minor surgery for about a week.
A small number of men have experienced long-term pain in their scrota after vasectomies. But generally, this is a minimally invasive procedure and side effects are very rare. There's a myth that vasectomy will lessen your sex drive, but research has shown the opposite: Men with vasectomies tend to enjoy greater sexual satisfaction, maybe because they're not worried about pregnancy. There is a small increase in testosterone in the blood, but that hasn't been shown to have any physiological effect.
In recent years, there also have been questions raised as to whether a vasectomy raises the risk of prostate cancer. The answer, so far, isn't clear - and researchers are still arguing about it. Two large studies have found that men who have had vasectomies are more likely to develop prostate cancer than other men. But other researchers debunk the results, arguing that it's hard to come up with a biological explanation. They note a number of reasons to be skeptical about the studies; for one thing, undiagnosed prostate cancer is so common that small differences between groups could easily look very dramatic. And two other large studies don't show any connection between the surgery and cancer. The National Institutes of Health convened a special panel to consider the issue and concluded that the procedure is safe and highly effective.
A slight risk will always remain that a vasectomy could spontaneously reverse itself over time, if the ends of the cut come together on their own. But I wouldn't recommend going into a vasectomy thinking you might want to undo it later. Yes, deliberate reversal is possible and has been successful in some 90 percent of men who change their minds from three to eight years after the vasectomy. Their partners have enjoyed pregnancy rates of 50 to 70 percent.
But this is a technically demanding procedure and you can't count on it. Reversal depends first of all on how the vasectomy was done. Also important is the skill of the surgeon doing the microsurgery.
I like the approach suggested by Dr. Carl Djerassi, inventor of the birth-control pill. He suggests that men have vasectomies as a matter of course, but first preserve their sperm in liquid nitrogen refrigerators at frozen storage facilities. Then they can still have children, if they desire, using artificial insemination.