Vasectomy

What is vasectomy?

Vasectomy is a surgical procedure performed to make a man sterile or unable to father a child. It's a permanent male birth control measure, and a means of contraception used in many parts of the world.

Generally, vasectomy leaves the patient unchanged except that the vas deferens—the tubes leading to the testes—are blocked. The testes still produce sperm, but the sperm die and are absorbed by the body. A man who's had a vasectomy still produces semen and is able to ejaculate, but the semen doesn't contain sperm and is unable to impregnate. The level of testosterone remains the same and all male sexual characteristics remain the same. For most men, the ability to have an erection is unchanged.

Among married couples in this country, only female sterilization and oral contraception are relied on more often for family planning.

What are the different types of vasectomy?

• Conventional vasectomy. The conventional method is a surgical procedure that involves small incisions made on each side of a man's scrotum. The tube leading from each testicle, called the vas deferens, is cut and sealed in order to stop sperm from reaching the prostate where it mixes with the semen. Without sperm in the semen, a man can't make his partner pregnant.

• No-scalpel or nonsurgical vasectomy. In the no-scalpel method, rather than making an incision, 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 method as in conventional vasectomy. Because no incision was made, there is little bleeding and no stitches are needed to close the tiny opening. The opening will heal quickly with little or no scarring.

Can a man have unprotected sex right after a vasectomy?

Although a man can usually resume sexual activity soon after vasectomy, precautions should be taken against pregnancy until a test shows that his semen is free of sperm.

A vasectomy procedure only blocks the vas deferens at the point where it was sealed. The vasectomy has no effect on sperm that are already beyond that point. Therefore, it's important to not have unprotected sexual intercourse until the absence of sperm from the ejaculate has been confirmed with two negative sperm checks, four to six weeks apart. Generally, the test is first performed after the patient has had 10 to 20 postvasectomy ejaculations.

What are the risks or side effects associated with a vasectomy?

Although complications, such as swelling, bruising, inflammation, and infection, may occur after the surgery, they aren't common and usually not serious. Men who, at any time, develop the following symptoms, as defined by the National Institute of Child Health and Human Development, should contact their doctors:

• Epididymitis or orchitis. Epididymitis or orchitis (painful, swollen, and tender epididymis, or testis), may occur after vasectomy. This local inflammation most often occurs during the first year after surgery.

• Immune system reactions. After vasectomy, the testes continue to make sperm. When the sperm cells die, they are absorbed by the body, just as they are in a man who hasn't had a vasectomy. Sometimes, however, men, following a vasectomy, develop immune reactions to sperm.
  Sperm usually don't come in contact with immune cells, so they don't elicit an immune response. But, vasectomy breaches the barriers that separate immune cells from sperm, and men can develop antisperm antibodies after the surgery. Some doctors and researchers are concerned that these immune reactions against parts of one's own body could cause disease. Rheumatoid arthritis, juvenile diabetes, and multiple sclerosis are some of the illnesses suspected or known to be caused by immune reactions of this type.

• Prostate cancer risk. Some studies have raised questions about a possible relationship between having a vasectomy and the risk of developing prostate cancer—the most common cancer in American men and the second leading cause of cancer death, after lung cancer. Other studies have shown no increase in prostate cancer among men who have had a vasectomy.

Consult your doctor regarding any concerns you may have about vasectomy.