Site logo - 10 years online
Website design and content DRB September 1, 2012

Hello, and welcome to Vasectomy Information.

This is our 13th year online! The site originally started on a free host back in 1999, and the content of that site was moved to this domain in July 2000. Some of the stories submitted by our readers date from the start of the original site in 1999, and are still online at this site today. The site grew out of the newsgroup alt.support.vasectomy, and remains true to the principles the newsgroup was founded on over 10 years ago. We have always made a lot of effort to collect (or link to) as much information from all sources as possible here, in order to help men considering vasectomy make an informed choice. The site is a mixture of general information, advice from our online Doctor, informative articles, contributions from our visitors and carefully selected web links. The links to all of our site content are on the right, below we have some general information about the procedure, and further down is information on our main features and latest site updates.

Vasectomy - a brief history

Vasectomy isn't a new procedure. Believe it or not, the first ever study into vasectomy was published in the UK, way back in 1830 by Sir Ashley Cooper. It was entitled "Observations on the Structure and Diseases of the Testis". In a nutshell, they performed a vasectomy on a dog and observed that the dog was able to have sex, yet unable to get other dogs pregnant. The researchers found that despite shutting off the exit of the sperm, the testicles still produced sperm, and it continued to be produced until the dog died some 6 years later. Towards the end of the 19th century vasectomy was used as a fashionable "Rejuvenator" named Steinaching after the surgeon who introduced it. The idea being that it increased testosterone, so increased sex drive. Freud and WB Yeats were amongst the great and good to be Steinached. Vasectomy was used throughout the world during the first half of the 20th century to control population by sterilizing criminals, drug addicts and anyone the authorities didn't like. Over the years, vasectomy has been used as a cure for enlarged prostate, and a cure for masturbation amongst other ideas - mostly based on poor scientific evidence comprising of very loose observations. Fast forward to the 1940's and 1950's. In the USA, studies were being performed into vasectomy as a method of birth control. Research work was also done into vasectomy reversal during this time period. However, despite many years of research, vasectomy didn't come into mass use as a birth control method in the USA until the early 1960's.

The above paragraph has been adapted from the History of Vasectomy. The link to this is opposite, if anyone is interested in the full story.

General information

A common misconception is that after vasectomy men no longer ejaculate. This isn't true, as sperm represent only approximately 3% of the ejaculation, with the other 97% coming from various fluids stored in the prostate. Another common misconception is that after vasectomy, men become less masculine. Again, this isn't the case. The male hormone testosterone produced by the testicles is still produced in the same quantity after vasectomy. So you aren't going to get a higher voice and lose all your body hair!

As regards satisfaction with the procedure, in general satisfaction rates are high, with 95% plus of men glad they did it, and men often report that their sex lives are better due to having no worries about pregnancy after unprotected sexual intercourse. However, it's not the right choice for everybody, as discussed below.

In common with all medical procedures, as well as the benefits there are risks to be considered too. The most common post surgery after effects are bruising, swelling, discomfort, post procedure infections and scrotal hematoma. These complications are routine, and usually easy to resolve. There are some longer term after effects including spermatic granuloma's, congestive epididymitis and in a small percentage of men, longer lasting pain. There is a much fuller discussion of these topics in the Risks and Complications page (link opposite). When discussing risk, it is important to take all factors such as the effect of long term use of the pill, the risks of female sterilization, previous medical history and the reliability of other methods into consideration. Many men opt for vasectomy because it represents the most reliable method of preventing pregnancy, coupled with the lowest overall medical risk for the couple.

In most cases, vasectomy is performed in a Doctor's office setting under local anesthetic. Depending on procedure type, one or two incisions are made in the scrotum. Then the vas deferens are separated from the spermatic cord, pulled through the incision, cut, and the ends closed. Again, the details vary by procedure type. It's fair to say that most men describe the procedure as "uncomfortable", but not as bad as they were expecting. Often, men will complain that the worst bit was the itching when the hair grows back afterwards, as most Doctors require the testicles to be partially shaved for the procedure.

Recovery usually takes a few days. The general advice is to wear supportive underwear, keep the area iced (especially in the first few days) and to rest and take things easy for a few days. If you have a physical job, then please make sure you explain this to the doctor when you have your consultation, and take his advice. Similarly, if you are an active sportsman then try and schedule the procedure for "off season" if possible, and make sure that you discuss with your doctor when it will be possible to fully resume your sporting activities.

The majority of men are able to start having unprotected intercourse after about 20 ejaculations / 2-3 months, however some men will take longer due to a variety of factors. If you are taking longer that this to clear - don't worry about it. It's not as unusual as you think! Have a chat with your doctor, and keep ejaculating regularly to help clear the tubes of all sperm. Remember that you are not sterile until the doctor says you are having analyzed a sample of your semen, and that you must use an alternative method of contraception until then.

A commonly asked question is "What happens to the sperm after vasectomy". As explained in the history of vasectomy, even when the spermatic ducts from the testicles are sealed, sperm are still produced. The body has a way of coping with this. In un-vasectomized men, approximately 40% to 50% of sperm produced never reach the point of being ejaculated. Sperm produced in the testicles move to the epididymis to mature over the period of a month prior to ejaculation. Survival of the fittest is the order of the day, with the ones that don't make it being broken down inside the epididymis and being reabsorbed into the body. After vasectomy, this reaction steps up a gear to break down and absorb all of the sperm produced. It's the same reaction that kicks in to protect the testicle should you pick up an infection that blocks the spermatic duct, you sustain an injury or experience testicular torsion that blocks the sperm's way out.

Our FAQ discusses the above points in more detail, along with every commonly asked question men have - and some uncommon questions too! Click the link opposite to go to the FAQ.

Vital statistics

It's generally accepted that the failure rate for vasectomy is about 0.05% once semen samples have been taken, analysed and the "All clear" has been given by your doctor1. This compares to approximately a 0.5% failure rate for female sterilization1. The FDA puts the failure rates for condoms at 11%2, but this figure can vary dramatically depending on a variety of factors including infrequent/incorrect use.

The uptake rate of vasectomy is not entirely straightforward, owing to the way statistics are calculated in the USA. For years, vasectomy figures have been calculated from data about the birth control methods women rely on - not a straightforward count of the number of procedures. It's currently guesstimated based on this method of calculation that annually 500,000 men in the USA undergo the procedure, and about 12% of the male population between 18 and 65 years of age have had a vasectomy. In other countries the rate is higher, with New Zealand topping the table at 20% plus of men in that age group being vasectomized. Personally, I feel that if the same method of calculation (a straightforward count of procedures performed annually) was used, the figures in the USA would be higher.

Is vasectomy the right choice for you?

We should point out that vasectomy should be considered permanent. It's not a method of birth control that can be turned on or off as required, therefore is not the right choice for everybody and you must be absolutely sure that this is what you want before signing the consent form. The men who are most likely to gain from vasectomy are men in couples where both partners agree they have all the children they want, and both do not want to use (or are unable to use) other methods of contraception. The men most likely to regret vasectomy are3

  • Men in couples where either partner is unsure about if they want children (or not) in the future.
  • Men who are having the operation primarily for the sake of their partners and not wholly for their own reasons, and men that are pressurized into having a vasectomy by their partner and/or extended family.
  • Men whose current relationship is unstable, or going through a stressful phase.
  • Men who are counting on having children later by storing sperm or by surgical reversal of the vasectomy.
  • Young men who still have many life changes ahead.

These points are discussed in more detail in the FAQ and other pages of the site.

If you are considering the procedure, then the first step is to decide if it's the right choice for you, and it's what you want. To help you through the decision, we have an FAQ section based on the most asked questions in the newsgroup and our Ask the Doctor page. We also have a checklist that follows on from the FAQ that might help you to think of questions to ask your doctor if you go for a pre-vasectomy consultation. As part of the decision making process, you should be considering the risks and benefits as well as any potential complications of the procedure. We have a variety of articles that discuss these important issues, plus links to research articles.

There are several versions of the procedure, and we discuss the differences between them, and their relative risks and benefits on various pages of the site. It's best to discuss with your GP or clinic what procedure they will use. Although there are differences between the procedures, the over-riding factor to a successful vasectomy is not procedure type - it's the experience of the surgeon performing it.

If you have made the decision to go ahead, then you will want to know how to prepare for the procedure and what to expect on the big day, and we have a page especially written for men considering vasectomy. You probably don't know this, but Doctors only need to perform a handful of procedures before they are deemed qualified. Complications, including long term pain can be associated with inexperienced surgery, so please read this page for more information about this.

If you have already undergone the operation, then you will want to know how to take care of yourself afterwards including what is/isn't normal in the way of bruising and swelling and after care in general. Please check the links opposite for information on these topics.

Feature:- Ask The Doctor

Dr. E. Karpman M.D. is our resident expert. Over the years he has answered the normal concerns men have, and many unusual questions too! The section is now closed to new questions, but there is a wealth of advice and general information available, so please visit the Ask the Doctor archive.

Feature:- Vasectomy pictures

We have a section of vasectomy pictures submitted by visitors to this site. This section is one of the most visited areas of the site, and shows photographs of normal healing and unusual complications following vasectomy. On September 1, 2012 I added some new pictures of vasectomy scars over thirty years after vasectomy.

Feature:- Vasectomy stories

In this section, we have a wide variety of website visitors experiences of vasectomy dating back to 1999. On September 1, 2012 I added a few new stories, and an updated one to the site. Please look at the stories index page for a full list of new and updated stories.

Question not answered, can't find what you are looking for?

If you can't find the information you are looking for, try searching the site with Google site search, or our regularly updated Site map has a list of all the pages on the site.

About us

Please be aware that we are not doctors or psychologists. Just men that either have been through, or are contemplating having a vasectomy. Also please note that the webmaster is not a doctor, and has no medical qualifications. If you are considering a vasectomy, please make sure that you discuss all options and concerns with your physician prior to agreeing to any procedures. We strongly believe that visitors to this site should have the benefit of viewing medical texts whole, and in context. Therefore medical information will usually be an HTML link to the original document. The information you find on this site is designed to support, not replace the relationship that exists between you and your doctor.

If you have any comments or suggestions about the website, please click the Email Webmaster link on any of the pages.

References

1 - Royal College of Obstetricians and Gynaecologists evidence based clinical guidelines for male and female sterilisation - January 2004
2 - FDA Birth Control Guide 2003
3 - Harvard Medical School Well Connected - Vasectomy and Vasovasostomy (Reversal Surgery) 2001
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