Contraception: Methods and Practices Part 2

Nancy Coiro, sexuality educator

MyPleasure's continued educational article about contraception so we can help you find the right form of birth control for you.

Birth Control Method
Surgical sterilization

Description
A vasectomy is an operation that blocks the vas deferens, the tubes that carry a man's sperm to the penis.

How It Works
Vasectomy involves severing, sealing or tying the vas deferens, the tubes which deliver the sperm from the testes to the penis, through an incision in the scrotum. This procedure is usually performed in a doctor's office using local anesthetic and takes less than thirty minutes. Recovery may involve some pain or discomfort and scrotal discoloration for several days after the operation, but the pain can usually be relieved with mild pain medications. An ice pack must be kept on the scrotum for at least four hours after surgery to reduce the chances of swelling, bleeding and discomfort. Some form of scrotal support, such as jockey shorts, must be worn for two days after the operation.

Should You Use It?
Some sterilized men regret their decision at some point in their lives, mostly due to a change in marital status, the death of a child, or a renewed desire to have children. While many people are under the impression that sterilization is easily undone, sterilization should be considered permanent -- reversals can be very expensive and may not be successful. Although sperm can be found in the ejaculate of most men who have their vasectomies reversed, only 50% are successful at fathering children.

Effectiveness
Except in extremely rare cases, this procedure is 100% effective.

STI Protection
Vasectomy does not prevent the transmission of sexually transmitted infections (STIs), including HIV.

Advantages
Safe, effective and minor operation.
Excellent form of contraception for men in stable relationships who do not want any more children.
Less expensive and involves fewer complications than tubal ligation.
Gives the man the opportunity to play a responsible role in the contraceptive process.
Does not affect a man's ability to enjoy sexual intercourse.

Disadvantages
Requires surgery -- some men are afraid of having an operation on their testicles.
The operation is not effective immediately. You will need to use condoms until the sperm clears from your tubes (15-20 ejaculations). To find if you are sterile, have your semen examined under a microscope after about 15 ejaculations.
Regret after vasectomy is greater if the man's partner is under 25, he divorces or remarries, a child dies, or when vasectomy is done immediately after having a new baby.
The operation to reverse a vasectomy is highly technical, expensive and not guaranteed.
A vasectomy offers no protection against STIs, including HIV.

Where to Buy It
Most urologists, many family practitioners and some nurse practitioners perform vasectomies. You can get a referral to a clinician who does vasectomies from your primary care provider, health department, family planning clinic or local medical society, or you can call the Vasectomy Information Line, the national toll-free, 24-hour hotline at 1-888-VASEC-4-U for free referrals.

Follow Up
None. Once the surgery is complete and you have been confirmed as sterile, there is nothing else you must do -- EVER.