Vasectomy and Vasovasostomy - Considerations

Treatment

After deciding that permanent birth control is the best solution, a couple still has the option of either vasectomy for the male or tubal ligation (female sterilization) for the female. Female sterilization is performed three times as often as vasectomy, but vasectomy is a less complicated and less expensive procedure, and poses fewer risks for complications. [For more information, see In-Depth Report #91: Birth control options for women.]

Vasectomy is very safe and is nearly 100% effective for preventing pregnancy. It does not protect against sexually transmitted diseases (STDs). Condoms remain the best method of STD prevention for sexually active people.

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The decision to have a vasectomy should be carefully considered. A reversal procedure can be performed, but it is a major operation that does not guarantee restored fertility. In addition, these reversal procedures (vasovasostomy and vasoepididymostomy) are much more complicated surgeries than vasectomy.

After-Effects

Surveys indicate that the vast majority of men are satisfied with vasectomy and that this satisfaction persists. Most men who have vasectomies feel relieved that the worry about pregnancy is over, and most couples respond well to their new-found contraceptive freedom.

Vasectomy does not affect a man's hormonal levels and does not impair sexual potency, desire, or satisfaction. Some men may go through a brief period of self-consciousness, wondering whether others notice some difference in their masculinity. For most men, this tentativeness passes quickly. Some couples may experience difficulties, which manifest in sexual dysfunction such as erectile dysfunction, premature ejaculation, or painful intercourse. In such cases, the underlying cause is usually unresolved emotional issues, not the vasectomy itself.

Who Should Have a Vasectomy

Vasectomies may be right for:

• Men in relationships in which 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
• Men in relationships whose partners have health problems that make pregnancy unsafe
• Men in relationships in which one or both have genetic disorders that they do not want to transmit