Vasectomy - The Traditional and The Experimental

Although some vasectomies are reversible, choosing to have a vasectomy is considered a permanent method of birth control. The procedure prevents the release of sperm when a man ejaculates. When a vasectomy is performed, the vasa deferentia from the testicles are sealed which prevents sperm from mixing with the semen that is ejaculated from the penis. An egg, carried by a female, cannot be fertilized without sperm. After a vasectomy, the testicles continue to produce sperm, but they are reabsorbed by the body. Ejaculation will still produce about the same amount of fluid as before the procedure was done.

The procedure is done in the physician’s office and takes about 30 minutes. In preparation for the surgery, an antiseptic will be used to clean the testicles and scrotum. If necessary, they may be shaved. Medication is given to help the patient relax and become drowsy. The surgeon will then locate the vasa deferentia and inject a local anesthetic into the area. One or more small openings are made in the scrotum, which allow access, so the vasa deferentia tubes can be cut and the ends sealed. The vasa deferentia are replaced inside the scrotum and the openings are closed with dissolvable stitches. The scrotum will remain numb for 1-2 hours after the vasectomy. There may be some swelling and minor pain for a few days after the surgery. Most patients will be able to return to work in 1-2 days. Sexual intercourse may be resumed as soon as the patient is comfortable.

There is a very low risk of complications after a vasectomy. Possible complications may include infection at the incision site, sperm leakage from a vas deferens into the tissue surrounding it causing a small lump or inflammation of the tubes that move sperm from the testicles. All are usually mild and easily treatable. Rarely is a surgical procedure necessary to correct these issues.

Vasectomy reversal or surgery to reconnect the vasa deferentia is available, but the procedure is difficult and may not always work. Researchers are studying a new type of reversible vasectomy. Reversible vasectomy involves plugging the vas deferens and then removing the plug when birth control is no longer wanted.

The plugs are injected into the vasa deferentia in liquid form. The plugs then harden in place and block the flow of sperm. Two different types of injected plugs have been tested: medical-grade polyurethane (MPU) and medical-grade silicone rubber (MSR). The plugs are created by mixing two liquid ingredients at room temperature and this forms a polymer that sets within minutes. This polymer is injected directly into the vasa deferentia. The process takes less than 30 minutes, and is an outpatient procedure performed under local anesthesia.

MPU plugs have good results in large-scale clinical trials, with the largest group of 12,000 men showing 98% at zero sperm count. However, it takes 18-24 months after the procedure is completed to reach this rate of effectiveness.

Studies of MSR have yielded varied results and researchers think that MSR may be too soft to form an effective plug. More testing will be required in determining whether MSR can be an effective birth control method.

A vasectomy will not interfere with sex drive, ability to have erections, or orgasm. Another plus to consider is that having a vasectomy is a safer, less expensive procedure, which causes fewer complications, than tubal ligation in women.

It takes about two months (10-20 ejaculations) after a vasectomy for all remaining sperm to be ejaculated or reabsorbed. To insure against the risk of accidental pregnancy, use another form of birth control during this period of time. Follow through by having a semen sample test that shows a zero sperm count before you stop using other forms of birth control. Vasectomies are a 99.85% effective birth control method. Very rarely, does the spontaneous reconnection of a vas deferens allow sperm to mix with the semen again.

Before making a decision, discuss birth control options with your partner and your health professional. Vasectomy is not for everyone. Consider your options carefully when making your decision.