Vasectomy: Why It’s a Better Choice for Men and Women

By Parviz K. Kavoussi, MD | Published 11/17/2020 20

affectionate couple (vasectomy)

A vasectomy can benefit both men and women who no longer want to have children.(Photo by Vera Arsic via Pexels.com)

Vasectomy is a form of birth control for men that is becoming more popular over time. It is the most common non-diagnostic operation that urologists in the U.S perform.[1] Approximately half a million men undergo vasectomies every year in this country. That is about 5% of all married men of reproductive age.[2]

It is a permanent form of birth control that involves a minor surgical procedure to seal the vas deferens so that sperm does not reach the semen. A vasectomy is over 99% effective in the long run.  Per Penn Medicine, only 1-2 women per 1,000 get pregnant within a year after their partner has a vasectomy.[3] Further, the procedure has a number of great benefits for both men and women.

Why vasectomy is a better choice for men

A vasectomy is a reliable form of birth control that helps prevent unplanned pregnancy. Read on to learn about the benefits it provides, specifically for men. Benefits for women are covered later in the article.

  • Effective

A vasectomy is one of the most effective forms of birth control. According to the Urological Association guidelines [1] the risk of pregnancy after vasectomy is approximately 1 in 2,000 for men who have a sperm count of zero in a post-vasectomy semen analysis. This is equivalent to the contraceptive effectiveness of tubal ligation.

  • Easy procedure

This 20-30 minute procedure is almost always done in a doctor’s office rather than in an operating room. If the patient is anxious, oral or intravenous sedation can be administered. Then, the scrotum is cleaned with an antiseptic (sometimes shaving is required). After the vas deferens are located, a local anesthetic is injected to numb the area.

The doctor then makes one or two small openings in the scrotum through which the two vas deferens tubes are cut. Both ends of the severed vas deferens are then tied, stitched, or otherwise sealed. Sometimes electrocautery is used to seal the ends with heat. Scar tissue as a result of the surgery will block the tubes. The vas deferens are then returned to the scrotum and the skin openings are closed with resorbable sutures.[4]

Anatomy of vasectomy 512 x 377 Wikimedia

Photo attribution: Author: K. D. Schroeder. Vasectomy diagram-en.svg from Wikimedia Commons. License: Creative Commons Attribution-ShareAlike 3.0

Unlike tubal ligation, a vasectomy does not require going under general anesthesia. 

  • Reversible

While a vasectomy is a reliable form of birth control to prevent unplanned pregnancy. However, it can be reversed should a couple desire to have children after the procedure. Modern approaches utilize microsurgical techniques, robotic-assisted surgery, and video microsurgery.[5]

Between 6-10% of men choose to reverse their vasectomy. And, reversals tend to be successful [6], ranging from a 30-90% success rate depending on the type of procedure and other factors [6].

  • Lower health risks 

Vasectomy patients have lower surgical risks than women who undergo tubal ligations. One reason is that a vasectomy avoids risks associated with general anesthesia.

A vasectomy is also a less invasive procedure, lowering the risk of bleeding and infection. Lastly, vital organs are not exposed, unlike in a tubal ligation.

  • Lower cost

A vasectomy is one of the most cost-effective forms of contraception. The average cost of the procedure is far less expensive than the sterilization methods for women, such as tubal ligation. This shouldn’t be a surprise because the procedure is performed in a doctor’s office instead of an operating room. Further, general anesthesia is not required. 

  • One-time cost

A vasectomy is a permanent choice of birth control. This means it is just a one-time expense. While other contraceptives like condoms or pills may have a cheaper initial cost, the total cost accrues with each purchase.

Years of using oral contraceptives and condoms become more expensive over time [4]. For couples who no longer want to have children, a vasectomy is the most cost-effective option.

  • Often covered by insurance

Not only are vasectomies a one-time cost, but this cost is usually covered fully or in part by health insurance (after any co-pay or deductible). 

  • Does not affect sexual pleasure

Although many studies on the correlation between sexual pleasure and vasectomies are poorly defined, men reported [1] that they did not experience negative effects on sexual function. Approximately, 98-99% of men were satisfied with the results of their vasectomies. Evidence also shows that a man’s orgasm does not change after a vasectomy.

Related content: How to Delay Age-Related Erectile Dysfunction

  • Fast recovery

Men may experience minor symptoms [7] after a vasectomy including bruising, swelling, and pain after the procedure. However, those symptoms typically only last for a few days.

ADD_THIS_TEXT
 

According to the American Urological Association, only 1-2% of men experience chronic scrotal pain.[1] After getting a vasectomy, a patient needs to rest for 24 hours and abstain from sexual activity for a week. This recovery time is much shorter than tubal ligation, which may take from one to two weeks.

  • No-scalpel vasectomies available

To speed up recovery time, a no-scalpel vasectomy procedure has been developed.[8] First introduced to the United States in 1984, it relies on specialized surgical instruments, not scalpels, to expose the vas deferens. This option is less invasive and has fewer risks associated with it including less bleeding, infection, and pain.

Why vasectomy is a better choice for women

While vasectomies are performed on males, they provide a number of benefits to female partners as well. Although tubal ligation is still a more popular form of permanent birth control [1], read about some of the benefits a vasectomy offers specifically to women.

  • Stop hormonal birth control

While each woman reacts differently to oral contraceptives, the pill typically results in exaggerated mood changes. If her partner undergoes a vasectomy, a woman can avoid taking hormonal pills and can effectively regulate her mood better. A vasectomy also removes the constant worry of trying to remember a daily pill.

  • Avoid tubal ligation

As mentioned, tubal ligation is a much more invasive procedure than a vasectomy. There are greater risks, a longer recovery time, and a higher cost associated with tubal ligation.[1]

A vasectomy prevents a woman from having to undergo this invasive procedure, going to the operating room, and being put under general anesthesia. Because of these risks, a vasectomy is actually safer than tubal ligation.

  • Prevent risks of female sterilization

Female sterilization is associated with an increased risk of ectopic pregnancy in which the baby develops outside the womb. Vasectomy avoids exposing women to the increased risk of this serious pregnancy complication.

The bottom line when it comes to vasectomy

A vasectomy has many benefits for both men and women. The decision to undergo this procedure is a very personal one and, of course, should be discussed between the couple. Consult a doctor if you are considering this procedure or if you have any further questions.

References:

      1. The American Urologic Association. Vasectomy Guidelines (2015) https://www.auanet.org/guidelines/vasectomy-guideline – accessed 11/17/20.
      2. The Cleveland Clinic. Vasectomy (Male Sterilization). https://my.clevelandclinic.org/health/treatments/4423-vasectomy-sterilization# – accessed 11/17/20.
      3. Penn Medicine. 7 Things You Didn’t Know About Vasectomies. March 2019. https://www.pennmedicine.org/updates/blogs/health-and-wellness/2019/march/7-things-about-vasectomies – accessed 11/17/20.
      4. Procedure description adapted from Cigna. Vasectomy Surgical Overview – accessed 11/17/20 https://www.cigna.com/individuals-families/health-wellness/hw/medical-topics/vasectomy-hw7265 – accessed 11/17/20.
      5. American Society of Reproductive Medicine. Vasectomy Reversal: Contemporary Techniques. https://www.fertstert.org/article/S0015-0282(19)30009-3/fulltext#secsectitle0030 – accessed 11/17/20.
      6. Mayo Clinic. Vasectomy reversal. https://www.mayoclinic.org/tests-procedures/vasectomy-reversal/about/pac-20384537 – accessed 11/17/20.
      7. Mayo Clinic. Vasectomy. https://www.mayoclinic.org/tests-procedures/vasectomy/about/pac-20384580 – accessed 11/17/20.
      8. Medscape. No Scalpel Vasectomy (updated Jan 19, 2016) https://emedicine.medscape.com/article/148512-overview – accessed 11/17/20.
      9. Medical News Today. Is Pregnancy After Tubal Ligation Possible? https://www.medicalnewstoday.com/articles/323044#is-pregnancy-after-tubal-ligation-possible – accessed11/17/20.

Published on 2/5/17. Reviewed and updated 3/25/19, 11/17/20.

Parviz K. Kavoussi, MD

Website: https://www.austinvasectomycenter.com/

Dr. Parviz Kavoussi holds academic positions as Adjunct Assistant Professor at the University of Texas at Austin and in the Department of Urology at the University of Texas Health Sciences Center at San Antonio, where he teaches residents training in urology; helps guide best clinical practices in male fertility in his position on the American Society of Andrology Public Affairs and Policy Committee; and is an expert peer reviewer for multiple scientific medical journals. Dr. Kavoussi runs the Austin Center for Vasectomy & Vasectomy Reversal and is the leading and only specialty fellowship trained Vasectomy Urologist in Austin, TX.

Comments:

  • There are many factors which decide whether the vasectomy expert is the better option or not. It could be either health factor and cost effective as well. The another advantage that vasectomy has it is effective and hasn’t have any side effects like other birth control contraceptives.

  • Every single article I have ever read about vasectomies ALWAYS compares it to tubal ligation. That one is what philosopher’s call a “false dilemma”. Couples definitely have more than two surgeries. So doctors need to stop presenting vasectomy as the “sensible alternative to tubal ligation”.

    The sensible alternative to a PERMANENT, INVASIVE SURGICAL PROCEDURE is to do something NON-SURGICAL, and NOT PERMANENT. Don’t like pills? They make you moody? Ok, lemme go under the knife to help you out.

    What gets left out in the descriptions is this: Men who have vasectomies actually tilt the balance of power in favor of their wives in the relationship. It’s more difficult for an infertile/sterile partner of either gender to get re-married after a divorce as most people getting married do want kids. So the woman whose husband gets a vasectomy puts herself at an advantage as she maintains a higher market value after a divorce (she can marry again and have more kids) while this man who can’t make any more babies has now permanently altered his market value to future wives (who usually only want to marry men who can provide them with children).

    What must not be lost is the woman is asking the man to undergo a PERMANENT PROCEDURE instead of her going through TEMPORARY measures. She has to deal with being moody? He’s being permanently altered (mutilated). And now he has given her a leg up.

    But hey, at least if she gets knocked up, he knows she cheated, right? Game theory, people…

    • Seth – So if a gal asks you to wear a condom and you bitch about any concerns regarding it then I hope she has a similar reply and tells you to basically ‘deal with it’. Also, a female’s sole purpose isn’t to give/make you babies regardless of the relationship – gf, fiance, wife. I’d love to see guys like you be a woman for a year and go through the shit they do. I’m speaking as a doctor who has watched women go through the worst side effects and repercussions of invasive therapies or medications simply because a ‘big strong man’ such as yourself refuses to do a REVERSIBLE and safe procedure that is a same-day, walk out of the office with your wits still about you time line. Some of us men understand reality ‘bro’ and some of you all need to check yourselves.

    • Sam:

      1. White knight any harder and you might get laid, bro.

      2. Condoms are painless, temporary, leave no lasting effect, and though worn by the male, reduce pleasure for both him and her. So a condom is definitely a “balanced” method in that it doesn’t benefit or disparage one over the other (Don’t believe me? Do a survey and ask how many women carry MALE condoms in their purses or by their beds, versus how many use “female condoms”.)

      3. Vasectomy is not 100% reversible, but keep promoting that lie. The reversal is EXPENSIVE, PAINFUL, and at best 50% successful — IF DONE SHORTLY AFTER THE ORIGINAL VASECTOMY. Stop spreading this misinformation about it being “reversible” as if it’s flicking a light switch on or off.

      4. As a “doctor”, you should know that women can get a “simple procedure” and go home the same day as well. Rather than getting injections into their genitals, they get an IV, take a nap, and wake up later. It’s called a tubal ligation, and it’s more popular than vasectomy THE WORLD OVER. It’s only American doctors/marketers selling vasectomy as the newest fad. But wait, Oh now anesthesia is risky? Tell that to all the women who get nose jobs and boob jobs.

      5. Your “reality” is that you are a feminized cuck who most likely is on par with the average American male: Married and having sex once a month if that with an overweight woman who runs the house. No thanks.

    • Way to make it all about you, bro.

      1. Condoms are NOT always painless. They are awful and painful for some people, especially for those with allergies. They do reduce pleasure, so why would you want to use one in your monogamous relationship?

      2. A tubal is not just some simple procedure, just take a nap, wake up and go home. It’s a major surgery for women. And since we live in the misogynistic world that we do, our doctors love to make us jump through hoops to get it done. Like getting our husband’s permission. Or just making us wait years because what if we change our minds because we’re just so young. Because our decisions aren’t our own to make, you know. It happens.

      3. Your whole “the woman now has a leg up”/“market value” (lol what is she, livestock?) is honestly cracking me up. If that’s what you’re worried about in your relationship, perhaps your relationship has bigger problems than worrying about whether or not your partner is going to get pregnant. Hormonal birth control carries a lot more risks with it than moodiness. Blood clots and stroke, just to name two. But go on with your fragile masculinity.

    • My husband and I are in our 50’s and having any more kids isn’t a plan. We had one together and he’s 20. He was delivered via c-section and after that I took birth control pills. So not only do I have the little scar from the section to deliver our son I put chemicals in my body to prevent any more births. Now when we should be relaxed from the fear of having a child my husband is afraid of being “cut”!! Are you freaking kidding? The one time you can be an active participant in this you don’t want to be “cut”? And by the way I’m not trying to go out and have anymore kids, I simply would prefer my husband do this because there’s less involved on his part than mine. But hey. We as women seem to have to do everything anyway! 😔

  • Vasectomy awareness is important but less than 1 in 100 women have gotten pregnant after their partner has undergone a vasectomy as per report. This is not a great success rate. If it is 1 in 10000, people then it is good.

  • That’s impressive that the risk of pregnancy is approximately 1 in 2,000 for men who had vasectomy. I can see why that’s a valuable procedure. It’s important to talk with your partner about any family planning decisions though.

  • Although there is not a defined minimum age for vasectomy, he should be at least the age of a consenting adult, responsible for his own medical decision-making. We caution our patients that this is a decision we like our patients to be definite about, especially because out of the half million men in the US that undergo vasectomy, roughly 6% (or 30,000 men) change their minds within 10 years of the vasectomy. Although vasectomies are reversible and we have a very high success rates in vasectomy reversals, a vasectomy should be approached as a permanent sterilization decision.

  • In your article, you stated that a vasectomy is one of the most effective forms of birth control and after getting a vasectomy, the risk of pregnancy is approximately 1 in 2,000 for men who have a sperm count of zero in a post-vasectomy semen analysis. My brother called me last night because his wife told him that she didn’t want to have any more children and someone suggested that he have a vasectomy operation. I wonder if there is an age that is considered too young to have this type of procedure.

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