Is a vasectomy right for you?

Source: Best Health Magazine, October 2008

Vasectomy, a highly effective birth control method, is a popular choice for couples. (According to the 2002 Canadian Contraception Study, 13 percent of women up to age 44 said it was the method of birth control they rely on.) During a vasectomy, which is relatively painless, 30-minute procedure, the doctor seals off the two tubes of the vas deferens, which connects the testicles to the urethra. Ninety-nine percent effective, the surgery doesn’t impact erections, sex drive, or risk of heart disease or prostate cancer. ‘A lot of couples find sex is more enjoyable afterwards’there is no worry about pregnancy,’ says Dr. Ian Macdonald, a general practitioner/surgeon who does vasectomies at the Alpine Medical Clinic in Banff, Alta.

A vasectomy can be reversed‘meaning sperm are again present in the semen’in about 50 percent of cases. However, the pregnancy rate for partners of men who undergo a reversal is lower than for women whose mates have not had a vasectomy. The more time between a man’s vasectomy and its reversal, the lower the chances of his partner becoming pregnant. That’s why Macdonald advises that a vasectomy should be considered permanent.

New approaches

Consider both the style of surgery and the doctor’s experience with vasectomy when getting a referral. To seal off the vas deferens and prevent sperm from getting into a man’s semen, doctors can use either a scalpel or a forceps-like instrument that punctures the skin of the scrotum. A 2006 scientific review found that the no-scalpel approach is faster; results in less bleeding, infection and pain; and allows men to return to sexual activity sooner after a vasectomy. (Risks are rare and pain minor even with the traditional style, however.)

As well, many Canadian clinics now minimize pain using an anesthetic spray rather than a needle. A Michigan State University study rated the pain levels of 50 men who had a needle anesthetic into the scrotum to numb one tube of the vas deferens and a spray delivered by an air-jet injector for the other tube. Most men found the anesthesia phase much less painful when delivered by the injector (and a few reported less pain with the no-scalpel vasectomy).

After a vasectomy

Vasectomies have a low failure rate’less than one percent’but they do not always take effect immediately. It’s best to keep using birth control until your guy gets the all-clear. Men should have their semen analyzed two months after a vasectomy to ensure no sperm are present. A study published in the British Journal of Urology International found that one-quarter of vasectomy patients never submit that semen sample.

More options

Researchers in the United States and China are now perfecting intra vas devices (IVDs), expected on the market in a few years. Plugs are implanted into the vas deferens, blocking sperm. Once they’re removed, some men’researchers aren’t sure yet how many’will be fertile again. Meanwhile, in Australia, University of Adel­aide researchers are developing a tiny vas deferens implant controlled by a radio frequency that blocks and unblocks sperm. It could make the return to fertility as easy as the flick of a switch.

This article was originally titled "Swithing it off" in the October 2008 issue of Best Health. Subscribe today to get the full Best Health experience’and never miss an issue!’and make sure to check out what’s new in the latest issue of Best Health.