What is vasectomy?

Permanent sterilization for men. It is done by cutting the vas deferens tubes between your testicles and your groin, and sealing them either with stitches or heat sealing (cauterization). The procedure is usually done under local anaesthesia. There are several procedure types practiced.

How long has the procedure been around?

Since the late 19th century. It started to be regularly performed for the purposes of family planning in the USA in the 1940's, and in the majority of the West it came into common use in the late 1960's.

The first study into the effects of ligating the vas deferens was published in London in 1830. It didn't start out as family planning - it started out as a method of controlling unwanted sections of society such as "Delinquents, degenerates, drug habitues and idiots". In the 1890's vasectomy was suggested as an alternative to the practice of castration for an enlarged prostate. In 1918 it was also called "Steinarching", and used to provide a hormone boost that was "proven" to increase intellect and sexual performance. Sigmund Freud and W.B. Yeats were amongst those "Steinarched". Vasectomy was also used to "Cure" excessive masturbation!

Complete version of the "History of vasectomy".

Does it hurt?

Most men report the procedure as "Uncomfortable". The worst part for most is the anaesthetic being administered (about the same as an injection at the dentist) and the hair growing back afterwards itches.

Are men usually glad they had it done?

Satisfaction with the procedure is generally very high - in excess of 95% of men responding to studies say they are glad they had it done. If counselling is good, the figure tends to rise even higher.

Will it affect my sex life?

Most surveys report that men's sex lives are either better, or unchanged. Some men report that it's worse. One survey (Harvard/"Well connected") reports that "30% of couples report that they have sex more often, enjoy it more and consider their marriages stronger".

What's the difference between male and female sterilisation?

Vasectomy is usually done under a local anaesthetic, and a tubal ligation is done under a general. Vasectomy is less intrusive, statistically more reliable, and has less long term complications.

How does it compare to other contraceptive methods for reliability?

No contraceptive method is totally risk free. Maybe not having sex is the exception - and I guess someone's done research into the harmful practice of sexual abstinence! For many of us, vasectomy represents the least risk alternative.

Can it be reversed?

Vasectomy reversal is possible, but the chances of reversal with restoration of fertility tend to vary widely depending on many factors. In addition, whereas medical insurance policies and national health schemes cover the cost of vasectomy, they don't usually cover the cost of reversal - and reversal surgery doesn't come cheap!

There is the option of freezing sperm for later use employing alternative techniques for conception. Many hospitals and clinics offer this on a commercial basis, so it's worth contacting your local hospital or searching the web for contacts and information on this. Again, the costs involved with storage and IVF at a later date are very high.

Will a vasectomy protect me against venereal disease, HIV or other sexually transmitted diseases?

No. To protect yourself and partner against these diseases you need to use condoms.

Can it reverse itself again making me fertile again?

The statistics available suggest the chances of this happening are very low - approximately 0.030%. One Canadian study reports that "DNA-confirmed paternity with apparent azoospermia after vasectomy has been documented with an incidence of approximately 1 in 4000" - 0.00025%.

Will I still produce something when I ejaculate?

Yes. What you ejaculate contains normally 3-5% sperm. The rest is seminal fluid produced by the seminal vesicles/prostate gland. After vasectomy you ejaculate about 95-97% of what you did prior to vasectomy.

Will I still feel like a real man afterwards hormonal?

Yes. Your testes still produce testosterone so there is no reduction in your masculinity. Some major studies indicate that the level of testosterone in vasectomised men seems to decrease more slowly with age, so vasectomised men seem to have higher levels of testosterone longer into their lives than the non-vasectomised. This led to the fear some years ago that vasectomy may lead to increased incidence of prostate cancer. Later and more comprehensive studies have removed this fear.

As the vas deferens is cut during the procedure, will my balls dangle lower because they are unsuspended?

Some diagrams suggest the vas deferens are the only things connecting our testicles to the rest of us. In fact, the vas tubes are just one part of the spermatic cord that contains arteries and veins, the cremasteric muscles (which cause your testicles to pull up when you are cold or anxious), bunches of nerves, lymphatic vessels, etc. The spermatic cord is what supports the testicles in the scrotum. The vas deferens are thin, hard tubes mixed up in all of this, and they are the only things cut during vasectomy. The spermatic cord is not cut during vasectomy.

So if the vas deferens is sealed during the procedure, what happens to the sperm still being produced?

Most websites say they are "Harmlessly re-absorbed into the body". This doesn't answer the question that still remains in peoples minds - "How, exactly?". ALL men (vasectomised or not) produce sperm that are reabsorbed back into the body. In fact 40%-50% of sperm you produce is reabsorbed. Sperm go from the Testicle to the Epididymus for storage and maturing. It takes about a month to mature them. Whilst in the Epididymus, excess fluid content is re-absorbed through membranes, and solid content is broken down and reabsorbed through the membranes.

If you cut your finger your body reacts to this to protect itself. The same happens if the flow through the vas deferens is obstructed (either by vasectomy or a medical condition). To compensate for the additional sperm, the membranes increase in size to absorb more fluid, and additional degeneration of the solids occurs.