Cutting the Wires

For men without children (and who don’t want any) or for couples with children but who don’t want more, a vasectomy is probably the best birth control method available today.  The decision to obtain one shouldn’t be taken lightly; it is a life-altering decision that should be well-considered beforehand. 

There are many reasons for a man to get a vasectomy.  The most obvious is simply not wanting children.  Many couples subscribe to the Zero Population Growth philosophy.  This is a practice in which a couple agrees to have but two children during their reproductive years, thus replacing themselves in the general population without creating a surplus.  The practice then requires the couple to refrain from having more children.  The best way to do this is through sterilization.  But, a tubal ligation for a woman is medically invasive, very costly (compared to a vasectomy), and requires more recovery time.

A vasectomy is probably the best permanent contraceptive solution for most couples (or for single men, for that matter).  In the first place it relieves a man’s female partner(s) of birth-control responsibilities.  As is now known, female contraceptives, rich in hormones, are linked to cervical and breast cancers if used for extended periods.  A vasectomy can release a woman from slavery to The Pill.  It can definitely ease her mind about pregnancy fears if she knows her partner has been “fixed”.  Secondly, it restores spontaneity (sometimes lacking for couples) by not having to interrupt to fumble around for contraceptive devices, creams, foams, etc.  Finally, the best reason is, if done right, a vasectomy is a 100% effective contraceptive.

If a man is single he need consult no one to get a vasectomy.  But if married or in a relationship with a woman the man and his partner should agree on this course of action together.  Such a decision does affect both partners in the relationship. 

The next discussion would be with a qualified urologist.  A physical exam is scheduled; the doctor will get a medical history and conduct a routine physical, which includes an exam of the scrotum.

Vasectomy procedure illustrationCredit: emedicinehealth

Surgery is done under local anesthesia on an outpatient basis.  The minutiae of the operation may vary slightly from doctor to doctor but the basic procedure is the same. 

First, a local anesthetic is administered to the testicular area.  Then, a small incision (about 3 cm long) is made in the scrotum.  The vas deferens (the “tube” in which seminal fluid flows) is cut.  Usually, a roughly one to two-inch piece of vas deferens is removed.  Next, the doctor cauterizes (either electrically or with a laser) the “upstream” end of the vas deferens (insuring no sperm cells escape), or he may suture this or use a small clip made of medical titanium.  The “downstream” end (nearer the source of sperm manufacture) is likewise sealed off.   The access incision is sewn shut, usually with catgut.  The process repeats on the other side of the scrotum.  This whole operation takes around forty minutes. The urologist provides the patient with after-care instructions (one of which is no strenuous activity for a few days), and the patient is free to go home and convalesce.  

A vasectomy is relatively painless.  Recovery time is only a few days.  Very slight bruising and swelling around the incision areas can be expected.  Pain in the groin is tolerable and requires very little in the way of pain medications to ease.  After a few days one can return to normal activity.  Sexual activity without fear of pregnancy, however, requires the approval of the urologist; he will need a sperm sample to analyze to insure there are no viable sperm in the ejaculate.  This test is normally done about two weeks after the surgery.

The cost of this procedure varies slightly, but can be done for as little as $1200.  Compared to the cost of an unwanted child this is minimal.  Health care insurance providers almost all overwhelmingly pay for this operation since it is cheaper for an insurance company to pay for one vasectomy than it is to pay for a single live birth and the attendant costs associated with pregnancy. 

A vasectomy is in no way emasculating (as some ill-informed people want to believe).  It does not affect a man’s testosterone producing abilities in any way.  It does not, in any way, alter or otherwise adversely affect one’s sexual performance.  Everything is the same after a vasectomy as before with one exception: a man cannot impregnate a woman.  The peace of mind this brings is priceless. 

A last, cautionary word: any man who undergoes this treatment needs to understand (and this should go without saying), a vasectomy does nothing but prevent pregnancy.  It does not protect one from AIDS, herpes, or any other STD.  For those in non-committed relationships regular safe-sex precautions should still be observed. 


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