Is Vasectomy the Appropriate Choice?

Worldwide, more than 30 million couples use vasectomy as a method of birth control. The great majority of men who seek a vasectomy have been married for 10 years or more and have a stable relationship. Some reasons for a vasectomy include are having all the children the couple wants, not wanting or able to use other methods of contraception, a health problem in the woman that makes pregnancy unsafe, a genetic disorder, or a desire to enjoy sex without fear of unwanted pregnancy.

Even if all these factors are present, a couple must consider their options carefully before proceeding, and both partners should completely agree that they no longer want to have children. After deciding that permanent birth control is the best solution, the couple has the option of either vasectomy for the male or tubal legation for the female partner.

Studies indicate that between 5% and 10% of men have regrets after vasectomy. Men should not make the decision frivolously. Vasectomies may not be right for those who are unsure about having children in the future, whose current relationships are unstable or going through a stressful phase, who are considering the operation just to please their partners, or who are counting on having children later on either by storing sperm or surgical reversal of their vasectomies.

Long–Term Risks

Long–Term Testicular Pain. Research has indicated that up to a third of men have some pain that lasts longer than three months. The source of the pain is not fully known. Some experts believe there are two specific causes. scarring from the surgery and obstruction of part of the epididymis that causes another section to widen. Some believe that granulomas may cause more chronic pain than generally believed, but others point out that open–ended procedures, which actually stimulate granuloma production, result in less pain than closed–ended techniques.

It is not yet known if no–scalpel techniques will further reduce this complication. Many physicians believe that in most cases it is probably caused by pinched nerves. Surgery, including removal of the epididymis and surrounding tissue, may be required if more conservative measures fail. A surgical procedure that blocks nerves in the sperm cord can bring relief in severe cases. Surgery to reverse vasectomy also may relieve pain in men who have the procedure for this purpose.

Vasectomy & Prostate Cancer

Long–term high–normal levels of testosterone are associated with an increased risk for prostate cancer. Because testosterone levels remain higher for a longer period in men who had vasectomy, experts have been concerned that such men have a greater chance for developing the cancer. Studies investigating the relationship between vasectomy and prostate cancer have been conflicting. Research on the relationship with prostate cancer is continuing, although if any link is found, it is likely to be very weak. Men with a family history of prostate cancer should discuss the risks and benefits of vasectomy with their physicians.