Vasectomy is a minor surgical procedure wherein the vasa deferentia of a man are severed, and then tied/sealed in a manner such to prevent sperm from entering the seminal stream (ejaculate).
Usually done in an outpatient setting, a traditional vasectomy involves numbing (local anesthetic) of the scrotum after which 1 (or 2) small incisions are made, allowing a surgeon to gain access to the vas deferens. The "tubes" are cut and sealed by tying, stitching, cauterization (burning), or otherwise clamped to prevent sperm from entering the seminal stream.
Variations of the procedure currently in practice may reduce recovery time, while mitigating post-surgery pain (and/or pain syndrome(s)).
The No-Scalpel method (coined Key-Hole), in which a sharp hemostat, rather than a scalpel, is used to puncture the scrotum may reduce healing times as well as lowering the chance of infection (incision).
An "open-ended" vasectomy obstructs (seals) only one end of the vas deferens, which allows continued streaming of sperm (by virtue of the un-sealed vas-deferens) into the scrotum. This method may avoid build-up of pressure in the epididymis. Testicular pain (from "backup pressure") may also be reduced using this method.
The "Vas-Clip" method does not require cutting the Vas Deferens, but rather uses a clip to squeeze shut the flow of sperm. This method may facilitate a better chance/outlook for reversal, as well as reduced pain (post-procedure). That said, statistics suggest a much lower overall success rate compared to traditional methods.
The Royal College of Obstetricians and Gynaecologists state there is a generally agreed upon rate of failure of about 1 in 2000 vasectomies which is considerably better than tubal ligations for which there is one failure in every 200 to 300 cases. Early failure rates, i.e. pregnancy within a few months after vasectomy typically result from having unprotected intercourse too soon after the procedure. Late failure, i.e. pregnancy after recanalization of the vasa deferentia, has been documented but is very rare.
Most Physicians/Surgeons who perform vasectomies recommend one (sometimes 2) post-procedural semen specimens to verify a successful vasectomy.
Worldwide, approximately 6% of married women using contraception rely on vasectomy. In the U.S. about 3 times as many women at risk for unintended pregnancy rely on tubal ligation as on vasectomy. In the U.S. tubal ligation is used more frequently than vasectomy, although the proportions vary from state to state. In Britain, vasectomy is more popular than tubal ligation, though this statistic may be as a result of the data-gathering method.
Couples who opt for tubal ligation do so for a number of reasons, including:
- Convenience of coupling the procedure with giving birth at a hospital
- Fear of side effects in the man
- Fear of surgery in the man
Couples who choose vasectomy are motivated by, among other factors:
- The lower cost of vasectomy
- The simplicity of the surgical procedure
- The lower mortality of vasectomy (for example 0.1 per 100,000 vasectomies vs. 4 per 100,000 tubal ligations in industrialized nations)
- Fear of side effects in the woman
- Fear of major surgery in the woman
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