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Vasectomy (cont.)

Vasectomy Risks

  • Risks with vasectomy are few. No death has ever been attributed to this procedure. On the other hand, tubal ligation, a frequently performed surgical sterilization procedure in women, is associated with no fewer than 20 deaths per year. These deaths occur because of the risks of the procedure itself, anesthesia complications, and increased ectopic pregnancy rates.
  • Complications with vasectomy are usually related to bleeding or infection. Prolonged pain sometimes occurs as a result of inflammation along the vas due to sperm leakage (sperm granuloma) or congestion of sperm at the epididymis (epididymitis). These conditions usually go away with rest and anti-inflammatory medication.
  • Some earlier studies suggested that vasectomy may be associated with an increased risk of heart disease and prostate cancer. According to the National Institutes of Health, research that examined this issue found no evidence that men with vasectomies were more likely than others to develop heart disease or any other immune illness. Other studies, including a recent study of 2,000 men, have shown that the risk of prostate cancer is not increased among vasectomized men.
  • Fears about the procedure: Fear can prevent a man from choosing a vasectomy. The following issues are addressed to help a man understand that a vasectomy procedure is simple and safe:
    • Fear of pain - Men don't like to think of any procedure near their genitals. Fact: What men need to understand is that an anesthetic is used to numb the area. There is usually no pain or just some pulling after the anesthetic is given. The procedure is usually so well tolerated that upon completion of the procedure, men are frequently surprised that it is over.
    • Fear of loss of masculinity - Fact: A vasectomy does not affect manliness. A vasectomy does not affect the blood and hormone supply to the penis. The amount and appearance of semen ejaculated will not change noticeably. Of course, during the recovery process, men may be sore, thus making sex less desirable. Later, some men report that sex is actually more enjoyable without the threat of pregnancy. Women may appreciate that their partners have chosen to take the responsibility for sterility (permanent birth control).
    • Fear of failure of the procedure - Fact: Except for complete abstinence, no method is more effective than vasectomy in preventing pregnancy.
  • Alternatives: Before choosing a vasectomy, a couple should seriously consider the many alternative methods of contraception (birth control). Table 1 shows that the effectiveness of each of the methods can vary greatly. For a more complete description, visit vasectomy.md.
Table 1. Theoretical and Actual Success Rates With Various Methods of Contraception
Method Used by Theoretical
Failure Rate*
Actual
Failure Rate†
Advantages Disadvantages
Vasectomy Man 0.02%-0.1% 0.02%-0.2% Very high effectiveness; no cumbersome methods to use before or during intercourse Should be considered permanent; some risk of infection
Tubal ligation (tying off tubes) Woman 0.2% 0.2%-0.4% Comparable in effectiveness to vasectomy More expensive and complicated than vasectomy with higher surgical risk
Birth control pill Woman 0.1% 0.16%-3% High success rate; no loss of sensation; other established health benefits
Side effects can be significant
Condom Man 1%-3% 1%-33% No side effects; adds protection from sexually transmitted diseases Reduced sensation; risk of pregnancy if not used correctly; application cumbersome
Diaphragm Woman 1%-6% 1%-21% No loss of sensation Prescription required; application cumbersome
Spermicidal jelly, foam, cream, or suppositories Woman 3% 13%-28% No serious side effects or loss of sensation; prescription not required
Cumbersome; lower effectiveness
Hormonal implants Woman 0.2% 0.2% High effectiveness; one implant lasts up to five years Requires surgical insertion and removal; irregular vaginal bleeding
Intrauterine device (IUD) Woman 0.6%-1.5% 0.5%-3% Onetime application; high success rate; no loss of sensation
Prescription required; some side effects
Natural family planning (rhythm method) Both partners 1%-3% 14%-47% Nothing to buy or apply Requires abstention for five to 15 days per month; high risk of pregnancy
Withdrawal Man 4% 19% Nothing to buy or apply Reduced satisfaction; high risk of pregnancy
No method Both partners 85% 85% Nothing to buy or apply Play now, pay later
*Theoretical failure rate signifies rate when method is used correctly over a one-year period.
†Actual failure rate signifies rate when method is used routinely over a one-year period.
Medically Reviewed by a Doctor on 7/29/2014
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