It’s not unusual for urologists to see the number of scheduled vasectomies go up around the NCAA basketball tournament, the ACC tournament or the Masters tournament. ESPN reported that, in the last several years, American urologists saw up to a 50% rise in the number of vasectomies scheduled for the days prior to the NCAA tournament, in particular.
Not only is a vasectomy the most effective form of birth control for men, the short recovery time usually takes about a weekend of rest – conveniently the time frame to watch a good sports tournament on TV.
Dr. Roland Morris Friedman, a urologist with Novant Health Urology in Winston-Salem and Kernersville, said he also sees a rise in scheduled vasectomies around the end of the year, when people have met their health insurance deductibles. Regardless of timing, there are a few common reasons men choose to get vasectomies.
“Most men I see for vasectomy have completed their family and want to have a one-and-done birth control method,” Friedman said. Or, on occasion, he said their female partners have been advised to stop taking hormonal birth control due to an increased risk of blood clots, so the vasectomy is a good solution.
Considering the procedure? Here’s what to know about getting a vasectomy, from cost to side effects.
What is a vasectomy?
A vasectomy is a common male sterilization procedure that involves the removal of a piece of the vas deferens, a tube in the testis that moves sperm cells along. Annually, more than 500,000 men in America choose to get a vasectomy.
“Every urologist probably does the vasectomy a tiny bit differently,” Friedman said. “But the general concept is, we take a segment of the vas deferens out on each side. We then cauterize (burn) each of the two cut ends. I then tie them off with sutures, and then the fourth and last thing I do to prevent them from growing back together is to tack some tissue in between them.”
Vasectomies are almost 100% effective.
“Vasectomy is far more effective than nonsurgical means of birth control, such as condoms or the pill,” said Friedman, since sperm can no longer travel from the testis to the penis to be ejaculated.
Only local anesthesia is needed for the procedure.
“Most men do fine with local anesthesia (numbing medicine) and a Valium pill taken just prior to the procedure,” Friedman said. “We have their wife or a buddy drive them to the clinic and then home. It typically takes about 20 minutes, and usually we’re just chatting during it.”
He compares a vasectomy to getting a cavity filled – not something you relish, but nothing too intense, either.
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It can take at least six weeks for a vasectomy to be considered effective birth control.
“We always tell guys that they’re not safe right away,” Friedman said. “Most men can relate to this – I discuss with them that there are rounds in the chamber, so to speak. It probably takes 25 or more ejaculations to expel all of the sperm that are downstream of where we divide the vas deferens tube.”
“You need to keep using birth control until you come in and have a sperm count, usually six weeks later, and we tell you it’s zero,” he said.
If sperm is lingering, the patient is advised to continue using another form of birth control with his partner until a later semen sample shows zero sperm.
Reversing a vasectomy is difficult and may not work.
The vasectomy itself is generally partially or fully covered by health insurance. Reversal is not.
“Vasectomy reversal tends to be very expensive – at least several thousand dollars or more,” Friedman said. “It’s usually done in the operating room.” Depending on the length of time since the vasectomy and other factors, the success rate for vasectomy reversal may be low.
A vasectomy won’t change a man’s experience of sex.
“Patients aren’t even going to know they’ve had a vasectomy in terms of sensation, sex, erections, or ejaculation,” Friedman said. “Nothing’s different.”
Post-procedure recovery usually just lasts a few days. (Like the length of a sports tournament weekend.)
“I’ll tell them to keep ice on the incision for the first couple of days,” Friedman said, adding they should stay off their feet for a few days. “Most men can go back to work Monday if they have it on a Friday.”
But if they don’t have a desk job and instead work in a physically demanding environment, they’re advised to take a week off. All men are told to take a week off from sex and exercise like heavy lifting and biking.
Vasectomy side effects are usually minor and don’t usually last long.
“Everyone’s going to get some swelling and bruising – that’s normal,” Friedman said. “I tell them not to take any aspirin or ibuprofen for a week before until a week after the procedure to minimize bleeding risk, and I usually give men a prescription for a few hydrocodone tablets for afterwards in case they have pain. Some men will have a little soreness. There's always a slight risk of bleeding or infection like with any surgery, but those are very low risks.”
After the first few days of recovery, Tylenol is typically a good option if pain management is still needed.
There’s a slight chance a man’s body could reverse the vasectomy.
“There’s a 1-in-2,000 to a 1-in-3,000 chance of the vas deferens tubes growing back together,” Friedman said. “So, if you think about it, that’s really rare.”
It would also be a surprise – a man wouldn’t feel any different if his vas deferens grew back together.
There are no known long-term health complications caused by a vasectomy.
“If you go back through the history of vasectomy, some doctors in the past have thought there might be long-term problems with increased risk of hardening of the arteries or developing prostate cancer, and that’s all been debunked,” Friedman said. “So, there is no need to worry about any long-term complications or problems in other areas of your body.”
Considering a vasectomy? Start with a consult.
“We require a pre-vasectomy consultation visit so we can go over the risks and benefits, let the patient know what to expect, and examine them,” Friedman said. He also wants to be sure the patient has made a final decision about having more children and that their partner is on board.
And Friedman will never be surprised if you schedule a vasectomy right before a televised sports tournament.
“The Friday of the ACC tournament goes fast,” he said.
Men can rest over a weekend of watching basketball. Is it that easy for women?
Women looking for permanent birth control, also known as female sterilization, can choose tubal ligation. A procedure commonly called “getting your tubes tied”.Dr. Lee Ann Garner, an obstetrician and gynecologist with Novant Health Glen Meade OB/GYN, said tubal ligations are more invasive than a vasectomy, because doctors need to reach a woman’s fallopian tubes. Doctors will then either cut, clip, or burn a section of the tubes – or remove them entirely – to prevent an egg and sperm from joining together.
The procedure is more than 99% effective in preventing pregnancy.
Garner said tubal ligations are fairly easy to do when a woman has a Caesarean section (C-section) while giving birth. In that case, they take about 5 minutes and don’t add any recovery time or increase the risk of bleeding or complications.
But women who aren’t combining the procedure with a C-section will need a laparoscopic surgery – that’s when a doctor makes 1 to 3 small incisions in a woman’s abdomen to reach the tubes. Recovery time can range anywhere from 2 to 6 weeks, depending on the woman and her overall health. And it’s not always an outpatient procedure, like a vasectomy.
Garner said of her patients who choose tubal ligations, about half undergo the procedure with a C-section and half choose the laparoscopic surgery.
Despite the fact that vasectomies are lower risk and less invasive than tubal ligation, twice as many women get their tubes tied as men who get sterilized, according to a 2015 United Nations estimate. — Annmarie Caprario