By Michael J. Martin, D.O.
Women have historically carried most of the burden for birth control and have many options including birth controls pills, intrauterine device implantation and tubal ligation. Hormonal therapy and major surgery carry more risk than the options for men.
Men historically have two major options aside from abstinence: condoms and vasectomy. Condoms are very effective if used every single time and used correctly. Unfortunately, these human issues often result in unwanted pregnancy.
Benefits of Vasectomy
Vasectomy rarely fails. Even though tubal ligation is a great method, vasectomy is about eight times better at preventing unwanted pregnancy. Most sources quote failure rates of vasectomies to be between one in 1000 to one in 2000.
Vasectomy is a much safer procedure with a faster recovery and is typically performed in the office. There are no reported deaths from vasectomy and most men are able to return to light activity in 1-2 days with full activity in about a week. Tubal ligation is a very good procedure, but around 14 women die each year from this hospital-based, intra-abdominal surgery that may require a longer period to return to full activity. There is also less risk with anesthesia, as vasectomy is usually performed with local anesthetic and medication that makes you sleepy but allows you to be awake. The majority of tubal ligations are done under general anesthesia.
Cost is always an issue, but again vasectomy wins. Tubal ligation costs about 5 times more than vasectomy.
About the Procedure
Most men will be seen in the office 30-60 days before the procedure. The patient is examined and the procedure is discussed with him, and hopefully with his partner. The risks and benefits are discussed and insurance coverage verified. (Yes, insurance usually pays for it! Check with your insurance carrier or call us for more information.)
When it is procedure day, the patient comes dressed comfortably with loose fitting clothes. He is given medication to relax him and a local anesthetic at the surgery site. A small opening is made on the scrotum. The tubes that carry sperm, the vas deferens, are gently grasped through this opening and a small segment of each tube is removed and sealed shut. The interrupted tubes are then returned to the scrotum which often does not even have to be stitched closed because the opening is so small.
Cold compresses and medication help control swelling and discomfort. Most men watch television or nap after the procedure, with advice to avoid vigorous activity for a week. We check semen samples several weeks after surgery to verify success.
Dr. Martin is a full-time Assistant Professor for the University of Tennessee, teaching in the Family Medicine Residency Program in Jackson, TN, where he sees patients in the clinic. Dr. Martin is also on staff at Jackson-Madison County General Hospital for patient of all ages. He attended residency in Family Medicine at the University of Tennessee Medical Center in Knoxville. Dr. Martin is board certified and teaches vasectomies to other physicians.
The University of Tennessee
Family Medicine Center
294 Summar Drive, Jackson, TN 38301