Convincing your partner to have a vasectomy.

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From Womenforvasectomy.com

Convincing Your Partner / Myths About Vasectomy

 

Convincing your partner that vasectomy is the right choice for birth control is a simple task. That is because vasectomy truly is the safest, cheapest, and most effective form of birth control. To convince your partner, just present the following facts:

  1. Vasectomy does not cause any hormonal changes, nor will it change his sexual function or desire.
  2. Vasectomy will not significantly change the character or quantity of his ejaculation. It simply blocks the sperm cells from being in the seminal fluid.
  3. The local anesthetic used is injected into the skin of the scrotum, not into the testicle.
  4. The no scalpel vasectomy is an innovative method of performing a vasectomy. It is done through a single small puncture through the scrotal skin, not an incision. It does not even require a stitch or a suture to close the skin.
  5. MAN UP! The burden of birth control and child bearing needs to be shared. Tell him that stepping up for a vasectomy is an important way for him to do his share.
  6. A Board Certified Urologist is a fully trained surgeon, and the no scalpel vasectomy is commonplace and easy for him. The procedure is safe and easy to perform.
  7. Show him the less than perfect options in our COMPARING OPTIONS section.
  8. Again: Vasectomy is the safest, cheapest, and most effective form of birth control.

Vasectomy: Risks, Complications, and Side Effects

From Vasectomy.com’s Website

All surgeries carry some risk, but complications from vasectomy tend to be rare, minor, and seldom require intensive medical treatment. Below, find some of the most common risks and side effects for a vasectomy.

If you have concerns or want more information about the possible risks, complications, and long-term effects of a vasectomy, talk to your doctor.

Vasectomy risk factors

Allergic Reaction – Rarely, some men may experience itching and hives, as the result of an allergic reaction to the local anesthetic.

Antibodies – After a vasectomy, sperm produced in the testicles are absorbed by the body. This process may cause the immune system to produce antibodies to the sperm. These “anti-sperm antibodies” are mostly harmless, but they can affect the success of a later vasectomy reversal. (They have not, however, been linked to other immune-related diseases. For more information, see “Is there a link between vasectomy and disease?“)

Bruising – Bruising may occur on the skin of the scrotum or the penis. This is a normal side effect of a vasectomy, and the bruises should be gone after about two weeks.

Chronic Scrotal Pain – Fifteen to 19 percent of men who have had a vasectomy experience pain that lasts more than three months and interferes with daily activities. This type of pain, however, can also have causes unrelated to the vasectomy—such as inflammation of the epididymis, trauma, or twisting of the testicle (torsion).

Epididymitis – One of the more common post-vasectomy complications, occurring in up to 6 percent of vasectomies, epididymitis is caused by inflammation and swelling of the epididymal tube. Heat and anti-inflammatory medications (alone or combined with antibiotics) can usually clear it up within a week.

Hematoma – Pooling of blood within the tissue occurs in up to 29 percent of all vasectomy patients. It usually starts within the first week after the procedure, and can cause pain or swelling. While it is rarely serious, you should report any bleeding to your doctor.

Infection – Infections occur in about 3.5 percent of vasectomy patients. These are usually minor and respond favorably to antibiotic treatment, antimicrobial creams, and hot baths. More serious infections are rare.

Postoperative Pain – Short-term pain after a vasectomy is normal and usually resolves within a day or two, although a slight ache can remain for a while longer. Surgeons usually recommend acetaminophen (e.g. Tylenol) with or without codeine for the first 48 hours, since aspirin and ibuprofen (such as Advil or Motrin) can cause bleeding.

Sexual Difficulties – A vasectomy should not affect your sex drive, or your ability to have erections or ejaculate. If you experience sexual difficulties after a vasectomy, contact your doctor. They may be a sign of either emotional or physical issues, including heart disease.

Sperm Granulomas – These small, usually painless lumps occur when sperm leak out of the vas and cause an inflammatory reaction. The resulting cluster of immune cells does not pose a danger and usually resolves over time. Granulomas do cause pain in a small number of men, typically about two to three weeks after the vasectomy.

References

Adams CE, Wald M. Risks and complications of vasectomy. Urol Clin North Am. 2009; 36(3):331-6.

Davis BE, Noble MJ, Weigel JW, Foret JD, Mebust WK. Analysis and management of chronic testicular pain. J Urol. 1990; 143(5):936-9.

Kendrick JS, Gonzales B, Huber DH, Grubb GS, Rubin GL. Complications of vasectomies in the United States. J Fam Pract. 1987 Sep;25(3):245-8.

Schwingl PJ, Guess HA. Safety and effectiveness of vasectomy. Fertil Steril. 2000 May;73(5):923-36.

Using the form below you can leave your number 24/7 and we’ll call with an appointment or you can ask a question and Dr. McHugh will answer it. 

Vasectomy patients say the darnedest things.

1306060431-frontSo, my husband had a vasectomy this morning. The procedure was a breeze, and he’s fine, aside from feeling a little embarrassed at some things he said. He had to take a Valium before the procedure, and his comments reminded me of the time he was drugged up and had his wisdom teeth out. I […]

via Funny Friday: Valium — That’s What Anxious Mom Said

Birth control after vasectomy?

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From Vasectomy.com

After a vasectomy, it can take many months before your semen is free of sperm. During this time, you will need to continue using another form of birth control while having sex.

Anatomy of a Vasectomy

Sperm travel from the testicles through several tubes before they are mix with the semen. One of these tubes is the vas deferens, which runs from each testicle. During a vasectomy, both vas deferens are cut. This prevents new sperm made in the testicles from being ejaculated along with the semen.

However after a vasectomy, some sperm still remain in the part of the vas deferens closer to the penis — the upper part. It can take 20 to 30 ejaculations before all the sperm are cleared from these tubes. In most men, it may be three or more months before they have no sperm — or very few non-motile (non-moving) sperm — in their semen.

It only takes one sperm to fertilize a woman’s egg. So until the vas deferens is free of motile sperm, there is still a chance of pregnancy. During this time you will need to use another type of contraception every time you have sex.

Follow-up Testing

Your doctor will retest your semen about eight weeks after your vasectomy to see if there are still sperm present. This shows whether the vasectomy was successful, meaning you are infertile. If the tests show that your semen is free of sperm, then you no longer have to use additional birth control.

Some men, though, will continue to have a small number of non-motile sperm in their semen. Because the sperm are non-motile, the risk of pregnancy may be low.

One study found that around 10 percent of men undergoing a vasectomy reversal still had sperm in their semen. However, no pregnancies occurred in the partners of these men since their vasectomy.

If sperm is still present in your semen during the follow-up test, your doctor will talk to you about your options. This may include further testing. Your doctor may also decide that the chance of pregnancy is low enough that you don’t need to worry.

Vasectomy Failures

A vasectomy failure means that sperm continue to be present in the semen after a certain amount of time has passed since the vasectomy. This can happen during the period before the vas deferens tubes were cut. In rare cases, men may have two vas deferens on one side, and one of these is missed during the surgery.

In other cases, the two cut ends of the vas deferens can rejoin to form a complete tube. Your doctor may suspect this if you continue to have motile sperm after a vasectomy, or your sperm count continues to increase.

When the vasectomy is a failure, men will either have to continue using another form of contraception or undergo another vasectomy.

Question- Does vasectomy cause prostate cancer? Northeast Georgia Urology

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This is probably one of the most common questions asked at a vasectomy consultation.

The second most common? “What is the success rate of a vasectomy?” (I’ll address that next time.) J.M.

Vasectomy Not Associated With Prostate Cancer

Urology – February 28, 2009 – Vol. 25 – No. 04

There is no association between prostate cancer and age at vasectomy or years since vasectomy.

Article Reviewed: Vasectomy and the Risk of Prostate Cancer. Holt SK, Salinas CA, Stanford JL: J Urol; 2008;180 (December): 2565-2568.

Background: The majority of the literature now has shown no association between vasectomy and prostate cancer. The effect of vasectomy on men with a family history of prostate cancer or on those who underwent a vasectomy at a young age or had an extended period of time since the procedure has been poorly studied due to small sample sizes and short study follow-up.

Objective: To assess the risk of prostate cancer in men by age and length of time to exposure from vasectomy to disease.

Design: Population-based, prostate cancer case-controlled study.

Participants: 1327 men aged 35 to 74 years residing in King County, Washington, with a diagnosis of prostate cancer.

Methods: Cases of prostate cancer were identified from the SEER database for this population. Structured in-person interviews were conducted. Eligible controls were identified by random digit telephone dialing. Analysis based on prostate cancer Gleason score and stage was performed. Analysis was also performed based on demographics, age, prostate cancer screening history (within the last 5 years), family history of prostate cancer, and vasectomy parameters.

Results: 1327 men were eligible for study from the SEER database; 1001 completed the personal questionnaire. In total, 1340 controls were identified, of which 942 were interviewed. The control population showed that men who had undergone vasectomy were older, white, married, non-smokers with higher income and education, and had undergone PSA screening. Of men with prostate cancer and controls, 36% had undergone a vasectomy. Mean number of years since vasectomy in cases and controls was 21.1 years. No significant association was seen between prostate cancer and vasectomy status, age at vasectomy, years since vasectomy, or year of vasectomy. There was no evidence of risk estimates across vasectomy parameters. Risk did not change if men with prostate cancer within 2 years of vasectomy and controls with no PSA screening within 5 years (n=136) were excluded.

Conclusions:

No association was found between prostate cancer and vasectomy, even in men who had a vasectomy performed at a young age or had an extended period of time since vasectomy.

Reviewer’s Comments: This paper is a well-conducted, large case-control study that answers the concern about possible limitations of previous work that reported the lack of association between prostate cancer and vasectomy. This criticism often indicated inadequate follow-up since vasectomy to make this claim. In this study, average time since vasectomy in cases of prostate cancer and controls was 21 years. Multiple variables were looked at including vasectomy in the face of prostate cancer family history and screening. This large study should end the criticism on previous work that did not answer the question of prostate cancer and time from vasectomy. (Reviewer–Ajay K. Nangia, MBBS).

Question: What is this lump after my vasectomy?

From Vasectomy.com

I had a vasectomy a year ago and now I have a small pea size lump on my vas deferns and it feels as if the two ends have connected. Is this possible?

This is a common finding following a vasectomy. It can be nothing more than the normal healing process that would occur with any procedure as the body attempts to heal the trauma of the transected vas deferens.

A sperm granuloma again is a natural body response to the leakage of sperm that may have occurred at the vasectomy site.  These areas are sometimes tender to the touch or in certain sitting positions. Uncommonly if the pain is significant enough, a course of antibiotics or anti-inflammatories are necessary. Rarely the discomfort is often enough and bad enough that a patient will request that the can be removed surgically.

I did a vasectomy on a friend of mine who developed a sperm granuloma and it was painful to him about every six months or two years and responded to antibiotics, although there is no real scientific reason for this. The after a few years, it stopped bothering him.  He would call and say, “John, my sperm “granola” is back.” J.M.

ANSWERS FROM DOCTORS (3)


2 months ago by Steven K. Sterzer, MD

Yes, you may have had a sperm leak early on post-vasectomy that the ever magnificent body healing process took care of. The pea-sized lump is probably what is called a granuloma. This is of no clinical significance, unless you wish to get a reversal of the vasectomy. In that case, the reversal success rate will be higher than if this did not occur. Best wishes!


2 months ago by Mark J. Saslawsky, MD – Memphis Office

It’s typical for the vas ends to “approximate”, but they rarely reconnect. The knot could be scar tissue or a cyst from back pressure.


2 months ago by Randy Brett Ackerman, MD

If the semen analysis shows no sperm, then you should not be able to father a child. Small pea-sized lumps following a vasectomy can happen, but there is no indication from them that the procedure has failed.

Epididymitis after Vasectomy-How common?

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From Vasectomy.com

Epididymitis and Vasectomy

Epididymitis is an inflammation or infection of the epididymis—a long coiled tube that is attached to the upper part of the testicle and is used to store sperm. It’s a rare complication that, if it occurs, usually hits during the first year following a vasectomy. Occasionally, however, it can manifest years after the procedure.

Common symptoms of epididymitis include:

  • swelling of the testicles
  • mild to severe pain in the scrotum
  • low-grade fever
  • pain when ejaculating
  • pain in the groin when lifting
  • pain during intercourse

Epididymitis Treatment

Consequently, since epididymitis can be caused by bacteria (and may or may not be a direct complication of vasectomy), treatment often starts with a course of antibiotics to get rid of the infection, combined with conservative therapies of reduced activity and pain management (including non-steroidal anti-inflammatories such as ibuprofen, scrotal support, and applying heat or cold).

If you still experiencing significant discomfort after a few months of conservative pain management, additional treatments for chronic pain may be necessary. These include the use of local steroids, tricyclic antidepressants, or transcutaneous electrical nerve stimulation analgesia.

For the few whose pain is not relieved by non-surgical approaches, surgery can offer relief.

Surgical options include:

Reducing the Risks of Epididymitis

These days, urologists have made some modifications to the vasectomy technique to decrease a man’s risk of developing post-vasectomy epididymitis.

Because one potential cause of inflammation is pressure from sperm building up in the epididymis, an open-ended vasectomy procedure—in which one end of the vas deferens is left uncauterized, thereby relieving pressure and decreasing the likelihood of sperm granulomas, or masses that develop in an immune reaction to sperm that have leaked from the cut vas.

Another technique is preemptive analgesia, in which the urologist floods the vas deferens with a local anesthetic before it is cut. Early evidence suggests that both these procedures can reduce the chances of epididymitis post-vasectomy, but further study is needed for conclusive results.

There is still much researchers and physicians don’t yet understand about epididymitis as a post-vasectomy complication, including what causes it and how to further prevent it. Controlled studies focusing on newer vasectomy techniques, the role of sperm granuloma in the condition and the role of the immune system post-vasectomy will help build a more comprehensive understanding of epididymitus and how best to treat it.

Updated on June 27, 2016

Having a vasectomy improves sex life? Couldn’t hurt.

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Vasectomy May Lead to Increased Sexual Intercourse Frequency

Urology – April 30, 2016 – Vol. 34 – No. 1

Vasectomy is not associated with decreased frequency of sexual intercourse.

Article Reviewed: Relationship Between Vasectomy and Sexual Frequency. Guo DP, Lamberts RW, Eisenberg ML: J Sex Med; 2015;12 (September): 1905-1910.

Background: Men often report the concern that having a vasectomy will impair their future sexual function.

Objective: To determine in an objective and quantifiable manner if vasectomy leads to a decrease in sexual frequency.

Design: The authors analyzed data from the National Survey of Family Growth (NSFG), which is a large survey of American households.

Methods: Data were extracted from 2 cycles of the NSFG (2002 and 2006-2008) and analyzed. Men were included if they were previously sexually active and were aged >25 years. Female partners were also surveyed in the NSFG and were included if they were between 25 and 45 years of age. Sexual frequency was compared between men (or male partners of female respondents) who had a vasectomy and those who did not. The database captured sexual intercourse frequency over the preceding 4 weeks.

Results: A total of 5838 men met inclusion criteria, with 353 of these having a previous vasectomy. Men who had a vasectomy engaged in intercourse at a mean rate of 5.9 times per month compared to 4.9 times in men who had not had a vasectomy (P =0.0004). Additionally, men who had a vasectomy were less likely to have not engaged in any sexual intercourse in the preceding month. In the survey of female partners, 5211 women responded regarding their male partners, and 670 partners had a previous vasectomy. Again, men with a previous vasectomy had a higher frequency of sexual intercourse during the previous month (6.3 vs 6.0), although this difference was not statistically different (P =0.1341).

Conclusions: Vasectomy does not appear to negatively influence sexual frequency.

Reviewer’s Comments: The more invasive tubal ligation still outnumbers vasectomy among the options for permanent sterilization for couples. The rationale for this involves speculation, but male partner anxiety surrounding issues of sexual function have been proposed and are certainly evident when counseling males before vasectomy. Previous reports have investigated if vasectomy has any effect on sexual function and satisfaction, with most finding minimal to no effect on sexual function. In fact, some reports have demonstrated improved sexual function with improved sexual satisfaction, likely due to the loss of anxiety about unwanted pregnancy. The authors of this article demonstrate through objective survey results that sexual frequency does not decrease and may increase with vasectomy. While no explanation can be extracted from these data, the results are encouraging and can certainly be mentioned while counseling men before vasectomy.(Reviewer–Charles Welliver, MD).

 

Want to have children after a vasectomy? You are not alone!

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1 in 5 Men Desire Future Fertility After a Vasectomy

Urology – September 30, 2013 – Vol. 30 – No. 10

Predictive factors for vasectomy include income, number of biologic children, access to care, education level, religion, and race.

Article Reviewed: Vasectomy Demographics and Postvasectomy Desire for Future Children: Results From a Contemporary National Survey. Sharma V, Le BV, et al: Fertil Steril; 2013;99 (June): 1880-1885.

Background: Nearly half a million men choose vasectomy each year. Having a clear understanding of which men undergo a vasectomy can help improve counseling and possibly provide guidance to increase acceptance in those not currently seeking vasectomy. Additionally, because the rate of desire for subsequent fertility is often calculated from men presenting for vasectomy reversal consultations, this may underestimate the numbers.

Objective: To determine the demographic factors of men choosing vasectomy and to define the number of men subsequently desiring fertility post-vasectomy.

Design: Analysis of National Survey of Family Growth (NSFG).

Methods: The NSFG was conducted from June 2006 to June 2010 and sampled 10,403 men aged 15 to 45 years. Participants were questioned by female interviewers and compensated $40. Using Centers for Disease Control and Prevention methodology, the 110 diverse sampling units were adjusted based on census data to estimate national results.

Results: 8992 men aged ≥18 years were surveyed and 368 had a vasectomy during this time frame. This corresponds to a prevalence of 6.6%, markedly lower than the tubal ligation prevalence of 16.4% in women for the same age ranges. White men were more likely to have undergone vasectomy, with a prevalence of 9.1%. Black men and Hispanics had a prevalence of 2.4% and 2.1%, respectively. Other factors increasing the prevalence of vasectomy included income, education level, access to health care, and U.S. born (compared to immigrants). In total, 84% of the men had at least 2 children and 21% of men who were adoptive fathers had a vasectomy. The overall strongest predictor was number of biologic children. Overall, 19% of men who had undergone vasectomy desired future children and this was more likely when men belonged to a religion. Only 2% of men had undergone a vasectomy reversal.

Conclusions: Predictive factors for vasectomy include number of biologic children, race, and access to care. Nearly 1 in 5 of these men desired subsequent fertility.

Reviewer’s Comments: These data match my general perception of the typical male presenting to my office for vasectomy consultation. It is interesting to see that black men and Hispanic men do not pursue vasectomy as often and this may be an area for growth if cultural concerns can be addressed. Most interesting in this manuscript is the fact that 1 in 5 men desire subsequent fertility. I am curious if some of the men described as adoptive fathers were in this group. I believe counseling on the option of vasectomy reversal or in vitro fertilization is important during the vasectomy visit so men realize there are options, but the cost of these procedures should also be discussed. It would also be interesting to see if the same demographics are seen in countries with universal health care and limited access issues.(Reviewer–Gregory Lowe, MD).