Male Sterilization

Are you aware that approximately 7 million pregnancies in United States are unintended? According to latest statistics (1), more than 48% of these unintended pregnancies are due to failure of contraceptive techniques used.

Contraception in males is widely classified into two major types; temporary and permanent. As the name indicates, temporary sterilization refers to temporary birth control method with a 100% reversal rate and can be achieved by various means such as physical barrier method (condoms), abstinence, chemical method (use of spermicidal jellies) etc. On the contrary, permanent sterilization is usually achieved by vasectomy – an out-patient minor surgical procedure that is irreversible.

Male sterilization is performed by either of the two popular techniques:

• NSV or No-scalpel vasectomy: In this procedure, the physician introduce a small amount of anesthetic agent into the skin at the level of vas deferens to achieve anesthesia. As part of the procedure, no incisions are made, but tiny holes are introduced to pull the tube that carries the sperm and is tied off without using sutures.
• NNV or No needle/no scalpel vasectomy: In this procedure, your physician introduce a cut/ incision in the area of vas deferens after anesthetizing the local tissues. The severed ends are then ligated or cauterized.

Based on a new study reported in the Journal of Urology (3) investigators analyzed the results of vasectomies performed in 1,429 patients via either of the two techniques listed above and concluded that no-scalpel approach (NSV) is more superior and less painful than NNV approach.

Who Are Ideal Candidates For Male Sterilization?

You may be an ideal candidate for male sterilization procedure if:

• You and your partner have already completed your family and want no more children.
• You and your partner are in absolute agreement regarding the long term consequences of the procedure.

After vasectomy, the patient can still be able to produce semen (as well as reach climax and ejaculate normally), but there will be no sperms in the semen; hence no chance of impregnating the partner. But it is important to keep in mind that it may take up to 3 months for sperms to completely clear off from the ejaculate.

What Are Some Classic Benefits Of Male Sterilization?

Unlike most temporary methods of contraception, male sterilization has a very low failure rate (0.10 to 0.15%). Other benefits of male sterilization are:

• Long term (or rather permanent) contraception.
• Low (no) risk of side-effects.
• Very quick recovery and early resolution to day-to-day activities (or sexual functions).
• Low cost and high convenience (no need to make arrangements for temporary contraceptive methods).
• No risk of hormonal imbalance.
• As opposed to female sterilization (with a patient regret rate of 26%), the patient regret rate in males is only 5% (2)

What Are Some Risks Associated With Male Sterilization?

The procedure is highly safe; but in some susceptible patients, following side effects may occur:

• Reaction or allergy to the local anesthetic agent.
• Temporary and self-resolving burning or painful sensation in the local region.
• An extremely rare risk of post-procedure infection (that is largely localized).
• Vasectomy reversal procedures are not only expensive and complex, but also have a very low success rate; hence do not opt for vasectomy if you are unsure about your fertility decisions. According to the CREST study, within 5 years of vasectomy, only 1.4% males and 2% of their female partners request for vasectomy reversal procedure (4).

What Else Should You Know About Male Sterilization?

It is imperative to follow post-procedure instructions given by your healthcare professional. This out-patient procedure is highly safe and effective. The patient can resume normal sexual functions just one week after the procedure. It is important to mention that some type of protection must be used until you get a negative sperm test (usually performed after 3 months of performing the procedure). Also, vasectomy can only stop you from unwanted pregnancies, but does not provide any protection against sexually transmitted diseases. In other words, you should continue to practice caution in chance encounters to minimize the risk of contracting sexually transmitted infections.

References

1. Bartz, D., & Greenberg, J. A. (2008). Sterilization in the United States. Rev Obstet Gynecol, 1(1), 23-32.

2. SOKAL, D., McMULLEN, S. U. S. A. N., GATES, D., DOMINIK, R., & TEAM, T. M. S. I. (1999). A comparative study of the no scalpel and standard incision approaches to vasectomy in 5 countries. The Journal of urology, 162(5), 1621-1625.

3. Jamieson DJ, Kaufman SC, Costello C, et al. A comparison of women’s regret after vasectomy versus tubal sterilization. Obstet Gynecol. 2002; 99:1073-1079.