Vasectomy Remains Popular Contraceptive

By Deborah Jeanne Sergeant

With all the varieties of contraceptives available, are vasectomies still popular? Area experts say yes — and for good reasons.

Ali Houjaij, chief of urology and a urologist at the Buffalo VA, said that locally, more men are asking for vasectomy.

“It’s easier and safer than tubal ligation,” he said, referring the equivalent female sterilization method. “Some guys ask which is easier and safe.”

Vasectomy costs about one-third that of female sterilization via tubal ligation.

He explained that although vasectomy is a surgical procedure, it’s performed under local anesthesia as an out patient surgery. Only 5 to 10 percent of men experience chronic scrotum pain, and only a small percentage of those find it to be life-changing.

The chances of injury to the blood supply can cause loss of testicle, but less than 1 percent of men experience this side effect. Less than 5 percent of men experience bruising and infection.

Ryan Sidebottom, urologist with Upstate Urology of Auburn, said that the new “no-scalpel” technique provides a minimally invasive way of doing it, as it uses one poke in the center of the scrotum. “We can bring out the vas deferens and separate the connection.

“Some guys wonder why they were so worried, once it was done. It’s a very tolerable procedure,” Sidebottom said.

Despite local popularity of vasectomy, the U.S. overall lags behind Canada and the UK, according to United Nations figures. American women experience double the tubal ligations as men experience vasectomies; however, the large number of cesarian sections performed in the U.S. may account for some of that figure, since for couples done having babies, it’s easier to go ahead with sterilization for the partner who’s already undergoing surgery.

Vasectomy 101

Men commonly believe in a few misconceptions about vasectomy.

• It’s easily reversible. “Reversal is not easy. It requires a three-hour procedure under general anesthetic. The success rate after a vasectomy reversal can range from 50 percent with a common urologist to 70 percent with a reversal specialist. Vasectomy should be done only for the man who’s absolutely sure he doesn’t want any more kids.”

• Vasectomy reduces erections and sexual satisfaction. “Vasectomy does not affect sexual function, including the amount of ejaculate. The testicles contribute very little ejaculate. Most is from the prostate.”

Ali Houjaij, chief of urology and a urologist at the Buffalo VA

• Few men seek vasectomy. “It’s actually quite popular. There are very few birth control methods for men.”

• Tubal ligation of women is better. “Vasectomy is cheaper and safer and less risk of failure compared with tubal ligation for women. It’s easily covered by nearly all insurance.”

• Recovery is difficult and sex is off-limits for a long time. “After the surgery and three days’ rest, they can have sex but with protection. Eighty percent of guys clear at two months.  Others may require a few more ejaculations to get sperm count to zero. I use very specialized instruments that allow for a very delicate dissection of the vas tubes. There’s very little down time. I do a lot on Thursday or Friday so by Monday, they’re back to work.”

• It likely won’t work. “The chance of failure is less than 1 percent, compared with 3 percent for tubal ligation.”

J.C. Trussell, associate professor and urologist with Upstate University Hospital’s urology department.

No other urologists in the Buffalo area responded to multiple requests to comment for this article.