Vasectomy Background B.C. type Sterilization First use  ? Failure rates Perfect use under 1% Typical use % Usage Duration effect Permanent Reversibility Often, but not always User reminders Additional methods required until 3 negative semen samples Clinic review None Advantages Benefits Generally, minor local anaesthetic. Some states such as NJ now require full anaesthesia. Disadvantages STD protection No Weight gain No A Vasectomy is a birth control method in which all or part of a males vas deferens are surgically removed, thus sterilizing the patient. Vasectomy should not be confused with castration: vasectomy does not involve removal of the testicles and it affects neither the production of male sex hormones (mainly testosterone) nor their secretion into the bloodstream. Therefore sexual desire (libido) and the ability to have an erection and an orgasm with an ejaculation are not affected. Because the sperm itself makes up a very small proportion of the ejaculate, vasectomy does not affect the volume, appearance, texture or flavor of the ejaculate. Similarly, in females, hormone production, libido, and the menstrual cycle are not affected by a tubal ligation. When the vasectomy is complete, sperm can no longer exit the body through the penis. They are broken down and absorbed by the body. Fluid content is absorbed by membranes in the epididymis, and solid content is broken down by macrophages and re-absorbed via the blood stream. Sperm is matured in the epididymis for about a month once it leaves the testicles, and approximately 50% of the sperm produced never make it to ejaculation in a non-vasectomized man. After vasectomy, the membranes increase in size to absorb more fluid, and more macrophages are recruited to break down and re-absorb the solid content. Contents 1 Safety and effectiveness 2 Recovery 3 Reversal 4 See also 5 References Safety and effectiveness Early failure rates of vasectomy are below 1%, but the effectiveness of the operation and rates of complications vary with the level of experience of the surgeon performing the operation and the surgical technique used. Early complications, including hematoma, infection, sperm granulomas, epididymitis-orchitis, and congestive epididymitis, occur in 1%–6% of men undergoing vasectomy. The incidence of chronic epididymal pain is poorly documented[1]. Animal and human data indicate that vasectomy does not increase atherosclerosis and that increases in circulating immune complexes after vasectomy are transient. The weight of the evidence regarding prostate and testicular cancer suggests that men with vasectomy are not at increased risk of these cancers.[2], however there is some evidence that men who might want the procedure reversed risk suffering damaged sperm[1]. Although late failure (caused by recanalization of the vasa deferentia) is very rare, it has been documented.[3] Vasectomy is the most effective long-term contraceptive method, and is among the safest options for family planning. How popular sterilization is as a birth control method varies by age, with men in their mid 30's to mid 40's being most likely to have a vasectomy. The rate of vasectomies to tubal ligations worldwide is extremely variable, and the statistics are mostly based on questionaire studies rather than actual counts of procedures performed. In 2005, the CDC published state by state details of birth control usage by method and age group[4]. Overall, tubal ligation is ahead of vasectomy but not by a large factor. In Britain vasectomy is more popular than tubal ligation, though this statistic may be as a result of the statistical data gathering methodology. Couples who opt for tubal ligation do so for a number of reasons, including: Convenience of coupling the procedure with delivery at a hospital. Refusal of the man to undergo vasectomy due to fear of possible side effects. Couples who choose vasectomy are motivated by, among other factors[5]: Fear of surgery in the woman Knowing men who have had the procedure and are satisfied with the results A stronger motivation for sterilization in the man The lower cost and simplicity of vasectomy The lower mortality of vasectomy Recovery Once you have the procedure, you must be in bed in a supine position for 24 hours (going up or down the stairs once or twice is fine). Do not shower for 24 hours. Do not drive or engage in moderate activity (such as climbing stairs) for 72 hours. You can move around and drive after 72 hours but it is recommended that you wear scrotal support (can be found in sporting goods stores) for two weeks. No sex or heavy exercise (including biking) during this time. You can engage in all normal activities at the end of two weeks. Reversal In order to allow for reproduction (via artificial insemination) after vasectomy, some men opt for cryostorage of sperm before sterilization. However, the long term viability of spermatozoa in cryostorage is questionable. Although men considering vasectomies should not think of them as reversible, and most men and their spouses are satisfied with the operation[6] [7], there is a procedure to reverse vasectomies using vasovasostomy (a form of microsurgery). It is, however, not effective in all cases, with the success rate depending on such factors as the method used for the vasectomy and the length of time that has passed since the vasectomy was performed. Men who get a vasectomy are advised to freeze their sperm first, because of the chance that the vasectomy will have permanantly damaged their sperm even if reversal is otherwise "successful". Various temporary male contraceptives are being researched but not yet available, such as male oral contraceptives and the intra vas device. There has been at least one documented case of a vasectomy being reversed on a dog, which then fathered puppies after the reversal.[8] See also Sterilization (surgical procedure) References ^ Christiansen and Sandlow (2003). "Testicular Pain Following Vasectomy: A Review of Postvasectomy Pain Syndrome". Journal of Andrology 24: 293–298. PMID 12721203. ^ Pamela J. Schwingl, Ph.D., and Harry A. Guess, M.D. (2000). "Safety and effectiveness of vasectomy". Fertility and Sterility 73 (5): 923–936. ^ Philp, T; Guillebaud et al (1984). "Late failure of vasectomy after two documented analyses showing azoospermic semen". British Medical Journal (Clinical Research Ed.) 289 (6437): 77–79. PMID 6428685. ^ Bensyl, D.M. and Iuliano, D. and Carter, M. and Santelli, J. and Gilbert, B.C. (November 2005). "Contraceptive Use — United States and Territories, Behavioral Risk Factor Surveillance System, 2002". Morbidity and Mortality Weekly Report 54 (SS06): 1-72. Retrieved on 5 May 2006. ^ William R. Finger (Spring 1998). "Attracting Men to Vasectomy". Network 18 (3). Retrieved on 5 May 2006. ^ Evelyn Landry and Victoria Ward (1997). "Perspectives from Couples on the Vasectomy Decision: A Six-Country Study". Reproductive Health Matters (special issue): 58–67. ^ Denise J. Jamieson et al (2002). "A Comparison of Women’s Regret After Vasectomy Versus Tubal Sterilization". Obstetrics & Gynecology 99 (6): 1073–1079. PMID 12052602. ^ "Dog's Vasectomy Reversed", CBS News, April 29, 2005. Birth control edit Natural methods: Coitus interruptus, Fertility awareness methods: Natural family planning, BBT, Billings, Creighton, Rhythm Method, Lactational. Avoidance Methods: Celibacy, Abstinence. Barrier: Condom, Diaphragm, Shield, Cap, Sponge. Intra-uterine: IUD, IUS (also progesterone). Hormonal: Combined: COCP pill, Patch, Vag.Ring. Progesterone only: POP mini-pill, Depo Provera. Implants: Norplant, Implanon. Post-intercourse: Emergency contraception & Abortion methods: Surgical, Chemical, Herbal/Drug. Sterilization: Tubal ligation, Vasectomy. Retrieved from "http://en.wikipedia.org/wiki/Vasectomy" Categories: Birth control