Vasectomy

Posted on February 25th, 2008 by olga

Once you’ve decided that you never want to have any more children, there’s no more trustworthy form of contraception than vasectomy. But one precaution: To lower the danger of your vasectomy failing, ensure the surgeon who does yours is qualified and has a lot of experience.

How vasectomies are done

To realize how a vasectomy works, you need to realize a bit of your own anatomy. Sperm are made in your testes and stored in an adjacent sac called the epididymis. From there, they travel, whipping their tails, through a 15-inch, shoestring-sized tube called the vas deferens. Inside your abdomen, the vas connects with the semen-producing prostate gland and seminal vesicles adjacent to the bladder.

This is the launching pad for the male contribution to reproduction. If the sperm don’t get to the pad, there’s still blastoff, but it’s the unmanned version — no sperm astronauts to join with the ova in her space.

To make a vasectomy, the surgeon first kneads the scrotum until he can feel the vas — a process that looks something like a guy trying to find the tie-string after it has retracted into the waistband of his sweatpants. Following finding it, the doctor pokes a hole (the best surgeons use a needle rather than a scalpel) in the scrotum and uses tiny clamps to pull out a short length of vas.

The best vasectomy method

Surgeons have used a variety of methods to cut, inactivate, and close the two ends of the vas. The best method, according to recent surveys, is called “intraluminal cauterization with fascial interposition.” With this method, the surgeon slices the vas in two, scars the inside — or lumina — of one tube with a heated needle. Then the surgeon pulls up the fascia — tissue surrounding the tube — and clamps or sutures it over the tube end.

Sewing up the tube prevents “recanalization,” which can take place when microscopic channels grow between the severed ends of the vas. When that occurs, sperm can get their way through these microchannels and into the semen.

Vasectomy pain

The majority men fear pain more than any other aspect of a vasectomy, and with good reason. While the procedure, if done well, is almost trouble-free, soreness for a few days later is ordinary. Sexual contact and sports are best postponed for a week. Estimates on the rates of chronic pain, though, range usually. In a variety of studies, anywhere between 1% and 50% of men complained of sore testicles, counting epididymitis (“blue balls”) for up to a year. As many as 15% described the pain after vasectomy as seriously aggravating.

Vasectomies and Prostate cancer

A handful of studies in the early 1990s reported a connection between vasectomy and prostate cancer, but a conclusive survey in New Zealand refuted the link.

In 2006, a group of Northwestern University researchers brought out a study that seemed to link vasectomy and dementia. The study was prompted by a patient at an Alzheimer’s disease clinic who told doctors that his aphasia—problems with speech—had begun shortly after a vasectomy. A survey of 47 clinic patients with early aphasia found that 19 had had a vasectomy.
The study caused some concern as there is a plausible, if unlikely, mechanism for a vasectomy to cause brain damage. Sperm normally doesn’t come in contact with the bloodstream, but antibodies to sperm form in the blood of about two-thirds of men who get vasectomies. (The sperm leaks into the normal tissue of the body after the vas is cut.) The theory put forward by the Northwestern study is that antibodies to sperm, which take place to have some proteins in ordinary with brain cells, might cause an autoimmune attack on the brain.

But the study was small and hasn’t been replicated, so it’s too early to make much of it.

Call your attention that you must be sure you don’t want kids anymore for the rest of your life, no matter what your personal situation is.