Before getting a vasectomy you need to be certain you don't want to father a child in the future. Although vasectomy reversals are possible, vasectomy should be considered a permanent form of male birth control.
vasectomy
A potential concern with vasectomy is that you might later change your mind about wanting to father a child. Although it might be possible to reverse your vasectomy, there's no guarantee it will work. Reversal surgery is more complicated than vasectomy, can be expensive and is ineffective in some cases.
Other techniques also are available to father a child following vasectomy, such as in vitro fertilization. However, these techniques are expensive and not always effective. Before you get a vasectomy, be certain you don't want to father a child in the future.
If you have chronic testicular pain or testicular disease, you're not a good candidate for a vasectomy. For most men, a vasectomy doesn't cause any noticeable side effects, and serious complications are rare.
You will ejaculate semen (seminal fluid) after a vasectomy but it will no longer contain sperm (the reproductive cells) once you have ejaculated about 20 times. A vasectomy blocks the sperm made by the testes from reaching the semen. Instead, the body absorbs the sperm, which is harmless.
A vasectomy doesn't provide immediate protection against pregnancy. Use an alternative form of birth control until your doctor confirms there are no sperm in your semen. Before having unprotected sex, you'll need to wait several months or longer and ejaculate 15 to 20 times or more to clear any sperm from your semen.
Sperm can still get out for a little while right after a vasectomy. Be sure to get the follow-up test that checks on that, so you know when you can stop using another method of birth control. (Watch a video about vasectomy and its effectiveness.)
The most current findings show that a vasectomy does not raise a man's risk of getting prostate cancer and that this concern should not be a reason to avoid having one. (Find out more on what causes prostate cancer.)
Vasectomy, or vasoligation, is an elective surgical procedure for male sterilization or permanent contraception. During the procedure, the male vasa deferentia are cut and tied or sealed so as to prevent sperm from entering into the urethra and thereby prevent fertilization of a female through sexual intercourse. Vasectomies are usually performed in a physician's office, medical clinic, or, when performed on an animal, in a veterinary clinic. Hospitalization is not normally required as the procedure is not complicated, the incisions are small, and the necessary equipment routine. The leading potential complication is post-vasectomy pain syndrome.
There are several methods by which a surgeon might complete a vasectomy procedure, all of which occlude (i.e., "seal") at least one side of each vas deferens. To help reduce anxiety and increase patient comfort, those who have an aversion to needles may consider a "no-needle" application of anesthesia while the 'no-scalpel' or 'open-ended' techniques help to accelerate recovery times and increase the chance of healthy recovery.[3]
Due to the simplicity of the surgery, a vasectomy usually takes less than 30 minutes to complete. After a short recovery at the doctor's office (usually less than an hour), the patient is sent home to rest. Because the procedure is minimally invasive, many vasectomy patients find that they can resume their typical sexual behavior within a week, and do so with little or no discomfort.
Because the procedure is considered a permanent method of contraception and is not easily reversed, patients are usually counseled and advised to consider how the long-term outcome of a vasectomy might affect them both emotionally and physically. The procedure is not often encouraged for young single childless people as their chances for biological parenthood are thereby permanently reduced, sometimes completely.
A vasectomy is done to prevent fertility in males. It ensures that in most cases the person will be sterile after confirmation of success following surgery. The procedure is regarded as permanent because vasectomy reversal is costly and often does not restore the male's sperm count or sperm motility to prevasectomy levels. Those with vasectomies have a very small (nearly zero) chance of successfully impregnating someone, but a vasectomy has no effect on rates of sexually transmitted infections.[citation needed]
When the vasectomy is complete, sperm cannot exit the body through the penis. Sperm is still produced by the testicles but is broken down and absorbed by the body. Much fluid content is absorbed by membranes in the epididymis, and much solid content is broken down by the responding macrophages and reabsorbed via the bloodstream. Sperm is matured in the epididymis for about a month before leaving the testicles. After vasectomy, the membranes must increase in size to absorb and store more fluid; this triggering of the immune system causes more macrophages to be recruited to break down and reabsorb more solid content. Within one year after vasectomy, sixty to seventy percent of those vasectomized develop antisperm antibodies.[4] In some cases, vasitis nodosa, a benign proliferation of the ductular epithelium, can also result.[5][6] The accumulation of sperm increases pressure in the vas deferens and epididymis. The entry of the sperm into the scrotum can cause sperm granulomas to be formed by the body to contain and absorb the sperm which the body will treat as a foreign biological substance (much like a virus or bacterium).[7]
Vasectomy is the most effective permanent form of contraception available to males. (Removing the entire vas deferens would very likely be more effective, but it is not something that is regularly done.[11]) In nearly every way that vasectomy can be compared to tubal ligation it has a more positive outlook. Vasectomy is more cost effective, less invasive, has techniques that are emerging that may facilitate easier reversal, and has a much lower risk of postoperative complications.Early failure rates, i.e. pregnancy within a few months after vasectomy, typically result from unprotected sexual intercourse too soon after the procedure while some sperm continue to pass through the vasa deferentia. Most physicians and surgeons who perform vasectomies recommend one (sometimes two) postprocedural semen specimens to verify a successful vasectomy; however, many people fail to return for verification tests citing inconvenience, embarrassment, forgetfulness, or certainty of sterility.[12] In January 2008, the FDA cleared a home test called SpermCheck Vasectomy that allows patients to perform postvasectomy confirmation tests themselves;[13] however, compliance for postvasectomy semen analysis in general remains low.
Short-term possible complications include infection, bruising and bleeding into the scrotum resulting in a collection of blood known as a hematoma.[17] A study in 2012 demonstrated an infection rate of 2.5% postvasectomy.[9] The stitches on the small incisions required are prone to irritation, though this can be minimized by covering them with gauze or small adhesive bandages. The primary long-term complications are chronic pain conditions or syndromes that can affect any of the scrotal, pelvic or lower-abdominal regions, collectively known as post-vasectomy pain syndrome. Though vasectomy results in increases in circulating immune complexes, these increases are transient. Data based on animal and human studies indicate these changes do not result in increased incidence of atherosclerosis. The risk of testicular cancer is not affected by vasectomy.[18]
In 2014 the AUA reaffirmed that vasectomy is not a risk factor for prostate cancer and that it is not necessary for physicians to routinely discuss prostate cancer in their preoperative counseling of vasectomy patients.[19] There remains ongoing debate regarding whether vasectomy is associated with prostate cancer. A 2017 meta-analysis found no statistically significant increase in risk.[20] A 2019 study of 2.1 million Danish males found that vasectomy increased their incidence of prostate cancer by 15%.[21] A 2020 meta-analysis found that vasectomy increased the incidence by 9%.[22] Other recent studies agree on the 15% increase in risk of developing prostate cancer, but found that people who get a vasectomy are not more likely to die from prostate cancer than those without a vasectomy.[23][24]
Post-vasectomy pain syndrome is a chronic and sometimes debilitating condition that may develop immediately or several years after vasectomy.[25] The most robust study of post-vasectomy pain, according to the American Urology Association's Vasectomy Guidelines 2012 (amended 2015)[26] surveyed people just before their vasectomy and again 7 months later. Of those that responded and who said they did not have any scrotal pain prior to vasectomy, 7% had scrotal pain seven months later which they described as "Mild, a bit of a nuisance", 1.6% had pain that was "Moderate, require painkillers" and 0.9% had pain that was "quite severe and noticeably affecting their quality of life".[10] Post-vasectomy pain can be constant orchialgia or epididymal pain (epididymitis), or it can be pain that occurs only at particular times such as with sexual intercourse, ejaculation, or physical exertion.[7]
Younger people who receive a vasectomy are significantly more likely to regret and seek a reversal of their vasectomy, with one study showing people in their twenties being 12.5 times more likely to undergo a vasectomy reversal later in life (and including some who chose sterilization at a young age). Pre-vasectomy counseling is suggested for younger patients.[30]
An association between vasectomy and primary progressive aphasia, a rare variety of frontotemporal dementia, was reported.[29] However, it is doubtful that there is a causal relationship.[35] The putative mechanism is a cross-reactivity between brain and sperm, including the shared presence of neural surface antigens.[36] In addition, the cytoskeletal tau protein has been found only to exist outside of the CNS in the manchette of sperm.[36] 2ff7e9595c
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