Vasectomy is a permanent sterilization technique for a man who does not want to father a child any more can be done on an outpatient basis (thanks to www.mhhe.com for these images).
It is done within 20 to 30 minutes on average and is done under a local anesthetic. Other than possible infection there is no risk regarding the procedure. There is a 90 day wash-out period where the man who had a vasectomy should still use a condom until the semen is microscopically proven to be completely sperm free.
Studies have been undertaken to show that vasectomy does not lead to impotence (Ref. 16, p. 718). There is concern for a minority of cases that an autoimmune antibody may cause a lupus like clinical picture and possibly hardening of the arteries. However, according to Ref. 17 (p.1344) a review of 15 trials has failed to show a conclusive connection between these autoantibodies and cardiovascular disease.
1 in 2000 men who had a vasectomy develop chronic testicular pain. However, 95% of these men can be helped by a removal of the epididymis (=the storage structure attached to the testicle) and the outgoing duct (=called “vas deferens”). These men need to see a urologist and tell the specialist about the problem.
There is a controversy about whether or not a previous vasectomy would be a cause of prostate cancer. Follow up studies 15 or 20 years after vasectomy failed to show a higher risk for prostate cancer (Ref. 17, p.1344).
Reversal of a vasectomy leads to a successful fathering of children only in about 30%. It is involved and expensive surgery. It utilizes an operating microscope and requires a urologist specializing in these procedures. The cut ends of the previous vasectomy have to be reunited by doing surgery in multiple layers.
The same ethical considerations apply as for tubal ligation. Many church and religious groups are opposed to this procedure.
References:
1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 235.
2. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper Collins, 1997.
3. Ryan: Kistner’s Gynecology & Women’s Health, 7th ed.,1999 Mosby, Inc.
4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 245.
5. AB Diekman et al. Am J Reprod Immunol 2000 Mar; 43(3): 134-143.
6. V Damianova et al. Akush Ginekol (Sofia) 1999; 38(2): 31-33.
7. Townsend: Sabiston Textbook of Surgery,16th ed.,2001, W. B. Saunders Company
8. Cotran: Robbins Pathologic Basis of Disease, 6th ed., 1999 W. B. Saunders Company
9. Rakel: Conn’s Current Therapy 2001, 53rd ed., W. B. Saunders Co.
10. Ruddy: Kelley’s Textbook of Rheumatology, 6th ed.,2001 W. B. Saunders Company
11. EC Janowsky et al. N Engl J Med Mar-2000; 342(11): 781-790.
12. Wilson: Williams Textbook of Endocrinology, 9th ed.,1998 W. B. Saunders Company
13. KS Pena et al. Am Fam Physician 2001; 63(9): 1763-1770.
14. LM Apantaku Am Fam Physician Aug 2000; 62(3): 596-602.
15. Noble: Textbook of Primary Care Medicine, 3rd ed., 2001 Mosby, Inc.
16. Goroll: Primary Care Medicine, 4th ed.,2000 Lippincott Williams & Wilkins
17. St. Paul’s Hosp. Contin. Educ. Conf. Nov. 2001,Vancouver/BC
18. Gabbe: Obstetrics – Normal and Problem Pregnancies, 3rd ed., 1996 Churchill Livingstone, Inc.
19. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 251.
20. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 250.
21. Ignaz P Semmelweiss: “Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers” (“Etiology, the Understanding and Prophylaxis of Childbed Fever”). Vienna (Austria), 1861.
22. Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th ed., 1998 Mosby-Year Book, Inc.
23. Mandell: Principles and Practice of Infectious Diseases, 5th ed., 2000 Churchill Livingstone, Inc.
24. Horner NK et al. J Am Diet Assoc Nov-2000; 100(11): 1368-1380.
25. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
26. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
27. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008
