Once you’ve made up your mind that you never want to have any more children,
there’s no more reliable form of contraception than vasectomy. But one
precaution: To lower the risk of your vasectomy failing, make sure the surgeon
who does yours is qualified and has a lot of experience.
When done correctly by an experienced physician, as few as 1 in 1,000
vasectomies fail to do their job — preventing you from ejaculating sperm when
you have an orgasm, thus preventing pregnancy. But when performed by doctors
who do vasectomies fewer than 50 times a year, the failure rate is as high as
10% to 17% or more.
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To understand how a vasectomy works, you need to understand 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 couple with the ova in her space.
To perform 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. After
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
The best vasectomy technique
Surgeons have used a variety of techniques to cut, inactivate, and close the
two ends of the vas. The best technique, according to recent surveys, is called
“intraluminal cauterization with fascial interposition.” With this technique,
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.