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Vasectomy Risks and Benefits

What every man should know

How much does a vasectomy cost?

About 500,000 vasectomies are performed each year in the U.S. Although the procedure is cheaper, faster, safer, and more reliable than female sterilization (1 pregnancy in 100), only 9% of sexually active men in the United States get vasectomies, while 27% of women get tubal ligations. More affluent men, however, are more likely to be sterilized than their wives.

The discrepancy probably has to do with the economics of our healthcare system. “Poor women have access to reproductive services, but they aren’t usually available to men,” says David Sokal, MD, a researcher at the Family Health Institute in North Carolina.

Fancy American urologists charge up to $1,200 for the in-patient vasectomy procedure, which takes all of 10 minutes, including local anesthetic. Planned Parenthood charges about $100. Under Canada’s nationalized healthcare system, the procedure is free and the state pays the doctor $55. That may explain why one-third of Canadian men are sterilized. (The highest rate of vasectomy is in New Zealand, where half of men go under the knife).

Cutting the risks after a vasectomy

It’s important to use birth control for at least three months after vasectomy because sperm are still swimming around “downstream” of the cut. At 12 weeks, it is a good idea for a man to get a follow-up test for sperm in his semen. A negative result generally confirms that the operation was successful.

“Still,” says Labrecque, “if the doctor tells you, ‘There are no sperm,’ there’s a 1 in 2,000 chance that you will later become fertile again. So if your wife gets pregnant, don’t assume she’s cheating on you. The first assumption should be that your body healed itself.”

Vasectomy pain

Most men fear pain more than any other aspect of a vasectomy, and with good reason. While the procedure, if done well, is almost painless, soreness for a few days afterward is common. Sexual intercourse and sports are best postponed for a week. “I had one guy who tried to have sex the day after the surgery,” recalls Labrecque. “He was in terrible pain and his scrotum was swollen.”

Estimates on the rates of chronic pain, however, range widely. In a variety of studies, anywhere between 1% and 50% of men complained of sore testicles, including epididymitis (“blue balls”) for up to a year. As many as 15% described the pain after vasectomy as seriously aggravating. Again, the surgeon’s technique and experience appeared to be key.

Do vasectomies increase the risk of prostate cancer and dementia?

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

In 2006, a group of Northwestern University researchers published 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. 

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