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
“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.”
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
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.