If you are male and have decided that you do not want any more children, you might consider a vasectomy. A vasectomy is a highly effective means of male birth control. Moshe Wald, MD, urologist at University of Iowa Hospitals and Clinics, talks about vasectomies:
When should a man consider having a vasectomy?
I think the most important point here is for a candidate to be sure that he is either done having children, or does not want to have any children. I would also recommend that this decision is made after discussing it thoroughly with a spouse.
What long-term considerations should be considered before a vasectomy?
I think the important thing is, again, to make sure that the decision is final--that this couple is not interested in having any more children. If you're asking more about the side effects, I believe we will talk about this later. But, again, the key point here is to really make sure the couple is ready for a permanent form of contraception.
Is there more than one method of doing a vasectomy? What are the different approaches?
It really depends on the surgeon's preference, but in brief, a vasectomy involves interrupting the vas deferens, which is the tube that delivers sperm outward from the testicles. There are different variations that depend on the surgeon's preference. But all have one thing in common--we interrupt the vas deferens on both sides.
Is one method more effective than the other? How effective is a vasectomy?
I think the standard procedure is considered to be quite effective. In order to do that, what I mean by this is that the vas deferens is not only divided, but we remove a small piece in between and we apply some cautery to burn the cut surfaces. And we even put the two edges of the vas deferens, after dividing it, in different tissue planes. While we do these measures, it is considered to be an effective procedure.
Overall, how effective is a vasectomy?
That is an excellent question and I think that we need to stress that a person is not sterile immediately after a vasectomy. We need to check a semen analysis. And we recommend having two that are completely negative for sperm to confirm that. Once we have two post-vasectomy semen analyses completely negative for sperm, this is a very safe method for contraception.
What should a man consider when choosing a physician to perform a vasectomy?
I think that the important thing is to make sure that this physician is familiar with the procedure, has done a substantial number of these, and can handle possible complications of this procedure.
Why is it important to ask questions concerning the number of vasectomies the physician has completed and complications rates?
Because a vasectomy is a surgical procedure and like any other surgery, you want to make sure that the surgeon is well experienced, has done many of these, gathered experience to handle possible complications of this, and do it appropriately.
What are the possible advantages of a university medical center urologist, like you, for consumers considering a vasectomy?
One major advantage is that the volume here at our clinic is very large and we do many vasectomies, so the experience that is gained here is substantial. The other thing is that we have a very strong lab that supports us in terms of checking the semen after a vasectomy. Let me tell you a little bit more about this. What we do here, and I'm not sure that this is done routinely in other places, we look not only at the semen when we check after a vasectomy, but we also centrifuge it. We spin it and look at the pellet, so this is like an extensive search to make sure that indeed there are no sperm left in the semen.
Are here any unique techniques associated with vasectomy that are offered at the University of Iowa?
Yes. We do the textbook vasectomy as described before, taking all the steps necessary to maximize the chances of a successful result. What we do here, that I believe is somewhat unique, is that we use different methods to apply the local anesthesia. We do not use the standard syringe with a needle that could be somewhat uncomfortable to the patient. We offer a device that delivers the same local anesthetic using high air pressure, so there are no needle sticks. This provides excellent local anesthesia, and in fact, even somewhat helps the surgeon in performing the procedure because the tissue is not as swollen at the time of the procedure. But I think the important thing for the patient--we can spare a needle-stick or several needle-sticks.
What is the recovery time of a vasectomy?
For these procedures, I would estimate that after two to three days, a man can be back at his desk. We, for example, do most of our vasectomies on Fridays and our patients are able to be back at their desk on Monday, However, I would recommend avoiding any heavy lifting or extensive physical work for approximately two weeks after the procedure.
How likely is it to be able to reverse a vasectomy if needed?
The success of vasectomy reversal really depends on the technique that was used at the time of the vasectomy. As I said, there are many variations for doing the procedure. By that I mean:
- The length of the segment of the vas deferens that was removed
- Whether an extensive cautery was applied to the vas deferens
- The type of suture material used
There are many factors that play a role here. Also it depends on the time that has passed since the vasectomy. In general, when the vasectomy was done many years ago, then we are looking at a somewhat decreased success rate, although it is not contraindicated. So I think it is difficult to give one straight answer. I think it is really something that needs to be individualized.
If someone wanted to learn more or schedule a consultation to see you, where would they call?
Certainly--our office number is 319-356-2421. |
