â€œCan vasectomies really make a difference? Mine made a big difference in my life, and to this day, I consider it the single most important contribution I have personally made to the wellbeing of future generationsâ€¦.â€œ Paul Ehrlich.
It was time: I walked across the hall, lowered my pants and lay down on the exam table. Dr. Sam Callaway took good care of me.
We had two great sons and our family was complete. Although my wife volunteered to get her tubes tied, I decided to practice what I preached and went for the vasectomy. That was thirty years ago, and Iâ€™ve never regretted that decision.
My largest fear was that Samâ€™s office nurse would be around still, but Judy had already left. Sam talked to me as he worked and I barely felt any discomfort. He explained that he used a very thin needle for the local anesthesia, made tiny incisions and he was gentle. In a few minutes it was all over and I was on my way.
Iâ€™ll admit to some soreness that evening when I spoke at the prepared childbirth class my wife was teaching. And I moved carefully the next day when I needed to perform a cesarean. All in all, I took just a few aspirins (that was before ibuprofen!) and never had any ill effects.
Men have an anatomical advantage when it comes to sterilization. Whereas a womanâ€™s tubes are deep inside her body, a manâ€™s tubes, the vasa deferentia (singular: vas deferens) are much more accessible. When they are interrupted, sperm cannot get released, and the man is unable to cause pregnancy. Fortunately, sperm are only a tiny fraction of the male ejaculate, so sex is unchangedâ€”or better, for lack of fear of pregnancy.
A vasectomy takes only a few minutes, is done with local anesthesia and is amazingly safe and effective.Â The main hitch is that it takes several months to wash out all the sperm, and the man should be tested to be sure that he really is shooting blanks before trusting the surgery. Fortunately, the failure rate is less than one in a hundred.
Tubal ligation is more common in the USA than is vasectomy. Among married couples, one in 7 men is sterilized while one in 5 women has had the surgery. Since many sexually active people are not married, the overall statistics show a larger preponderance of women taking control of their fertilityâ€”more than a half million women are operated on every year while only half that number of men get snipped.
The popularity of vasectomy varies by country. It is rare in many parts of the world such as in Africa, but a quarter of men in New Zealand have had the surgery.
In Durango perhaps only one physician is left performing this important procedure after Centura took over the family practice group at Mercy. Dr. Mark Forrest has performed hundreds of vasectomies, including on some of my friendsâ€”and they have all done well. He says that it usually takes two visits: a consultation, then the actual surgery. He will check semen samples two and three months later, and if both are negative for sperm, the surgery can be considered a success. If this protocol is followed, the failure rate is lower than the rate of pregnancy after tubal ligation.
Furthermore, vasectomy is much less expensive. Nationwide, the price of male sterilization is $350 to 1000. Female sterilizations can now be done without an incision. Essureâ„¢ is an office procedure performed through the womanâ€™s cervix, with mild sedation and local anesthesia. Unfortunately, its overall cost is about the same as tubal ligationâ€”$1500 to 6000.
The first World Vasectomy Day will be observed October 18th of this year. This event was decreed by Jonathan Stack, an award-winning documentary filmmaker. The event will be celebrated by Dr. Doug Stein performing his favorite operationsâ€”you guessed it!â€”live from Australia. Dr. Stein has performed over 30,000 vasectomies, perhaps a world record.
Mr. Stack went to Dr. Stein for his own procedure, and thus got the idea for the film. His reasons for favoring vasectomy include: â€œâ€¦itâ€™s time for men to share the burden of family planningâ€ and â€œâ€¦we have to do a fairer job of sharing the planetâ€™s finite resources.â€
You can find out more at: www.worldvasectomyday.org, including links to the film’s trailer. They need money to finish this important film. I donated already, and hope that you will also consider supporting this filmâ€”because it is time for men to share the burden of family planning!
Â© Richard Grossman MD, 2013