Male sterilization, or vasectomy, blocks the flow of sperm through the vas deferens (see Chapter 5). Typically, this procedure is simpler, less expensive, and safer than a tubal sterilization (Pollack, Carignan, & Jacobstein, 2004). After a vasectomy, the testes continue to produce viable sperm cells, but with nowhere to go, they die and are absorbed by the body. Semen normally contains approximately 98% fluid and 2% sperm, and after a vasectomy, the man still ejaculates semen, but the semen contains no sperm (there is no overall change in volume or texture of the semen after a vasectomy). All other functions, such as the manufacturing of testosterone, erections, and urination, are unaffected by a vasectomy procedure. In the United States there are approximately 500,000 vasectomies performed each year (Barone et al., 2004).
The surgery for a vasectomy is done on an outpatient basis in a physician’s office. The physician makes two small incisions about 1/4 to V2 inch long in the scrotum. The vas deferens is then clipped or cauterized under local anesthesia, which usually takes approximately 20 minutes. Immediately following a vasectomy, enough sperm remains for 20 more ejaculations, and so sperm counts are taken 2 to 3 months later to check sterility (Pollack, Carignan, & Jacobstein, 2004). The cost for the procedure varies widely, depending on where it is done. Overall, costs range between $300 and $700. Vasectomy does have some risk involved, including swelling, bruising, and possible internal bleeding or infection.
A less invasive alternative to vasectomy, the Vasclip, was approved by the FDA in 2002 but not marketed until 2003. The Vasclip is a locking plastic band that is placed over the vas deferens, effectively closing the tube. This permanent method eliminates cutting, suturing, or cauterizing the vas deferens and results in less swelling and infection than a vasectomy.