Thursday 19 July 2018

11 things you need to know about vasectomies (including why Jamie Oliver is right to be scared)

Pain thresholds differ in all vasectomy patients
Pain thresholds differ in all vasectomy patients

Jonathan Wells

It may be a straightforward procedure that hundreds of thousands of men undergo each year, but the vasectomy still strikes fear into many.

This week Jamie Oliver proved those attitudes are well and truly alive when he revealed to Alan Carr that he once intended to have 'the snip', eventually giving up on the idea due to both his squeamishness and the wishes of his wife, Jools.

Jamie Oliver and wife Jools
Jamie Oliver and wife Jools

The 40-year-old chef, who is set to become a father for the fifth time this year, was asked if he'd considered having a vasectomy by chat show host Alan Carr.

"Yeah, but I'm really scared of needles," he replied, adding that a friend of his recently underwent the surgery – a minor operation during which the tubes that carry sperm from a man's testicles and penis are cut, blocked or sealed – and "cried for three weeks". The friend's penis "went all black."

With so much anecdotal evidence and misnomers in play, then, what is the truth about the vasectomy? Before you consider cutting loose, sit back, cross your legs and read the 11 things you should know about getting the snip.


 1. Yes, it does hurt

It seems that Jamie's concern is well founded: a vasectomy is just as painful as it sounds. According to this article by Neil Lyndon, his surgeon told him he would feel nothing but a "scratch".

Some viable sperm will remain in the system after vasectomy
Some viable sperm will remain in the system after vasectomy

 "What I felt, however," continues Lyndon, "was like a sliver of white-hot fire entering and filling my balls. I had never before grasped the meaning of the term “climbing the walls” in agony. Now I found my back propelling itself up the wall at the head of the bed as I gave out a cry between a gasp and a scream."

And whilst 95 per cent of vasectomy patients report only report mild or minimal pain, doctors seem keen to stress that pain thresholds differ in all patients, and that you can't fully know what to expect until it may be too late.


2. You can have it reversed

Yes, should you change your mind, you can have your vasectomy reversed. The catchily-named vasoepididymostomy reconnects the tubes that were cut during the initial procedure, but can cost between £2,000 and £5,000.

Additionally, the procedure may not always be successful, with up to 50pc of men reporting that they still can't have children even after the reversal. This is possibly why doctors recommend considering all options before committing to the vasectomy in the first place.


3. You are not immediately sterile

The operation is not fail-safe
The operation is not fail-safe

Viable sperm will remain in your system for some weeks after the procedure, with an average of between 10 and 20 ejaculations needed to 'clear' the urethra.

Another common mistake is that the testicles stop producing sperm after a vasectomy. This is untrue. The epididymis (the long, coiled tube that rests on the back of each testicle and helps to transport and store sperm) may feel 'fuller' than usual for some weeks after the procedure given the excess of unused sperm.

However, these feelings usually pass after several weeks. But remember, because some viable sperm will remain in your system beyond the point of vasectomy, additional methods of contraception are still advised for the first six months.


 4. It does not affect your libido

According to a large Australian study published in The Journal of Sexual Medicine in 2010, vasectomies do not affect men's level of desire, their ability to maintain an erection or the quality of their orgasms.

The procedure has been linked to heart attacks
The procedure has been linked to heart attacks

As with sperm, your testicles will continue to produce testosterone. However, whilst the sperm is harmlessly absorbed into your body - leaving 'empty' semen to be ejaculated - testosterone will still fuel your virility.

In fact, the study concluded that vasectomised men were happier in their relationships, potentially due to "the procedure decreasing anxiety about unwanted pregnancy and conflict over the use of contraception."


5. The procedure has been linked to prostate cancer

A link between vasectomies and cancer was first raised by health professionals at the Harvard School of Public Health. Researchers studied over 50,000 men and found that those who had undergone the procedure were one-and-a-half times more likely to develop prostate cancer in later life.

And whilst health authorities have subsequently been keen to play down the results of this study, there remains a body of research that links vasectomies with both prostate and testicular cancer.


6. And heart attacks

Ordinarily, sperm do not come into contact with immune cells. However, after the procedure, certain barriers are breached and many men begin producing anti-sperm antibodies. This has troubled researchers, as when the body begins to defend against itself this can cause atherosclerosis, the clogging of arteries that leads to heart attacks.

Rheumatoid arthritis, juvenile diabetes, and multiple sclerosis are just some of the other illnesses suspected or known to be caused by immune reactions of this type.


7. There is a 1pc failure rate

Like any method of contraception, a vasectomy is not fail-safe. The NHS reports that out of every 2,000 men who undergo the procedure, one will likely fail to be sterilised.

As a result, health professionals tend to recommend the continued use of condoms, to both account for any viable sperm that remains in the reproductive system, and as...


8. It does not protect against STIs

A seemingly obvious point, many men believe that undergoing a vasectomy completely negates the chance of them being able to contract, or pass on, a sexually-transmitted infection.

In fact, you can still transmit or acquire these diseases when you have unprotected sex, as your sterilisation will have little or no impact on your sexual health.


9. It can still hurt for up to a year afterwards

Whilst most men only feel discomfort for several weeks after the procedure, there is a notable body of patients who take much longer to recover.

 Infections can take hold, and localised swelling is likely to flare up within the first year, but anti-inflammatory medications can be taken and usually quell the majority of unpleasant sensations.


10. You must take a week out after the procedure

For a week after the operation there is an extensive list of things that you must not do. Riding a bike, weightlifting, golfing, jumping, swimming, jogging and bathing are all off limits.

Interestingly, sex is permitted after only one day (although please refer to point 3 before getting frisky).


11. It empowers men to play an active role in family planning

World Vasectomy Day is all about confronting your fears about the procedure, talking your options through with a doctor and stepping up - as the man of the family - by making a decision that will benefit everyone in the long run.

As one of the safest forms of contraception, a vasectomy is much safer and less expensive than the female equivalent (a tubal ligation) so if you've decided that you don't want any more kids - it statistically remains the best way to go.

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