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What Factors Affect Vasectomy Effectiveness?

By Caitlin Kenney
Updated Jan 25, 2024
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Vasectomy effectiveness is very high, beating out condoms for the most effective male contraception. A vasectomy is a surgical procedure in which the vas deferens, or the tubes that transport sperm to the semen, are cut and sealed. This prevents sperm from reaching the semen so that, though the man can still ejaculate the same amount of semen, it will not contain any sperm. Thus, his partner cannot get pregnant. Vasectomy effectiveness is near 100 percent, but it can fail due to not using protection in the first few weeks, or sometimes months, after the operation or, rarely, because the tubes spontaneously reconnect.

A vasectomy is a safe method of male contraception that is intended to be permanent, though it can sometimes be reversed. The procedure can be performed with or without an incision, and the vasectomy effectiveness remains the same. In the incision method, the surgeon injects a local anesthesia into the pelvis to numb the patient and then either makes two incisions, one on either side of the scrotum, or one incision in the center of the scrotum. The surgeon then cuts the vas deferens and seals them by tying them, clamping them, or closing them with electrical currents.

In the no-incision vasectomy, two punctures are made into the scrotum to access the vas deferens, which are then cut and sealed off. This procedure reduces the risk of infection and bleeding, and produces no scarring. It only takes around five to 15 minutes, as compared to the open surgery, which takes around ten to 20 minutes.

Though each method of sealing the tubes works extremely well, cauterizing the vas deferens with electrical currents produces the highest vasectomy effectiveness, as it reduces the already slim chance that the tubes will spontaneously reconnect. Sealing off the tubes at both ends is also thought to increase vasectomy effectiveness, although sealing off only one end may cause less discomfort. Fascial interposition, in which a piece of tissue called the fascial sheath is positioned between the two cut tubes is also meant to increase vasectomy effectiveness.

Vasectomy effectiveness can be undermined by two events: unprotected sex before all of the sperm has been used up or reabsorbed, and spontaneous recanalization of the vas deferens. The first problem occurs because a vasectomy does not prevent pregnancy immediately. There may still be sperm mixed in with the semen past the point of the sealed tubes, and this all has to be used up before the vasectomy can be trusted as the only method of birth control. A semen analysis can tell the man when the semen is sterile.

The second problem that impairs vasectomy effectiveness is recanalization, when the disconnected tubes grow back together. This is very rare and usually occurs within the first few months. Recanalization can happen when an immune response causes a growth on the vas deferens, called a sperm granuloma, which then develops into a mass called a gasitis nosodum. This mass, in very rare occasions, can join up with the other end of the tube and allow sperm to pass.

Microrecanalization, or the forming of tiny channels through which sperm can pass, can occur due to scar tissue, usually as a result of a poor job on the part of the surgeon. In either type of recanalization, fertility is greatly reduced because much less sperm are passing through the vas deferens, but pregnancy is still possible. These are rare occurrences, however, and if the patient waits for the go-ahead after semen analysis, vasectomy effectiveness is near perfect.

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