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Let's talk about Vasectomies

In the United States, 1 out of 5 men over the age of 35 has had a vasectomy. Vasectomies are a 99% effective mode of permanent male contraception. You should not even consider one unless you are certain you do not want children in the future. Reversals (vasovasostomy) are available, but not a guarantee. There are differing opinions on the short-term and long-term effects of permanently altering the male anatomy, but I will present some studies today as well as some anecdotal testimonies submitted by my community. My personal philosophy is not to alter the way something was designed unnecessarily. Just because something is common does not mean that it comes without risk. Furthermore, if you or your spouse has already had a vasectomy, this post is not meant to scare, rather to inform those who are debating or want to learn more.

Let’s first understand better what it is. When a vasectomy is performed, each vas deferens is cut and cauterized or sutured closed to prevent sperm from leaving the epididymis. This way, no sperm are expelled from the penis at the time of ejaculation. (See diagram). What could the possible ramifications be for blocking the channel in which sperm is designed to travel? What are the side effects of having that blocked indefinitely?

Possible known complications

Sperm granuloma

A sperm granuloma occurs in 15 to 40 percent of men who undergo vasectomy. It is a mass that develops over time as a result of the body's immune reaction to sperm leaking from the cut end of the vas. This can potentially cause significant scrotal discomfort, and sometimes requires surgical removal.

Post-vasectomy pain syndrome

This condition is thought to result from buildup of fluid in the epididymis leading to a chronic dull ache in the testes. If pain persists, local nerve blocks or steroid injections are the next escalation in therapy, followed by surgery or a vasectomy reversal.

Decreased testosterone

This hasn’t been shown through peer reviewed data, but there are many anecdotal accounts of this occurring post vasectomy.

Prostate Cancer

There are many inconclusive studies dating back 40+ years or more trying to prove one way or another regarding the relationship between vasectomies and increased risk of prostate cancer. However, a recent 2020 study of 2,150,162 Danish men shows conclusive evidence that is worth looking closer at.

Immunological effects and antisperm antibody production

Vasectomy may lead to the exposure of sperm antigens to the immune system, which will stimulate an antisperm auto antibody reaction.

Anecdotal testimonies submitted by my community

  • Gangrene in one of the testicles post-op

  • ICU months later with sepsis from complications

  • Could feel the clamp/end of his vas deferens which were painful

  • Grew back together - unexpected pregnancy

  • Benign prostatic hyperplasia with urinary retention

  • Hematoma that took weeks to go down.

  • Grapefruit size swelling for weeks, sex issues & hormone imbalance

  • Low testosterone - Topical testosterone needed daily

  • Frequent sharp pain in testicles

  • Complication resulting in losing a testicle

  • Granuloma, low libido and erectile issues

  • Severe daily pain for years until reversal

  • Bacterial infection

  • Excruciating ejaculation

  • Post vasectomy pain for years

  • Pain during and after sex

  • Performance issues

  • Pain after sex

  • Continued infections

  • Pain with every erection

  • Testicular torsion

  • Impacted sleep

  • No sex drive

  • Phantom itch

  • Weight gain

  • Regret

  • Depression

  • Prostate cancer

  • Chronic pain


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