Should you get a vasectomy after Roe decision? Doctors explain how it works

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Since Roe v. Wade was overturned on Friday and Missouri's trigger ban outlawed nearly all abortion in the state, interest in vasectomies has been on the rise around Kansas City.

Since the ruling dropped on Friday, The Kansas City Urology Care, which has about a dozen locations in the region, has seen nearly a 90% increase in consultation, according to urologist, Dr. Christian Hettinger.

Vasectomies are a safe and effective form of birth control for people who have and are trying to prevent pregnancy, but Kansas City doctors warned they are intended to be permanent.

Here are a few things Hettinger and University of Kansas Health System Urologist Ajay Nangia said to consider when deciding if a vasectomy is a good option for you.

What is a vasectomy?

A vasectomy is a procedure where a doctor makes a small incision in the scrotum, and then severs and blocks the tubes that carry sperm from the testicles. The tube is called the vas deferens and will disconnect the tube and block it with clips or by burning the ends of where the tupe was separated.

"So it blocks the sperm from being released when a man has an ejaculation," said Hettinger. "So, in essence, they're shooting blanks. No sperm comes out when they have an ejaculation."

Are there multiple kinds of vasectomies?

Yes, there are two techniques for performing vasectomies, including the scalpel method and a no-cut method. The incision method uses a scalpel to make a cut on the scrotum. The no-cut method uses a tool to puncture a small hole instead of making a cut, according to Planned Parenthood.

"There are numerous ways you can do it, but in the end, it's a very similar procedure, just different, slightly different techniques to it," Hettinger said.

Can vasectomies be reversed?

Yes in some cases, but the success rate of reversals decreases over time.

If someone is having a vasectomy and is considering getting it reversed, it's better to get it reversed sooner than later, according to Hettinger. He suggested getting the procedure reversed in the first few years, and said that later than that might make reversal less possible.

"If you're waiting 10 to 15 years to get it reversed, your success rates drop pretty low," Hettinger said.

Dr. Nangia from KU Med said that he makes sure that his patients know that the procedure is supposed to be permanent.

"We have to make patients aware that we view this technique as permanent. We're doing this for them because they don't want any more children," Nangia said.

If a patient does change their mind about children after having the procedure, they can either try to have their vasectomy reversed, or they can have sperm retrieved from their testicles and use a process like in vitro fertilization (IVF) to conceive a child.

Do vasectomies hurt?

The doctors said vasectomies are typically not very painful. Most patients are awake for the procedure, as it only calls for a and has a pretty quick recovery period.

Nangia said he often prescribes Valium to his patients who might be anxious about the pain before the procedure.

Otherwise, patients typically walk out of the doctor's office in less than an hour and can manage any pain that follows with ice and ibuprofen.

How long does a vasectomy procedure take?

The procedure takes about 30 minute.

What are the risks?

Like any other procedure, there are some risks. But overall, the doctors said vasectomies are very safe. There is a 1-2% chance of infection or after a vasectomy, according to the American Urological Association.

And there is a 1 in 2,000 chance that the vasectomy fails or the sperm duct reconnects itself. However, the procedure is still more than 99% effective against pregnancy.

What's the recovery time after the procedure?

Recovering from a vasectomy should be a fairly smooth process. Both Nangia and Hettinger tell their patients to take it easy for up to two weeks. Most activity can resume as normal as soon as two days after, but it's important for patients to ice any pain, avoid sex and avoid strenuous activities.

"Then when they feel okay [or] they're not focus[ed] on anything hurting down there, they can resume protected intercourse or activities, sporting, work-related or otherwise," Dr. Nangia said. "They don't have to be off work, they may have to limit some of their work, especially depending on what career [they have]."

When can you have sex again after a vasectomy? Are you sterile right away?

After a week or two, patients can start having sex again. But the doctors said it's important to know that people who had the procedure aren't protected from pregnancy right away.

"You're not instantly sterile right after a vasectomy," Nangia said. Based on the American Urological Association guidelines, Nangia said patients need to wait at least three months and must ejaculate at least 20 times before they clear all the sperm and are considered sterile.

In the meantime, other birth control methods need to be used to prevent pregnancy. After waiting three months and ejaculating at least 20 times, patients have to revisit their doctor for a sperm analysis to make sure they have cleared all the sperm.

Do people still have semen after a vasectomy?

Yes. People still have semen and are able to ejaculate after having a vasectomy. However, there will be no sperm in the semen.

How much do vasectomies cost?

If you are uninsured, the procedure can cost up to $1,000. Some insurance covers vasectomy, so if you are insured, it's best to contact your provider to see how much the procedure will cost for you.

©2022 The Kansas City Star.

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