With rising costs in family expenses and tight budgets, contraception decisions are not always at the forefront. Contraception, however, can be a greater drain on a family budget than most realize, particularly when considered over a 5-10 year timeframe. 

With brand name drug prices through the roof and $50 co-pays prevalent, many women are turning to generic medications, but even the costs of generic birth control pills, $10 co-pay can add up. Depo Provera shots can exceed $500 annually, and IUD’s are several hundred dollars with a need for replacement every 5-10 years.  Permanent contraception for women can be very expensive. The costs of tubal ligation or a fallopian tube occlusion device like Essure can add up to $3000 and the procedures requiring potentially risky general anesthesia or heavy sedation. Even with insurance coverage, the costs of women’s contraception options can be high particularly in the face of ever increasing deductibles.

The most cost effective long-term birth control method is also the most efficient, Vasectomy. Vasectomy has a one time charge of approximately $1200 which can be less than the out of pocket costs for insured patient who choose tubal ligation or Essure. Many insurance companies cover vasectomy which can greatly reduce or eliminate the out of pocket expense, but even without insurance coverage, the vasectomy is a relative bargain.

The physicians at Alliance Urology Specialists currently offer state of the art Needle Free, No Scalpel Vasectomy. This is a simple 15-20 minute procedure that is performed in our office under local anesthetic and an oral sedative if desired. Only a rare patient requires more formal anesthetic, and that is usually if there has been prior scrotal surgery, anatomical anomalies, or severe anxiety. In the office, we use a special needleless injector that uses high pressure to force local anesthetic into the scrotal tissues with a sensation that is similar to the light snap of a rubber band against the skin. The anesthetic effect is nearly instantaneous and very effective. A small puncture is made through the anesthetized area, and in most cases, only one puncture is required to manage both the right and left vas deferens. Each vas is divided and a small section is removed. The ends are cauterized, clipped, or tied closed depending on the surgeon’s preference. No stitches are required for skin closure, and a light dressing is left in place overnight.

A vasectomy is generally well tolerated with mild discomfort that can often be managed with Tylenol or Ibuprofen alone, although a slightly stronger pain medication is made available for most patients to use as needed. Showering can resume the next day. Return to work is usually in 2-3 days with some restrictions on lifting and sexual activity for about a week. There are potential risks with the procedure, but they are not common. It is possible to have mild to moderate swelling and bruising of the scrotum, but serious bleeding is quite rare. There is a small chance of infection, and you may receive a preoperative antibiotic to reduce the risk. There is a 2-3% possibility of persistent testicular discomfort following the procedure that is thought to be related to congestion in the testicles which continue to make sperm following the procedure. Occasionally, some sperm can leak into the surrounding tissues following the procedure causing a small ball of inflammation called a sperm granuloma. There are rare reports of testicular shrinkage or atrophy following a vasectomy which is most likely related to compromise of the testicular blood supply during the dissection.

A vasectomy is very successful with failure rates of <0.5%. We do not consider the procedure a success until we have two negative post-procedure semen analyses. It can take ten or more ejaculations to flush all of the residual sperm from the system. Until we have seen two negative specimens, another form of birth control is recommended.  A vasectomy should have minimal impact on sexual function. The sperm makes up only 1% of the fluid that comes out with an ejaculation or climax. The remainder is produced by the prostate and seminal vesicles which are not affected by this procedure.

While intended as a permanent form of contraception, a vasectomy can be reversed with very good success rates in the first ten years following the procedure with a 90% likelihood of sperm returning to the ejaculate fluid. Recovery of function declines beyond ten years, but successful reversals are reported beyond ten years.

When considering the contraception options, a vasectomy is an excellent choice for men and couples who are not planning to have anymore children. Vasectomy remains the most effective, safe, and economical choice of permanent birth control with a very good reversibility rate if plans change. Our advanced No Needle, No Scalpel Vasectomy has made this procedure much more appealing to many men who would not have considered this in the past.

At Alliance Urology Specialists, we are proud to offer this excellent procedure along with a comprehensive array of male and female urologic services to the Piedmont Triad and surrounding communities.

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