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"  If you and your guy are done having kids, the vasectomy is the least invasive, most effective form of permanent birth control. Intrepid reporter (and snip-ee) Mike Zimmerman digs up everything you both need to know about the procedure \u2014 so you can talk him into it. Nearly every couple who&amp;#039;s finished having children will eventually sit down to have &amp;quot;the talk&amp;quot; about permanent contraception. But the conversation will never go like this: WOMAN: &amp;quot;Honey, I think you should have a vasectomy. It&amp;#039;s simple, safe, and it&amp;#039;ll make sex so much better for us.&amp;quot; MAN: &amp;quot;Sweetheart, you&amp;#039;re absolutely right.&amp;quot; TOGETHER: &amp;quot;Let&amp;#039;s make the appointment!&amp;quot; Agreeing that you&amp;#039;re done having kids is usually far easier than agreeing on who signs up for sterilization. But the choice between your tubes being tied and his getting snipped should be no biggie if you base it on statistical logic: &amp;quot;Vasectomy is by far the most effective form of permanent contraception,&amp;quot; says Marc Goldstein, M.D., professor and surgeon-in-chief of male reproduction at Weill Cornell Medical College in New York City, who&amp;#039;s performed more than 3,000 vasectomies himself. &amp;quot;It&amp;#039;s 10 times more effective than a woman tying her tubes. Also, every year 25 to 30 women die during a tubal ligation procedure because of complications from anesthesia or injury to the blood vessels or bowel. Zero men die from vasectomy.&amp;quot;  But for some guys (maybe one you know?), those reasons will not matter. It turns out that volunteering to be neutered is pretty high on the list of Things Ye Dare Not Do as recorded in the Secret Scrolls of Manhood. So why am I, a man, writing this story? I had a vasectomy myself (you can read all about it in a few short paragraphs), and the snip has done great things for my marriage and my sex life. Read this guide, show it to your guy, and decide for yourselves.  WHY MEN BALK AT VASECTOMIES &amp;quot;I would really like my husband to get one, but after lots of discussion, he continues to say no to vasectomy,&amp;quot; says Heather, 37. &amp;quot;I&amp;#039;m terrible at remembering to take the Pill. It would be much easier for him to snip-snip. But no matter what logical argument I make, what wins out is the stigma of someone messing with his &amp;#039;junk.&amp;#039;&amp;quot;  There you have one of the main reasons many guys are hesitant: &amp;quot;We spend our entire lives protecting our testes,&amp;quot; says Wayne Weissman, M.D., cofounder of the Vasectomy Center in Seattle, who has performed 7,500 vasectomies. &amp;quot;Women have their gonads inside their abdomens! Men walk around with their sack exposed, and it&amp;#039;s incredibly sensitive, so they feel more protective. Then, suddenly, you&amp;#039;re supposed to spread your legs in a doctor&amp;#039;s office. It&amp;#039;s not intuitive for men.&amp;quot; Bill, 41, was against vasectomy when his wife first brought it up. &amp;quot;My worries were about future sexual performance \u2014 I mean, what if I lost my sex drive?&amp;quot; he admits. &amp;quot;That&amp;#039;s a nonissue, it turns out. But it took several weeks to break me down. It didn&amp;#039;t hurt that my wife promised to make it worth my while for the rest of my life.&amp;quot; Mike, 40, hated the idea too, but eventually saw it as a fair trade-off. &amp;quot;Having the surgery wasn&amp;#039;t exactly what I wanted to do, because as guys, we think it&amp;#039;ll affect our manhood in some way,&amp;quot; he says. &amp;quot;But after my wife carried and gave birth to three kids, it was really my turn to take one for the team.&amp;quot;  For other men \u2014 like me, frankly \u2014 there&amp;#039;s some serious pondering to be done about what a vasectomy means. It isn&amp;#039;t just permanent contraception; it&amp;#039;s a gateway between one life stage and the next. You have to come to terms with the fact that you&amp;#039;re aging, that you&amp;#039;re through procreating, that you&amp;#039;ll be useless in any end-of-times scenario that requires survivors to repopulate the species. It is, quite decisively, setting in stone past accomplishments that will never be repeated. Moving on is not a man&amp;#039;s best talent.  Giving up the ability to have more kids also makes a man consider a lot of darker, almost unthinkable things. What if someone dies? God forbid, but if a man loses his wife or a child, there&amp;#039;s no going back to start over. And divorce? No one likes talking about it, but it happens.  If guys have misgivings about the no-more-kids thing, options exist. A man can bank sperm samples before the procedure. And if he has serious regrets, he can have a vasectomy reversal. But reversal surgery has a recovery time of three to four weeks, usually isn&amp;#039;t covered by insurance, and costs $7,000 to $10,000, Weissman says. So experts advise that a man never have a vasectomy thinking, Oh, I&amp;#039;ll just reverse it later. &amp;quot;Vasectomy should always be viewed as permanent contraception,&amp;quot; Goldstein says. My wife and I have three kids, and by 2005 we were very much done with family-building. I held out for as long as I could, but in the end, it just made sense.  EXACTLY WHAT A VASECTOMY ENTAILS The traditional vasectomy method that doctors used for decades involved a scalpel and a half-inch incision on each side of the scrotum, plus some stitches, Weissman says. But the surgery done most often now involves no stitching at all. It&amp;#039;s 40 to 50 percent faster than the old scalpel job and has roughly one tenth the complication rate. Plus, there&amp;#039;s less bleeding and pain, and no itchy sutures. Here&amp;#039;s how it goes: STEP ONE: A guy can take a Valium or a similar tranquilizer an hour before the procedure, to relax and allow the scrotum to &amp;quot;hang low.&amp;quot; Next, he lies down while the doctor administers a local anesthetic, usually by needle, which does hurt. &amp;quot;The biggest shock was the shot. Getting a syringe in the testicles was not fun, but it was manageable,&amp;quot; says Eric, 34, who had a vasectomy after he and his wife had baby number two.  NEXT, the doctor feels with his fingers for the vas deferens, the tube that moves sperm from the testicles to the urethra. He holds it with a small clamp and uses an instrument that looks like tiny needle-nose pliers to open a 3-millimeter hole in the scrotum. He then pulls out a half-inch section of the tube and snips it.  PERHAPS THE WEIRDEST PART of the vasectomy is cauterization, when the doctor burns the ends of the clipped vas so that scar tissue can form. Smoke literally drifts up from the patient&amp;#039;s crotch. (And for the record: Yeah, it smells nasty.) The doctor repeats the process for the other testicle using the same small hole.  FINALLY, the tubes are put back inside the scrotum and the doctor pops on a bandage. &amp;quot;The procedure was no big deal. I watched SportsCenter while it was happening,&amp;quot; says Eric. A man can get up off the table and walk right out, but it&amp;#039;s important to note that he is not yet considered sterilized. You&amp;#039;ll usually know within 12 weeks if the procedure worked. He also needs to clear all old sperm from his system, which is accomplished after either 15 ejaculations or three months, whichever, ahem, comes first. Until you get confirmation from a semen sample, the two of you must continue using whatever contraception you&amp;#039;ve been relying on.  THE ALL-IMPORTANT AFTER-CARE Many doctors do vasectomies on Fridays, which makes it simple for a guy to go home and lie around for the weekend with a bag of frozen peas on his package. &amp;quot;The scrotum is not a forgiving part of the body,&amp;quot; Weissman says. &amp;quot;The skin is loose, and it can accommodate a lot of blood and fluid. And gravity makes it worse, so if you&amp;#039;re up moving around, you could have bleeding and more swelling.&amp;quot; Says Eric: &amp;quot;It was actually like a vacation. With young kids, taking it easy for three whole days usually doesn&amp;#039;t happen!&amp;quot; After this sanctioned sloth, usually it&amp;#039;s back to work and nobody&amp;#039;s the worse for the wear.  Unless you&amp;#039;re me. The complication rate for vasectomies is about 1 in 1,000, says Goldstein. And the three most common complications are postoperative infection, hematoma (bleeding inside the scrotum), and sperm granuloma (a nugget that forms when sperm leak out of the vas and your immune system attacks them). These problems are incredibly rare, but by midnight of the first night after my vasectomy, I was working on all three. I spent Friday afternoon doing exactly what I was supposed to do: lying in bed with an ice pack, catching up on movies. But after my 4-year-old daughter started projectile vomiting, I spent the rest of the evening doing everything I wasn&amp;#039;t supposed to: lifting, moving, carrying her. My wife tried to handle the whole thing, but it was a two-parent job. By Monday I was limping around with a purple, throbbing Rawlings baseball between my legs. That turned out to be a hematoma and an infection, and I even developed a granuloma. Antibiotics lessened the pain and swelling within a week, but the granuloma hung around for a month, like a mini testicle just above my right ball. Then, finally, it was time to get back to normal, have some sex, and figure out whether all this nonsense was worth it. ABOUT THE SEX... Every doctor I interviewed wants you and your man to know these three things: 1. Vasectomy does not affect erections, orgasms, or sexual function whatsoever.  2. His semen will look the same and arrive in the same amounts. 3. Vasectomies do not have any negative effects on a guy&amp;#039;s health. (A previous belief that they might increase prostate-cancer risk has been debunked by larger, more recent studies.) THE BOTTOM LINE Even after hitting the 1-in-1,000 trifecta for post-op complications, I still think having a vasectomy was worth it. Why? From the time we&amp;#039;re teenagers, whenever we have sex, everyone worries about pregnancy. Stressing about condoms and pills and pulling out and all the other techniques and gadgetry invented to keep our sperm away from your eggs is a real drag. And we know that pills, patches, and IUDs aren&amp;#039;t side-effect-free for you women \u2014 and eradicating all that birth control angst makes sense for both partners.  Once I recovered, sex felt like playing with a new toy. My wife and I had reverted back to condoms after numerous birth control experiments over the years, and knowing I am forever free of my latex prison makes me giddy. The men I spoke to agreed. &amp;quot;My sex life has improved drastically now that I&amp;#039;m not worried about getting my wife pregnant,&amp;quot; says Eric. If you and your partner do decide to go the vasectomy route once you&amp;#039;re done with kids, there is one last thing you can do for a newly snipped man, aside from making sure he stays off his feet for a few days: Make him feel like it was worth it.   A QUICK GUIDE TO A HAPPY VASECTOMY The key to an easy procedure is finding a great doctor \u2014 and then following his instructions to the letter. Here&amp;#039;s how. 1. Look for a board-certified practitioner (urologists, surgeons, and even family-practice doctors can do the procedure) who does at least 20 vasectomies a year, says Weissman. Find docs in your area at vasectomy.com.  2. Ask if the doctor offers a no-scalpel vasectomy. The traditional procedure is still pretty minor, but no-scalpel produces fewer complications in skilled hands. 3. Offer to go with your man to his consult, and jot down his concerns beforehand. If the doc doesn&amp;#039;t take the time to sit down and address all of your worries, find a new one. 4. Get backup. It&amp;#039;s minor surgery, but it is surgery, says Weissman; men must take it easy the first few days afterward. If you have little kids, line up someone who can help out with child care for the post-op in case more hands than Mom&amp;#039;s are needed. WHO GETS SNIPPED: YOU OR YOUR GUY? A cheat sheet of your permanent birth control options. 1. TUBAL LIGATION   What&amp;#039;s involved: In a surgical setting, with the woman under general anesthesia, a doctor severs and seals the ends of the fallopian tubes so eggs can&amp;#039;t enter and be fertilized.  Pros: It&amp;#039;s 99 percent effective when done successfully.  Cons: It&amp;#039;s major surgery, one in 200 to 500 procedures fails, and the risk of death is one to two per 100,000, usually from complications from being put under. Other possible complications include bleeding, infection, and ectopic pregnancy (pregnancy occurring outside the uterus, usually in the fallopian tube).  Cost: $1,500 to $6,000  2. ESSURE COILS (Hysteroscopic Sterilization)   What&amp;#039;s involved: In a doctor&amp;#039;s office or clinic, using local anesthetic, small spiral coils are inserted in a woman&amp;#039;s fallopian tubes. (There&amp;#039;s no cutting \u2014 the doctor goes through the vagina and cervix to reach the tubes). Tissue forms around the inserts, blocking the tubes. After three months, an X-ray will confirm whether the procedure was successful.  Pros: It&amp;#039;s minimally invasive, and recovery can be as short as one day. It&amp;#039;s 99.7 percent effective when done right.  Cons: The inserts may not be placed properly, or they may move, which could require a second procedure. The fallopian tubes may not be fully blocked after three months, which means waiting three more months (or having a second procedure).  Cost: $1,300 to $3,500  3. VASECTOMY   What&amp;#039;s involved: In a doctor&amp;#039;s office, with local anesthetic, an M.D. snips and cauterizes a man&amp;#039;s vas deferens.  Pros: It&amp;#039;s minimally invasive, and the no-scalpel procedure takes only 10 to 20 minutes. (Recovery takes two to three days.) It&amp;#039;s more than 99 percent effective.  Cons: Complications include infection, bleeding, and sperm leaking from the severed vas and forming a granuloma (chances are 1 in 1,000 for each).  Cost: $500 to $1,000  Note: Depending on your carrier and plan, medical insurance may cover all of these procedures. Check with your provider. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.redbookmag.com/love-sex/relationships/advice/a12392/getting-a-vasectomy/>