Abstract
Male sterilization (vasectomy) is the most effective form and only long-acting form
of contraception available to men in the United States. Compared to female sterilization,
it is more efficacious, more cost-effective, and has lower rates of complications.
Despite these advantages, in the United States, vasectomy is utilized at less than
half the rate of female sterilization. In addition, vasectomy is least utilized among
black and Latino populations, groups with the highest rates of female sterilization.
This review provides an overview of vasectomy use and techniques, and explores reasons
for the disparity in vasectomy utilization in the United States.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ContraceptionAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- World contraceptive use 2007.Department of Economic and Social Affairs, Population Division, New York2008
Bureau PR. Family planning worldwide 2008 data sheet. In: Washington DCPRB, ed.; 2008.
- Demographics of vasectomy — USA and international.Urol Clin North Am. 2009; 36: 295-305
- Use of contraception in the United States: 1982-2008.Vital Health Stat. 2010; 23: 23
- Characteristics of men receiving vasectomies in the United States, 1998-1999.Perspect Sex Reprod Health. 2004; 36: 27-33
- External spermatic sheath injection for vasal nerve block.Urology. 1992; 39: 173-176
- Intra-vas deferens bupivacaine for prevention of acute pain and chronic discomfort after vasectomy.Br J Anaesth. 1995; 74: 612-613
- Topical anesthesia with EMLA does not decrease pain during vasectomy.J Urol. 2008; 180: 271-273
- Topical anesthesiawith eutetic mixture of local anesthetics cream in vasectomy: 2 randomized trials.J Urol. 1992; 147: 98-99
- EMLA cream (lidocaine/prilocaine) versus infiltration analgesia with carbocaine (mepivacaine) in vasectomy.Ugeskr Laeger. 1989; 151: 3159-3160
- Use of EMLA cream with vasectomy.Urology. 2002; 60: 135-137
- Taking the ‘ouch’ out — effect of buffering commercial xylocaine on infiltration and procedure pain — a prospective, randomised, double-blind, controlled trial.Ann R Coll Surg Engl. 2004; 86: 213-217
- No-needle jet anesthetic technique for no-scalpel vasectomy.J Urol. 2005; 173: 1677-1680
- Comparative analysis of effectiveness of two local anesthetic techniques in men undergoing no-scalpel vasectomy.Urology. 2007; 70: 1187-1189
- Minimizing pain during vasectomy: the mini-needle anesthetic technique.J Urol. 2010; 183: 1959-1963
- Pain during vasectomy: a prospective audit.Br J Theatre Nurs. 1999; 9: 79-83
- Comparative analysis of pain during anesthesia and no-scalpel vasectomy procedure among three different local anesthetic techniques.Urology. 2009; 74: 77-81
- A prospective study on nerve-sparing radical hysterectomy in patients with cervical cancer.Zhonghua Fu Chan Ke Za Zhi. 2008; 43: 606-610
- No-scalpel vasectomy at the King's birthday vasectomy festival.Lancet. 1990; 335: 894-895
- Vasectomy surgical techniques: a systematic review.BMC Med. 2004; 2: 21
- A comparative study of the no scalpel and standard incision approaches to vasectomy in 5 countries. The Male Sterilization Investigator Team.J Urol. 1999; 162: 1621-1625
- Vasectomy. A prospective, randomized trial of vasectomy with bilateral incision versus the Li vasectomy.Ugeskr Laeger. 2002; 164: 2390-2394
- An evaluation of the no-scalpel vasectomy technique.BJU Int. 1999; 83: 283-284
- Vasectomy in the United States, 2002.J Urol. 2006; 176 ([discussion 236]): 232-236
- Recent developments in vasectomy.BMJ. 2005; 330: 296-299
- No-scalpel vasectomy activities expand in Canada.AVSC News. 1993; 8: 31
- Prevalence of commonly used technique, follow-up protocols, follow-up rates/issues.in: Proceeding of an Expert Consultation on Vasectomy Effectiveness2001
- Vasectomy: principles and comments.J Fam Pract. 1991; 33: 571-573
- Vas deferens occlusion during no-scalpel vasectomy.J Fam Pract. 1994; 39: 577-582
- Vasectomy techniques for male sterilization: systematic Cochrane review of randomized controlled trials and controlled clinical trials.Hum Reprod. 2004; 19: 2431-2438
- Contraceptive failure in the United States.Contraception. 2004; 70: 89-96
- The risk of pregnancy after vasectomy.Obstet Gynecol. 2004; 103: 848-850
- The risk of pregnancy after tubal sterilization: findings from the U.S. Collaborative Review of Sterilization.Am J Obstet Gynecol. 1996; 174 ([discussion 1168-70]): 1161-1168
- Vasectomy reversal–microsurgery for best results.Br J Urol. 1994; 73: 449-453
- Vasovasostomy: current state of the art.Urology. 1983; 22: 567-575
- A 20-year experience with vasovasostomy.J Urol. 1986; 136: 413-415
- The reversibility of female sterilization with the use of microsurgery: a report on 102 patients with more than one year of follow-up.Am J Obstet Gynecol. 1984; 149: 57-65
- Microsurgical reversal of sterilization: a six-year study.Am J Obstet Gynecol. 1986; 154: 355-361
- Tubal anastomosis following unipolar cautery.Fertil Steril. 1982; 37: 613-618
- Analysis of failure of microsurgical anastomosis after midsegment, non-coagulation tubal ligation.Fertil Steril. 1983; 39: 618-622
- Tubal lesions subsequent to sterilization and their relation to fertility after attempts at reversal.Am J Obstet Gynecol. 1980; 138: 86-92
- Reversal of female sterilisation experience in a district general hospital.J Obstet Gynaecol. 1997; 17: 293-297
- Risk factors for regret after tubal sterilization: 5 years of follow-up in a prospective study.Fertil Steril. 1991; 55: 927-933
- Characteristics of women who considered or obtained tubal reanastomosis: results from a prospective study of tubal sterilization.Obstet Gynecol. 1990; 75: 661-665
- Patient characteristics associated with vasectomy reversal.J Urol. 1999; 161: 1835-1839
- Who asks for vasectomy reversal and why?.Br Med J (Clin Res Ed). 1982; 285: 490-492
- How little is enough? The evidence for post-vasectomy testing.J Urol. 2005; 174: 29-36
- Semen analysis after vasectomy: when and how many?.BJU Int. 2000; 86: 479-481
- Is the timing of post-vasectomy seminal analysis important?.Br J Urol. 1998; 81: 458-460
- How reliable is a vasectomy? Long-term follow-up of vasectomised men.Lancet. 2000; 356: 43-44
- Cost-effectiveness of contraceptives in the United States.Contraception. 2009; 79: 5-14
- Comparative risks and costs of male and female sterilization.Am J Pub Health. 1985; 75: 370-374
- Sterilization and its consequences.Obstet Gynecol Surv. 1999; 54: 766-777
- Sterilization in the United States.Rev Obstet Gynecol. 2008; 1: 23-32
- Transcervical sterilization: a comparison of essure(r) permanent birth control system and AdianaR permanent contraception system.Rev Obstet Gynecol. 2009; 2: 84-92
- Retrospective cost analysis comparing Essure hysteroscopic sterilization and laparoscopic bilateral tubal coagulation.J Minim Invasive Gynecol. 2007; 14: 97-102
- Office hysteroscopic sterilization compared with laparoscopic sterilization: a critical cost analysis.J Minim Invasive Gynecol. 2005; 12: 318-322
- Cost-effectiveness analysis comparing the Essure tubal sterilization procedure and laparoscopic tubal sterilization.J Obstet Gynaecol Can. 2008; 30: 581-585
- Racial differences in vasectomy utilization in the United States: data from the National Survey of Family Growth.Urology. 2009; 74: 1010-1014
- Sterilization among Currently Married Men in the United-States, 1991.Fam Plann Perspec. 1995; 27: 100-107
- Women, men, and contraceptive sterilization.Fertil Steril. 2000; 73: 937-946
- Contraceptive choices of women 35-44 years of age: findings from the Behavioral Risk Factor Surveillance System.Ann Epidemiol. 2009; 19: 823-833
- Race, insurance status, and tubal sterilization.Obstet Gynecol. 2007; 109: 94-100
- Use of contraception and use of family planning services in the United States: 1982-2002.Adv Data. 2004; : 1-36
- Does vasectomy explain the difference in tubal sterilization rates between black and white women?.Fertil Steril. 2008; 91: 1642-1645
- Unintended pregnancy influences racial disparity in tubal sterilization rates.J Gen Intern Med. 2009; 25: 122-128
- Vasectomy — views of Latinos and white men.J Fam Prac. 1987; 24: 493-496
- Differences in knowledge may contribute to racial variation in tubal sterilization rates.Contraception. 2009; 80: 1
Eliot JW. Fertility control and coercion. Fam Plann Perspect. 1973;5:132,187.
- Sterilized in the name of public health: race, immigration, and reproductive control in modern California.Am J Public Health. 2005; 95: 1128-1138
- Conspiracy beliefs about birth control: barriers to pregnancy prevention among African Americans of reproductive age.Health Educ Behav. 2005; 32: 474-487
- Attitudes toward contraceptive methods among African-American men and women: similarities and differences.Womens Health Issues. 2007; 17: 29-36
- Men's perceptions of their roles and responsibilities regarding sex, contraception and childrearing.Fam Plann Perspect. 1996; 28: 221-226
- The impact of race and ethnicity on receipt of family planning services in the United States.J Womens Health (Larchmt). 2009; 18: 91-96
- The effect of race and sex on physicians' recommendations for cardiac catheterization.N Engl J Med. 1999; 340: 618-626
- Access to coronary artery bypass surgery by race/ethnicity and gender among patients who are appropriate for surgery.Med Care. 1999; 37: 68-77
- Racial differences in how patients perceive physician communication regarding cardiac testing.Med Care. 2002; 40: 127-134
- Racial differences in the use of invasive cardiovascular procedures: review of the literature and prescription for future research.Ann Intern Med. 2001; 135: 352-366
- The effect of patients' preferences on racial differences in access to renal transplantation.N Engl J Med. 1999; 341: 1661-1669
- An elucidation of factors influencing physicians' willingness to perform elective female sterilization.Obstet Gynecol. 1988; 72: 565-570
- Intersections of ethnicity and social class in provider advice regarding reproductive health.Am J Public Health. 2007; 97: 1803-1807
- Race, gender, and partnership in the patient-physician relationship.JAMA. 1999; 282: 583-589
- Patient race/ethnicity and quality of patient-physician communication during medical visits.Am J Public Health. 2004; 94: 2084-2090
- Race/ethnicity, language, and patients' assessments of care in Medicaid managed care.Health Serv Res. 2003; 38: 789-808
- Low rates of vasectomy among minorities: a result of differential receipt of counseling?.Am J Mens Health. 2010; 4: 243-249
Article info
Publication history
Published online: October 11, 2010
Accepted:
August 25,
2010
Received in revised form:
August 25,
2010
Received:
June 10,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
