Mar 4, 2015

Interview Transcript

Interviewer: How do you know that a vasectomy is the right choice for you and your family? We'll examine that next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Dr. William Brant is a urologist at the University of Utah Health Care and he's done a lot of vasectomies, talked to a lot of men about this process and we would love to pick his brain right now and find out what are some consideration guys should keep in mind whether, when they're determining whether a vasectomy is right for them and their families? So, let's start out with this first question. Is there a good vasectomy candidate?

Dr. Brant: Yeah, a vasectomy candidate is one who has really talked about this issue with their partner and they want a real permanent form of birth control and they're both comfortable with that. Even though technically the vasectomy is reversible, we don't want them to think along those lines. We also need to make sure that they don't have any scrotal pain or anything that would cause them discomfort during the vasectomy and that their anatomy is favorable for doing an office type procedure. So we do like to evaluate them beforehand and we like to get the consent for it on a different day than we're doing the vasectomy so they have some real time to reflect on this and talk to their partner.

Interviewer: Do they have to bring in like a signed note from their partner? Do you encourage the partner to come to the meeting?

Dr. Brant: They don't have to bring in a signed note, but we do like their partner to come. We've never had an instance here where a partners not known about it and someone's gone around, but such stories are around.

Interviewer: Yeah, okay. So bring the partner to the meeting, that would be, that first consultation, that would be a good idea?

Dr. Brant: Mm-hmm.

Interviewer: Why do men or families, even couples choose this form of birth control out of all the other options? Like at what point do you go this is the right thing?

Dr. Brant: Well vasectomy is very popular in the United States and about 10% of American couples will choose it as a form of birth control. One of the reasons that people like it is its very reliable. If you look at the reliability of, for example, something like condoms, condoms are only reliable if you use them correctly. And they're subject to breakage and forgetting and using them poorly. So overall, they're not that reliable. Whereas a vasectomy is very, very reliable with a failure rate of less than 1%.
The other thing is that it gives a certain piece of mind because the men and their partners don't need to use any external paraphernalia. They don't need to take a pill. They don't need to use a diaphragm or have anything external. And I think one of the very important things is that in every other type of birth control, the only way you know if there is a failure is through a pregnancy. Whereas, with a vasectomy, the man gets a semen analysis done six to eight weeks after he has the vasectomy and if there's sperm there, then they would continue to check. So they would have an idea there's failure before they actually have a pregnancy.

Interviewer: Yeah, I never thought of it that way. This is a terrible analogy too, but as you were saying that it's kind of like the best camera is the camera you have with you, the best form of birth control is the form of birth control you have with you. And if you're not putting sperm out that's always going to be there with a vasectomy.

Dr. Brant: That's right.

Interviewer: You don't have to fuss around with all that other stuff like you talked about.

Dr. Brant: And a lot of women do fairly poorly with some of the other methods. So, for example, the pills that a lot of women take, they're not for everyone. People have mood changes and other kinds of effects from taking the medication. They may not like to do that, they may have hormonal changes from using things like an IUD. So I think this is a nice way to do it so the women can be as natural as possible. I think the other thing is that a lot of women have gone through a lot of things for the family. They've either given natural childbirth, they've had caesarean section. They've gone through a lot and it's now time for the man to step up and do their part.

Interviewer: Yeah. Another advantage of this form of birth control I think I've heard is, just the fact it's kind of like stress-free after that point. Coming back to your, that condoms fail, finally you can have anxiety free relations with your partner.

Dr. Brant: That's right, and that's really comfortable for a lot of people is, once they know the pipes are clear and there's no sperm sneaking in through there, they should be able to have intercourse without wondering whether it's going to fail.

Interviewer: We talked about some of the things that make a good vasectomy candidate. Is there an age maximum or minimum?

Dr. Brant: You know, for women, their ability to be fertile kind of drops off sort of precipitously in the mid 30's, but for men, that doesn't really happen and there's a slow decline in fertility but it's very slow. So we don't really have a maximum age for men to get a vasectomy. It depends more on their partner.

Interviewer: What's the most common question that you get when a couple is considering this as a form of birth control?

Dr. Brant: Is it going to hurt?

Interviewer: Well, that's more from the guy. I mean, do you find that the girl is kind of smiling at that prospect a little bit?

Dr. Brant: Yeah, I always tell the guys they're not going to get as much sympathy as they'd like from their partners who have been through a lot more than they have. But honestly, one of the questions that comes up a lot is, there's a lot of misinformation that's available about other things that can happen from a vasectomy.
And some, some couples are worried that they may be subjecting the man to getting prostate cancer or cardiovascular disease by having a vasectomy. And, while studies have shown that relationship, in all studies that have really examined this more thoroughly, it tends to be the case that men who get vasectomies utilize health care more than those who do not. And such, are diagnosed with common things more often.

So the analogy I always use is if you find a relationship between getting your blood pressure checked and having high blood pressure, that's not a good thing to assume that blood pressure checks cause high blood pressure.

Interviewer: Yeah, okay. So, we've done a few other podcasts with Dr. Brant on vasectomies, so if you're looking for some more information please seek those out. And also, you have a website out I imagine that people can go to. How could they best navigate there?

Dr. Brant: Healthcare.edu/eurology.

Interviewer: All right, looks like you can get some more information there and even request an appointment. It sounds like the first appointment is to actually just even have the discussion, so you can do that right there. And if you want to see Dr. Brant in action, he's right on the cover of that web page.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.


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