Sex, Pain, Relationship Breakdown and Vasectomy - Large cohort study

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INTRODUCTION

Does vasectomy (a means for permanent contraception offered to couples in a stable relationship) trigger marital breakdown? There are no literature publications on the subject. Why does a significant number of men request reversal of vasectomy shortly (within 2 years) after the procedure? This first ever study aims to shed light on this important sensitive topic.

METHODS

1832 men had vasectomy between 1996 and 2008 in Aberdeen Royal Infirmary. All were invited by letter to complete a validated questionnaire (using the test re-test method). The questions addressed overall outcome, regrets by the man or his partner, wound infection, pain, vasectomy reversal, sexual performance, partnership status changes / relationship breakdown. Thirteen men who attended for vasectomy reversal were interviewed at length.

RESULTS

721 men responded. 231 were untraceable and 217 had moved. Nine could not reply (severely ill) and 3 had died. 660 (91.5%) were satisfied. 232 reported short or long-term pain, 37 men and 45 partners had regrets. Most importantly 147 (20.4%) reported relationship breakdown (separation, divorce or re-marriage), most of whom had moved address. More crucially 49 (33%) of these blamed the vasectomy for the relationship breakdown. Lack of sexual performance following vasectomy was strongly associated with relationship breakdown. Circumstantial evidence suggests a significant percentage of the untraceable 448 who had moved address experienced relationship breakdown. Of 13 who attended for vasectomy reversal, 7 (54 %), indicated that the vasectomy was related to their relationship breakdown.

CONCLUSION

This is the first study ever to link vasectomy to relationship breakdown. Psychological factors, sexual dysfunction, or pain may all contribute. Couples should be adequately counselled before being offered vasectomy as a means of permanent contraception.

Funding: None