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Release: Aug. 4, 2000

UI study shows most vasectomy patients are comfortable with decision

IOWA CITY, Iowa -- Most men seeking a vasectomy undergo sterilization without hesitation although many are unaware that the procedure may be reversible.

And few men arrive at the decision on their own. Typically they've consulted with a wife, girlfriend or partner before committing to the procedure.

Those are some of the findings of a study, "The Psychological Correlates of Vasectomy," by John S. Westefeld, a professor in the University of Iowa College of Education's Division of Psychology and Quantitative Foundations, and Dr. Jay Sandlow, an associate professor in the UI College of Medicine's department of urology. The pair was assisted by Michael R. Maples, a psychology intern at Kansas State University, and Karen Scheel, a former assistant professor in counseling psychology at the University of Oklahoma who is now at the University of Akron in Ohio.

Westefeld will present the findings next week at the annual meeting of the American Psychological Association in Washington, D.C. and the study has been accepted for publication in Fertility and Sterility, a leading infertility journal.

Vasectomy is the most common form of male contraception used in the United States.

The procedure, which can be performed on an outpatient basis using local anesthesia, is intended to interrupt the vas deferens -- or sperm duct -- so sperm can no longer exit during an ejaculation.

Conventional vasectomy is performed through an incision made in the scrotum. The vas is then found, tied with suture or blocked with permanent clips, cut and cauterized.

Unlike previous research about the psychological impact of vasectomies -- much of which dates from the 1960s and 1970s -- Westefeld's and Sandlow's study examines the thoughts and feelings of men leading up to the procedure.

The study involved 74 vasectomy patients ages 22 to 62 in the University of Iowa Hospital's Male Fertility Clinic, of which Sandlow is director. Ninety-two percent of the men were white, 93 percent were married and 91 percent had two or more children. The subjects responded to questions on several psychology inventories, answered open-ended questions and filled out a questionnaire designed by Westefeld and Sandlow to gather demographic information about the men.

About 50 percent of the men indicated they had been thinking about having a vasectomy for a year or less before the procedure. Asked on a scale of 1 (extremely uncertain) to 10 (completely certain) how sure they were that having a vasectomy had been the right decision, 85 percent scored 8 or higher, indicating a high level of certainty. Also, most men indicated they underwent the procedure because they didn't want additional children and they felt a vasectomy was preferable to other forms of birth control.

Other findings of the study:

-- 91 percent of the men indicated that their wife, girlfriend or partner had been involved in the decision to have a vasectomy; 62 percent said both they and their partner had been equally in favor of the decision.

-- Asked how certain their partner had been that a vasectomy was the right decision, more than 90 percent responded 8 (very certain) or higher on the certainty scale.

-- Using a scale ranging from 1 (for no anxiety) to 10 (the highest possible anxiety level), 20 percent of the men indicated 5 and 8 percent indicated 8. Most of the anxiety stemmed from concerns about possible pain and "fear of the unknown."

Westefeld and Sandlow said they were surprised to find that not all the men knew going into the surgery that vasectomies may be reversible. Eleven subjects believed vasectomies are definitely not reversible, and 22 said they definitely are reversible. The remaining subjects were either unsure or their answer was qualified in some way.

The fact is that while the procedure is reversible in some cases, it typically leads to permanent sterilization and is recommended for men who are certain they no longer wish to bear children.

More information about vasectomies and other male reproductive issues can be found at the Web site of the University of Iowa Male Fertility Clinic at www.medicine.uiowa.edu/malefertility/.