March Madness Means Tying Tubes

The case of the month is an actual patient of The Turek Clinic

Traditionally, March Madness referred to the breeding season of the somewhat shy European rabbit. More recently in the U.S., it is a month of lots of college basketball playoffs, in which men are either glued to TVs or frantically attending games. In the last couple of years, it has also become a spirited time to have avasectomy, because, well… why not heal on the couch watching games?

Donning the Badge

The hare, upon which the March Hare in Alice in Wonderland is based (Courtesy: Wikipedia)
The hare, upon which the March Hare in Alice in Wonderland is based (Courtesy: Wikipedia)

“Should I do it or should she?” he asked. As a father of three, he was all done with family building. “I’m through with being a one-shot-wonder.” He was also tired of condoms. So, who gets the privilege of getting their tubes tied?

A Tubular Comparison

A very good question, indeed. Both sexes have “tubes” to tie. They are fallopian in women and vas deferens in men. Women have them inside their bellies and men have them inside their scrotums. You can access women’s tubes through keyhole surgery under anesthesia or from below through the vagina. You can access the vas deferens through small skin incisions, or better yet, through “no scalpel” punctures. Either way, once the tubes are tied, carefree contraception is virtually assured. So which is more popular in America?

Here are the stats comparing vasectomy and tubal ligation:

Tubal Ligation                  Vasectomy

Percentage of U.S. couples                         16%                                6%
Failure rate                                                   0.5%                               0.1%
Side effects                                                  Some                              Few
Reversibility                                                  Good                              Excellent
Cost                                                              More                              Less

Honestly, it still baffles me that tubal ligation is almost 3 times more popular than vasectomy. Although fiddling with the family jewels is a sensitive matter, vasectomies could not get much less invasive than they currently are. And pain issues are pretty well defined and avoidable with vasectomy. Tubals are performed right smack in the epicenter of a women’s body, in close proximity to several large beating vessels and gurgling intestines, giving it great potential to go awry. Lastly, tubal ligation reversals can’t hold a candle to the effectiveness of vasectomy reversals if I do say so myself.

And so it goes, much like many things in life that can’t be explained. As Graham Greene aptly stated: “Human nature is not black and white but black and grey.” So, during this playoff season, considering stepping up to the line and taking that jump shot for the family. I’ll bet you’ll be glad you did.

Dr. Paul Turek, Medical Contributor

View posts by Dr. Paul Turek, Medical Contributor
Dr. Paul Turek is an internationally known thought leader in men’s reproductive and sexual health care and research. A fellowship trained, board-certified physician by the American Board of Urology (ABU), he has received numerous honors and awards for his work and is an active member in professional associations worldwide. His recent lectures, publications and book titles can be found in his curriculum vitae.


  1. Yismel RosarioMarch 3, 2015

    Tubal ligation is simply more complicated than vasectomies. It seems that a vasectomy is the best choice for a couple that wishes to apply a more permanent/long-term contraceptive method. It is not only less expensive (which is favorable for the household economy) but it involves less complications.

    However, given the increased ‘benefits’ of a vasectomy instead of tubal ligation, I am amazed on the percentage of US couples that use vasectomies vs tubal ligation. I wonder the reasoning behind these numbers. Could it be something related to being/feeling manly and the awkward process it is for men to get a vasectomy?

    Also, I wonder if the tubal ligations reported in the study were done right after giving birth, which would somewhat explain why it has a higher percentage than vasectomies.

  2. Harry deCaboMarch 6, 2015

    What I would be interested to see is what kind of people are getting their tubes tied: single or coupled? If it is singles, I believe the statistics make logical sense. Women bear the greatest burden from pregnancy and are, thus, more inclined to protect themselves. If it is couples, then there should be research done as to why the wife or girlfriend seems to be more inclined to do the procedure. As this post states, the female procedure costs more and is more invasive. Logic would indicate that the men would do the procedure more often, but this is not the case.

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