Is there any link between vasectomy and erectile dysfunction?

Question

Hi Nigel

When I was about 40 married at the time with 3 children…..We decided we didn’t want any more children so instead of my ex wife getting her tubes tied …I opted for permanent vasectomy. Gradually over the years I’ve lost the ability to maintain an erection and have also lost semen volume to very little. The Doctor assured me there would be no loss of ability to maintain an erection …My question is ….”is there anyone out there that has been affected the same way I have since getting a Vasectomy…I’m in my early 70’s “ I’ve tried [oral medication] on and off but could not tolerate the side effects. Since using Xialla I’ve been able to maintain an erection and I’m convinced Venous leak must be the culprit.

Yours Sincerely,

O. 

Answer

Hi O., 

You may be glad to know that there is no known physiological link between vasectomy and erectile dysfunction. Numerous studies have proven this. As recently as 2014 the Journal of Sexual Medicine published a study on the sexuality of 76 couples following vasectomy. Using an assessment tool called the International Index of Erectile Function (IIEF), researchers compared the men’s ability to have erections before and after surgery. They found that overall, the men’s average IIEF scores increased slightly, with improvements in the erectile function, orgasmic function, and general sexual satisfaction domains. ED was not a problem for men after vasectomy. Their female partners reported better sexual function, as well.

Doctors have been performing vasectomies since the late 1800s. With more than a hundred years of research about vasectomies, there’s never been relevant evidence that they cause erectile dysfunction.

The reason vasectomies don't cause ED is that surgeries linked to ED involve the prostate or pelvic area. A vasectomy doesn’t involve the penis, testicles, or other internal organs. It simply involves tying off two tubes, the vas deferens, that carry sperm. 

Studies carried out in the 1980s showed that vasectomy had a positive psychological effect on patients, improving their sexual lives, harmony between couples, and sexual desire and increasing the frequency of sexual intercourse. Several studies undertaken in recent years have also confirmed that men after undergoing a vasectomy experience markedly improved erectile function, orgasms, and sexual satisfaction and feel safer and more confident in their sexual lives after surgery. Their female partners reported marked improvements in terms of sexual arousal, satisfaction, and orgasm, as well as lubrication and libido. In addition, Guo et al showed that men who had undergone a vasectomy experienced more instances of sexual contact per month than men who had not undergone a vasectomy. [Vasectomy and male sexual dysfunction risk, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489671/]

Having said that, there is some evidence of psychological linkage between vasectomy and ED. An interesting study was done by N P Buchholz , R Weuste and others in 1994. The study [https://pubmed.ncbi.nlm.nih.gov/7877130/] titled "Post-vasectomy erectile dysfunction", investigated two groups of men with regard to vasectomy acceptance, and subsequent erectile dysfunction. Group I was a group of 45 men chosen at random from 254 vasectomized patients. Group II was a group of 18 men who, out of 180 patients treated for erectile dysfunction, attributed their dysfunction to previous vasectomy. The groups were analyzed for social background, motivation for vasectomy and postoperative changes of sexual life or behaviour of the partners. The partnership constellation, particularly the role of a predominant female partner was found to be an important feature for vasectomy acceptance. The study found that low acceptance might cause erectile dysfunction. In particular, men in partnerships where the female predominates and where the female may have demanded that the male undergo vasectomy, may have difficulty later accepting and coping with such imposed decisions on reproduction. The psychological factors might lead to sexual dysfunction including erectile dysfunction. 

Regarding the possible link between venous leak and vasectomy, there is no evidence to support that link. Venous leak is quite common, occurring in 55% of males who have some form of ED. Venous leak can develop for many reasons, the most common of which is simply hardening of the arteries due to the normal aging process. 

I hope this helps to reassure you that your ED almost surely was not directly caused by the vasectomy. Sometimes the mind, once sufficiently reassured, can work wonders on the body's functions. 

Best regards, 

Nigel