Speaker: Joel Vilensky is a Scientech Club member and Professor of Anatomy (Emeritus) at the IU School of Medicine.
The talk will cover the history of this procedure which began as a means to reduce the size of the prostate in men with benign prostatic hypertrophy which proved to be ineffective. At the beginning of the 20th century, the eugenics movement led to the use of vasectomy as a procedure for sterilizing men considered unfit to reproduce. Dr. Harry Sharp lobbied for the world's first compulsory sterilization law in Indiana. He performed hundreds of forced vasectomies on prisoners at the Indiana Reformatory in Jeffersonville.
After World War II and the decline of the eugenics movements, vasectomy finally became firmly identified as an effective and safe means of birth control. Between 500,00 and 750,000 procedures are performed each year in the US, but it is still notably less prevalent than female sterilization due to the misguided notions in men that vasectomy reduces sexual ability and orgasm.
Today’s Presentation
Program: Vasectomy: A History and an Indiana Legacy
Speaker: Joel Vilensky, PhD, Professor Emeritus of Anatomy and Cell Biology, IU School of Medicine, Scientech Club member
Introduced By: Andy Ratermann
Attendance: NESC: 72, Zoom: 23
Guest(s): None
Scribe: Benny Ko
Editor: Carl Warner
View a recording of today’s Zoom presentation at:
Today's program 061024
Background
Human sexuality is an activity of daily living (ADL) but a most overlooked one. The speaker found that bewildering and began the lecture with an introduction to the male and female reproductive anatomy.
Sperm is produced in the testicles, collected in the epididymis, and through a long muscular tube, the vas deferens, goes up into the pelvic cavity, and arrives at the prostate upon ejaculation and from there into the urethra.
In a vasectomy procedure, the vas deferens are exposed at the base of the scrotum and ligated. It is a quick and safe procedure, commonly performed in the office, and inexpensive. Sterility is virtually 100% effective after a few months, and vasectomy is typically reversible.
In comparison, female sterilization, either by a tubal ligation or salpingectomy, is more complex requiring full anesthetization and an abdominal incision. There is also a higher risk of complications and higher cost. Despite this, female sterilizations outnumber that of male vasectomies.
History
In the late 19th century, British surgeon Dr. Reginald Harrison pioneered vasectomy as a treatment for benign prostatic hypertrophy, but it turned out to be not. In 1920, Austrian physiologist Eugene Steinach touted the procedure as the revitalization of aging. It was popularized by a physician named Dr. Robert Lichenstein and thousands were performed. Sigmund Freud was one of these patients. The claim was later debunked by other medical authorities and gradually lost favor.
Eugenic Vasectomy
In 1897, Dr. M.E. Van Meter advocated vasectomy to eliminate hereditary human disease as well as to sterilize criminals. In 1901, Dr. Henry S. Sharp, the chief physician at the Indiana State Reformatory at Jeffersonville, performed the first eugenic sterilization by vasectomy. By 1909, 280 vasectomies had been performed at the Reformatory. Aside from eugenic considerations, compulsory vasectomy was also used to control prison sexuality and as an alternate punishment to the castration of rapists and miscegenation violators. Sharp's work was promoted nationally and internationally and came to be known as the 'Indiana Plan.' He was supported by the then State Board of Health as well as the governor. By 1937, 32 states and many European countries had passed similar laws. Sharp became the president of the National Prison Association in 1907. In 1908, a Democrat governor was elected. Dr. Sharp vacated his position and forced vasectomies at the prison declined. In 1921, the eugenics laws were ruled unconstitutional and the 'Indiana Plan' of forced vasectomy ended.
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Vasectomy for Population Control
It was first mentioned in 1948 by Dr. Vincent O'Connor as a voluntary birth control method. Initially, the idea was not popular in the U.S., but it was quickly accepted in Thailand. In India, it was often by coercion. In America, some physicians were concerned about their patients having a change of mind and the patient's confusion between castration and vasectomy.
Vasectomy Today
Today, about 50 million U.S. men have undergone vasectomy. The number increased during and after COVID, and about 500,000 cases are now performed annually. It is approaching the number of
female sterilizations but should further increase. Vasectomy does not impact libido or sexual function and is nearly always reversible. Sperm fertility after reversal however is not guaranteed. The reversal procedure takes much longer and is technically more demanding.
The benefits of a vasectomy:
It simplifies sex life.
It is a simple procedure.
The partner is grateful.
It eliminates future contraceptive costs.
Joel Vilensky
(Photo: Kenhub)