Various dimensions of sexual self-concept in middle-aged men after vasectomy: a matched analysis

To compare men with and without vasectomy across four dimensions of sexual self-concept-toughness, body image, sexual self-esteem, and perceived pressure with regard to sexuality-and to examine differences in sexual behaviour and psychosocial factors.

Data were derived from the Bavarian Men's Health Study, a cross-sectional survey that collected detailed information on vasectomy status, sociodemographic and lifestyle factors, sexual behaviour, and psychosocial characteristics. Men with and without vasectomy were matched 1:1 using propensity score matching, adjusting for sociodemographic and lifestyle variables.

The final matched sample included 1140 men (mean [SD] age 50.6 [0.7] years). The mean (SD) time since vasectomy was 8.5 (5.7) years in the vasectomy group. There were no significant differences between men with and without vasectomy across any dimension of sexual self-concept. Additionally, no significant group differences were observed in terms of symptoms of depression or anxiety. However, men who had undergone vasectomy reported significantly higher frequency of sexual activity, greater sexual satisfaction, and greater perceived importance of sexuality (all P < 0.05).

This large, matched cross-sectional study suggests that vasectomy is not associated with negative impacts on key aspects of men's sexual self-concept, even after an average of 8 years since the procedure. Vasectomised men reported more active and satisfying sex lives and placed greater importance on sexuality. These findings may help clinicians to address persistent concerns among men considering vasectomy, particularly fears about its impact on the sexual self-concept.