Currently available nonendocrine options for male contraception are vasectomy and condoms. Vasectomy is a safe, simple outpatient surgery performed under local anesthesia in which a small scrotal incision is made, the ductus deferens severed, and the ends ligated. Vasectomies are extremely effective and safe, with a failure rate of <1% and a low incidence of complications. However, they are invasive and difficult to reverse, with 30% to 40% of men remaining infertile even after microsurgical reversal. Happily, earlier reports of associations with cardiovascular disease and prostate cancer have not been substantiated1 (see Chap. 225).