Being a "fixed" man, I had some hesitancy when I was first looking into it. This is well before I and the Mrs ever even contemplated the possibility of the existence of swinging, much less swinging ourselves (and we still haven't, swung, that is)
But, she didn't want kids (*really* didn't want, and doesn't still, want kids), I'm OK if the kids are old enough to use the bathroom without someone holding their hand, otherwise I'm not a kid person (have declined holding newborn neices / nephews, it makes me uncomfortable) So, I opted to get neutered.
I went for the no-scalpel surgery, took one initial visit with the Dr, then the surgery, and a follow up to a testing center (here's the cup, go home and fill it and bring it back within an hour) Got fixed on a Friday or Thursday (hey, it was almost 11 years ago!), was back to work on Monday (phone jockey, so no lifting / walking) No pain, no discoloration (bruising) Didn't even go for the general anesthetic, just a local, so I could drive myself home. She was able afterward to relax a lot more during sex, seeing as we no longer had to worry about the condom breaking.
As for why more guys don't get it done, I think it's in part, they use the word I did above for it, neutered. They think they'd be less of a "man" if they get fixed (this goes for men, period, not just lifestyle or vanilla) As for women, I think it's at least in part, the cost, and recovery time, and the fact that it is *far* more invasive.
Boy, took me a long time to get to the point of the thread, didn't it?
Jason