Vasectomy

A vasectomy is a minor surgery to block sperm from reaching the semen that is ejaculated from the penis.  Semen still exists, but it has no sperm in it. After a vasectomy, the testes still make sperm, but they are harmlessly absorbed, or soaked up, by the body.  Each year, more than 500,000 men in the United States choose vasectomy for birth control.  A vasectomy prevents pregnancy better than any other method of birth control, except abstinence.

The procedure typically takes 15-30 minutes to perform and most commonly is done in the office with local anesthesia.  In this setting, you may choose to drive yourself to and from the appointment, and there are generally no major restrictions afterwards.  

Occasionally, a vasectomy may be performed with sedation or general anesthesia.  Most commonly, this would be for challenging anatomy, need for other additional surgery at the same time, or simply patient preference due to nerves and anxiety. 

Most patients will have discomfort for several days with gradual improvement over a week or so. Mild pain medication and anti-inflammatories are usually recommended along with scrotal support during the recovery period. Ice can be helpful for the first several days. We advise avoiding sexual activity for about 1 week as well as heavy lifting and straining as these activities could increase risk for infection and bleeding, although still quite rare. Most men can return to light activity and work within a day or so of the procedure and typically have healed enough to return to normal within 1-2 weeks. Your surgeon will review specific recommendations with you on the day of the procedure. 

It is very important to note that sterilization does not happen immediately after a vasectomy. The exact number of  ejaculations or time needed to become sterile after a vasectomy is different for every man. The majority of men, however, will become sterile within 8-12 weeks after the vasectomy. Therefore, it is extremely important to continue a birth control method or methods until a post-vasectomy semen analysis can be performed to ensure there are no viable sperm remaining in the specimen. We recommend having this done between 8-12 weeks after the procedure. It is only safe to abandon other forms of contraception or birth control when your surgeon has reviewed a semen specimen and confirmed sterilization.

In general, vasectomies are very safe. However, all surgeries carry risks. It is normal to experience some pain and possibly mild oozing, swelling and/or bruising around the vasectomy sites. Infections are rare but can occur and may require additional treatment such as antibiotics or rarely additional surgery. Significant bleeding is uncommon but can occur during or immediately after the procedure or possibly in a delayed fashion much later. This could result in a painful hematoma and delay recovery or rarely require need for additional surgery. Surgical failure (in other words, not achieving sterile semen) occurs less than 1% of the time but it is of utmost importance to get a semen analysis 8-12 weeks after surgery to ensure successful sterilization. There is around a 1-2% incidence (1-2 patients out of 100) who may experience prolonged or persistent pain at the vasectomy site(s) which is referred to as post-vasectomy pain syndrome. This is a very rare but frustrating condition as there is almost always no identifiable problem or cause. Usually this is managed with mild pain medication or anti-inflammatories and can often improve over time.

Numerous studies have demonstrated that vasectomy does not increase risk of other medical conditions such as prostate cancer, testicular cancer, heart disease, or other problems. It is important to note that vasectomy does not lower testosterone levels and does not affect sexual function or ability. Likewise, ejaculation and orgasm are not affected by vasectomy.

A vasectomy is a great option for those who do not wish to father any more children. The procedure can also be a good option if pregnancy for a partner might pose a dangerous health risk. On the other hand, if you are unsure about having more children, another birth control option may be a better fit.  Vasectomies can be reversed but success rates are suboptimal and get worse over time so you should enter into the procedure considering it to be permanent.

A vasectomy may be right for you if:

• You are certain that you desire no more or any children
• Your partner should not get pregnant for the sake of her own health
• You and/or your partner are carriers for genetic disorders that you do not want your children to have

On the other hand, a vasectomy may not be right for you if:

• You and/or your partner are still unsure about whether you should have children
• You are interested in temporary birth control

Check out our list of the most commonly asked questions about having a vasectomy.