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Vasectomy

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Vasectomy is a permanent form of male birth control. This safe, minor operation is an excellent option for men who want to avoid unwanted pregnancy, and is an effective alternative to traditional birth control.

What is a vasectomy?

Vasectomy is a common urologic procedure that results in permanent birth control. It is an outpatient procedure that takes about 30 minutes and is done in the hospital, clinic or office.

Each testicle in the scrotum has a vas deferens, which is a tube that allows sperm to pass into a man’s semen. During a vasectomy, this tube is severed and closed so that sperm is blocked from leaving the testes, resulting in a form of birth control that is permanent (unless surgically reversed) and close to 100% effective.

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Who can have a vasectomy?

Any man with no major health conditions who would like a form of permanent birth control may be a candidate for a vasectomy. Males as young as 18 years old can receive a vasectomy, but may choose to wait due to the permanent nature of the procedure.

Reasons for having a vasectomy are numerous and personal. Some men may choose to have a vasectomy to prevent passing on an inheritable disease. Others may be involved in a long-term relationship with a partner who shares their desire to not have children.

How does a vasectomy work?

A vasectomy works by stopping sperm from getting into the semen ejaculated during sexual intercourse. Sperm is transmitted to the semen by the vas deferens, a tube in the scrotum that connects the testes to the seminal vesicle. The seminal vesicle is where semen is produced and moved to the urethra, the tube within the penis that semen is expelled from.

The vas deferens are cut, blocked or sealed with heat, preventing sperm from reaching the seminal vesicle. This means that when a man ejaculates, the semen contains no sperm and a woman's egg cannot be fertilized.

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Benefits and risks of vasectomy

Vasectomies are a permanent form of birth control, so it will not be possible to have children after the procedure. Men who have received a vasectomy are still at risk of contracting and spreading a sexually transmitted infection (STI). Sexual intercourse will still require the use of a condom in cases where risk of spreading a STI is present.

What happens during a vasectomy?

During a vasectomy, a piece of the vas deferens is removed and either clips or ties are applied. Some doctors turn the vas back or place the 2 ends in different levels. Entry is often gained to the scrotum using the no-scalpel method that results in only a small puncture rather than an incision.

Although a vasectomy is a minimally invasive procedure that can be performed without anesthetic in an office environment, there will be some pain and discomfort. Your doctor may recommended using an ice pack and pain medication after the surgery along with a few days of rest.

You must have protected intercourse until your physician confirms there is no sperm in the semen. Sperm levels are checked after a specific number of ejaculations (20) or based on timeframe (3 months or more after vasectomy). You will not be cleared for unprotected intercourse until the follow-up semen analysis shows no sperm.

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Vasectomy FAQ

  • No. There have been some associations made that a vasectomy can lead to an increased risk of heart disease and Alzheimer’s. These have not been supported by adequate studies.

  • No. There is no connection between the 2. Also, there is no connection with prostate cancer or any other cancers.

  • Yes, any affect on erections may be psychological – there are no changes hormonally that cause a problem. Some residual discomfort may play a role.

  • Yes. Any problems may be psychological. If he still has pain, that may lead to less desire.

  • Yes, the main fluid a man produces is “down stream” from the vasectomy.

  • Yes.

  • This is called “recanalization” and, unfortunately, the answer is yes, but rarely. The statistics range from a 1 in 1,000 to 1 in 10,000 chance. The reason is that there is a sort of “honeycombing effect.” This may be related to the technique of vasectomy performed and to the man being compliant with  instructions to have his semen checked to make sure there are no sperm. Fewer than 50% of men are checked to ensure they have no sperm. It is recommended the analysis not be performed until at least 15-20 ejaculations have occurred. Some doctors recommend a timeline, e.g., analysis after 6 weeks. The exact timeline is not completely clear.

  • Yes. Of the 520,000 or more men who have a vasectomy in the U.S. each year, approximately 6% feel that they have made a mistake or a change in their life situation causes them to consider reversing this permanent means of contraception. It is important to know that if a man is under age 30, he has a 12-times higher chance of wanting a reversal. See male infertility section.

  • This isn’t quite what everyone thinks. No scalpel does not mean “no pain.” No scalpel unfortunately doesn’t mean it is any less anxiety-provoking, nor any less of a procedure. In place of a scalpel is an instrument that stretches the skin to open it up, which still requires local anesthetic. The advantage is most times no stitch in the skin is required and the hole is small. Recovery may be better, but no real difference has been noted.

    As a patient, some time should be taken thinking about the options. It is an important milestone so it is important to get it right the first time. If a patient is unsure, vasectomy may not be the right option.

  • A vasectomy is a 30-minute procedure that is usually done in the clinic. Sometimes vasectomies are done in the operating room due to patient anxiety or anatomical issues.

  • The night before surgery, patients will need to shave the scrotal area, find supportive underwear and arrange a driver to take them to the clinic and then home after the procedure.

  • Patients will need to take a Valium 45 minutes before the procedure, which means the patient will not be able to drive afterward.

  • Neosporin is applied to the incisions after the procedure to prevent infection. The risks of infection and post-procedure bleeding are both under 1%. Patients will be asked to return to the clinic if they notice any prolonged discomfort, fevers, chills, swelling, significant bruising or redness.