Vasectomy Information for Patients

What is a vasectomy?

Vasectomy is a simple, safe, and effective form of permanent birth control for men. It is a gentle, office-based procedure that takes 20-30 minutes to complete. Vasectomy works by blocking the tubes (vas deferens) that carry sperm from the testicles. This prevents sperm from entering the semen.

How is it done?

During a vasectomy, the tubes are accessed through a single, small skin opening on each side of the scrotum. Each tube is divided and a small section removed and sealed off using a small suture. This prevents the passage of sperm but does not change the amount of semen in any way that can be noticed. The procedure takes about 20-30 minutes, plus a short in-office recovery time before you drive home.

Does it hurt?

Your vasectomy will be nearly pain-free. Most men say that it is similar to going to the dentist or getting blood drawn!

You will have little to no discomfort during the vasectomy. You will feel tuggy sensations, similar to a dental procedure. The doctor uses a spray applicator or a very fine needle (the size of a hair) for local anesthesia. This numbs the skin and area around the tubes. General anesthesia is not needed. The vasectomy site does not touch the testicles or other sensitive areas.

How well does it work?

Vasectomy is extremely effective (it fails less than 1 time in 2000). However, it can take up to 3 months for it to start working. The semen needs to be checked after the surgery to make sure there is no more sperm in it. Until then, another method of birth control must be used, or pregnancy can occur. Most men have no more sperm in their semen the first time it is tested. Sometimes it takes more than one test before it is clear of sperm.

Vasectomy is permanent

Vasectomy is meant to be for life. After a vasectomy, a man will no longer be able to get a woman pregnant. If a man is unsure about not wanting more children someday or doesn’t know, vasectomy might not be a good choice for him. A surgical procedure does exist to reverse vasectomy; but this operation, “vasovasostomy,” is expensive and does not always work. On average, only half of couples that try having children after reversal do have a child. We do not do reversals. For information about this, we can refer you to a urologist who does reversals.

What are the risks?

Vasectomy is a very safe, low-risk procedure, but with any surgery, some complications can occur. Mild bruising is the most common reaction. We recommend wearing tight underpants or a jockstrap for the first few days after the vasectomy to decrease your chances of bleeding.

Other rare complications include: infection (very rare and can be treated with antibiotics), a painful bump on the vas (sperm granuloma), and bleeding into the scrotum causing a collection of blood (scrotal hematoma). Several weeks after the procedure some men experience pain in the testicles that usually only lasts a few days (about 5%). This resolved with oral anti-inflammatory medications, like Advil or Motrin. Chronic pain is very rare (about 0.1-1%).

Although unlikely, the continuing ability to get someone pregnant is also a risk of vasectomy.

Aftercare:

Relax with your feet up on the day of your vasectomy. If you choose, you can return to work or light activity the following day. There may be some initial soreness for a night or two after the procedure. This is easily relieved with a cold compress and/or non-prescription pain relievers such as Tylenol. Wearing tight underpants or a jockstrap for support can decrease discomfort with movement. Vasectomy does not cause health problems. Vasectomy does not affect the male hormones produced by the testicles. After a vasectomy, the sexual function does not change. Sensations, erections, and ejaculations will be the same except that the ejaculate no longer contains sperm.

Vasectomy limitations:
  • Not 100% reversible
  • Must use other forms of birth control until sperm-free.
  • Does not prevent transmission of sexually transmitted infections (STI's)
Vasectomy Advantages
  • No (noticeable) change in the semen
  • No change in sex drive or climax sensation
  • No change in the testes
  • No change in erections
  • No need to use other methods of birth control

Frequently Asked Questions

For most men, not at all. If any change does occur, more men note an INCREASED sex drive after vasectomy. Vasectomy does not affect the male hormones produced by the testicles. After vasectomy, sexual function does not change. Sensation, erection, and ejaculation are the same except the ejaculate no longer contains sperm.
No. The amount of sperm in semen is so small that men do not notice any change. More than 95% of the semen in made in the glands above the vas tubes, the prostate and seminal vesicles, with only a small portion of the total volume being made in the testes. After a vasectomy, the only way to tell the difference in the semen is with a microscopic semen analysis. Vasectomy does not prevent ejaculation. You will not notice a difference in your semen.
Your body reabsorbs the sperm cells. Our bodies simply reabsorb the older sperm cells and recycle their proteins and parts.
Most men feel some soreness for a night or two after the procedure and then feel fine. We recommend wearing tight underpants or a jock strap for the first few days after the vasectomy to decrease your discomfort and chances of bleeding. Avoid any vigorous activity, including sports and sex, for the first 3-7 days after your vasectomy.
You should not consider yourself “clear” until a semen check verifies that your semen no longer contains viable sperm. Sperm can hide in the prostate and seminal vesicles for 2-3 months, so early on a sperm count could be positive even though the vas tubes were successfully sealed. Waiting allows the hidden sperm to be flushed out. There is a very rare chance that the tubes can grow back together after a vasectomy. After three months, the semen analysis should show if this occurred. The sample can be collected in the comfort of your own home. For most men, the semen check is a simple, last step in the process to ensure a successful vasectomy.

“So You Are Thinking About a Vasectomy.” Reproductive Health Access Project, 1 July 2013,
www.reproductiveaccess.org/resource/thinking-vasectomy/.