Vasectomy

Surgery Overview

A vasectomy is an operation to make a man sterile, or not able to make a woman pregnant. During the procedure, a doctor cuts or blocks the tubes, called the vas deferens, that carry sperm from the testicles to the penis. This keeps sperm from reaching a woman's egg to make a baby when ejaculation occurs during sex. A vasectomy is a simple procedure. It can be done at your doctor's office or clinic. It takes about 30 minutes.

No-scalpel vasectomy is a technique that uses a small clamp with pointed ends. Instead of using a scalpel to cut the skin, the clamp is poked through the skin of the scrotum and then opened. The benefits of this procedure include less bleeding, a smaller hole in the skin, and fewer complications. It works just as well as traditional vasectomy.^{footnote 1}

In the Vasclip implant procedure, the vas deferens is locked closed with a device called a Vasclip. The vas deferens is not cut, sutured, or cauterized (sealed by burning). This may reduce pain and complications. Some studies show that clipping doesn't work as well as other methods of sealing off the vas deferens.^{footnote 2}

A vasectomy won't change your sex drive or your ability to have sex. You will still be able to enjoy sex in the same way as before. You will still produce normal amounts of semen when you climax. The only difference is that the semen will not contain sperm.

Vasectomy is considered a permanent method of birth control. You should only consider having one if you have completed your family or are sure that you don't want children.

Surgery to reconnect the vas deferens (vasectomy reversal) is available. But it's hard to do. Sometimes a doctor can remove sperm from the testicle in men who have had a vasectomy or a reversal that didn't work. The sperm can then be used for in vitro fertilization. Both vasectomy reversal and sperm retrieval can be expensive. They may not be covered by insurance. And they may not always work.

What To Expect

Your scrotum will be numb for 1 to 2 hours after a vasectomy. Apply cold packs to the area and lie on your back as much as you can for the rest of the day. Wearing snug underwear or compression shorts will help ease discomfort and protect the area.

You may have some swelling and minor pain in your scrotum for several days after the surgery. Unless your work is strenuous, you can return to work in 1 or 2 days. Avoid heavy lifting for a week.

You can resume sexual intercourse as soon as you are comfortable, usually in about a week. But you can still get your partner pregnant until your sperm count is zero. You must use another method of birth control until you have a follow-up sperm count test 2 months after the vasectomy (or after 10 to 20 ejaculations over a shorter period of time). After your sperm count is zero, no other birth control method is needed.

Most people go back to the doctor's office to have their sperm count checked. But there is also a home test available.

A vasectomy won't interfere with your sex drive, ability to have erections, sensation of orgasm, or ability to ejaculate. You may have mild aching now and then in your testicles during sexual arousal for a few months after the surgery.

Why It Is Done

A vasectomy is done when you are sure that you don't want to have a child in the future. It is considered a permanent method of birth control. While there is a surgery to reverse a vasectomy, it doesn't always work.

How Well It Works

Vasectomy is a very effective (99.85%) birth control method. Only 1 to 2 women out of 1,000 will have an unplanned pregnancy in the first year after their partners have had a vasectomy.^{footnote 3}

Risk of failure

Pregnancy may occur after vasectomy because of:

• Failure to use another birth control method until the sperm count is confirmed to be zero. It usually takes 10 to 20 ejaculations to completely clear sperm from the semen.
• Spontaneous reconnection of a vas deferens or an opening in one end that allows sperm to mix with the semen again. This is very rare.

Risks

The risk of complications after a vasectomy is very low. Complications may include:

• Bleeding under the skin, which may cause swelling or bruising.
• Infection at the site of the incision. In rare instances, an infection develops inside the scrotum.
• Sperm leaking from a vas deferens into the tissue around it and forming a small lump (sperm granuloma). This condition is usually not painful, and it can be treated with rest and pain medicine. Surgery may be needed to remove the granuloma.
• Inflammation of the tubes that move sperm from the testicles (congestive epididymitis).
• In rare cases, the vas deferens growing back together (recanalization) so the man becomes fertile again.

A no-scalpel vasectomy has some of the same risks as a traditional vasectomy, such as bleeding, infection, and pain. But these risks may be less with the no-scalpel vasectomy.