Vasectomy

What is a vasectomy?

Vasectomy is a surgery a person may choose to have if they do not want to father any more children. It's lasting (permanent) male birth control.

During the surgery, two tubes called the vas deferens are cut and sealed. The vas deferens carry sperm from the testicles to the urethra. The urethra is the tube inside the penis. Once they are cut, sperm can’t get into the semen or out of the body. The testes still make sperm, but the sperm die and are absorbed by the body.

A person who has had a vasectomy still makes semen and is able to ejaculate. But the semen doesn’t contain sperm. The testosterone level and all other male sex traits stay the same. For most people, the ability to have an erection is unchanged.

There is a procedure to reverse a vasectomy, but it doesn’t always work.

Types of vasectomy

• Conventional vasectomy. Small cuts are made on each side of the scrotum to reach the vas deferens.

• No scalpel vasectomy. This method is done through a single tiny hole or two tiny holes in the skin. A tool is used to gently stretch the skin opening so that the vas deferens can be reached. It heals quickly with little or no scarring.

Why might I need a vasectomy?

Choosing a vasectomy as a form of birth control may be a good choice if:

• You are an adult male and you’re absolutely sure you don’t want to have children in the future.

• You are in a stable relationship and both partners agree to permanent birth control.

• Pregnancy would be a health risk for your partner.

• You or your partner has a genetic disorder that you don’t want to pass on to a child.

Vasectomy may not be the best choice for you if:

• You are not sure if you want to have children in the future.

• You may have other partners in the future.

• You plan to have children by reversing your vasectomy.

What are the risks of a vasectomy?

Vasectomy is very safe, but all surgeries carry some risks. Some possible risks of vasectomy include:

• An inflammatory reaction to sperm that spill during surgery called sperm granuloma, which can cause a tender lump under the skin

• Epididymitis or orchitis (painful, swollen, and tender epididymis, or testis) may occur after vasectomy. This most often occurs during the first year after surgery.

• Infection

• In rare cases, the vas deferens may grow back together. This could cause an unwanted pregnancy.

• Pain that lasts long after surgery

• Short-term bleeding, swelling, and bruising

A person can often start having sex again soon after a vasectomy. But another birth control method should be used. This is because some sperm may stay in the vas deferens for some time after surgery. Other birth control should be used until the surgeon tests the semen to be sure there are no sperm left. This is often about 3 months after surgery.

There may be other risks, depending on your specific health condition. Talk with your healthcare provider about any concerns you have.

How do I get ready for a vasectomy?

• Your healthcare provider will explain the procedure, and you can ask questions.

• You will be asked to sign a consent form before the procedure. Read the form carefully and ask questions if anything is not clear.

• Tell your healthcare provider if you are sensitive or allergic to any medicines, latex, tape, or anesthesia.

• Check that your healthcare provider has a list of all medicines (prescribed and over-the-counter), herbs, vitamins, and supplements that you are taking.

• Talk with your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning (anticoagulant) medicines, aspirin, ibuprofen, or other medicines that affect blood clotting. You may need to stop these medicines before the surgery.

• If you smoke, stop as soon as possible. This will improve your recovery from surgery and your overall health status.

• Your healthcare provider will tell you about any other specific things you need to do to get ready for surgery. Follow any directions you are given for not eating or drinking before the procedure. You may also be given instructions for cleaning your scrotal area before surgery. You may be asked to bring a jockstrap to wear after surgery.

• Ask your healthcare provider if you will need someone to drive you home.

Based on your health condition, your healthcare provider may ask for other specific preparation.

What happens during a vasectomy?

Vasectomy is almost always done under local anesthesia. That means the area is numbed, but you are awake. It takes about 30 minutes and is done as an outpatient. This means you go home the same day.

Generally, vasectomy follows this process:

1. You will be asked to remove any jewelry or other objects that might get in the way during the procedure.

2. You will remove your clothing and put on a hospital gown.

3. You will be asked to empty your bladder.

4. You will lie on your back on an exam table.

5. Your scrotum may be shaved and cleaned with an antiseptic solution.

6. The surgeon will inject a numbing medicine into your scrotal area. You will likely be awake for the procedure.

7. The surgeon will make a small cut in your upper scrotal area to find the vas deferens.

8. You may feel a tugging feeling as the surgeon pulls the vas deferens into the opening.

9. Your vas deferens will be cut, and small clamps or ties may be used on both ends.

10. The surgeon will then do the same procedure on the other side of your scrotum. In some cases, both vas deferens can be reached through the same cut.

11. In many cases, the cuts are so small that stitches are not needed. In some cases, small stitches or skin glue may be used to close the cuts.

What happens after a vasectomy?

You will likely be able to go home right after surgery. Ask your surgeon what type of medicine you may use for pain. You may be told to use an ice pack for the first day to reduce pain and swelling. Here is what you may expect during recovery:

• Rest at home the day after surgery. Don't do any strenuous activity.

• Depending on the type of work you do, you may be able to go back in 1 to 3 days.

• You should be able to return to most activities in a week.

• You may need to wear a jock strap for a few days.

• You may be able to return to sexual activity in about a week. But you still need to use birth control until the surgeon tests the semen to be sure there are no sperm left, generally around 3 months after surgery.

Tell your healthcare provider if you have any of the following:

• A lump in your scrotum

• Any drainage, bleeding, redness, or swelling

• Fever

• Chills

• Increasing pain or pain that is not eased by medicine

• Trouble passing urine

Your healthcare provider may give you other instructions after the procedure, depending on your situation.

Next steps

Before you agree to the test or the procedure, make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure