How do I prepare for a vasectomy?
Your healthcare provider will go over your health history as it relates to vasectomy and will do a brief physical examination. Tell your provider if you have any of the following:
- History of excessive bleeding or blood disorders.
- Allergy or sensitivity to local anesthetics, such as the "caine" (things like benzocaine or lidocaine or novicaine) drugs or antibiotics.
- Skin disease involving the scrotum, especially infected pimples.
- Regular use of aspirin or medicines that contain aspirin or drugs that affect bleeding.
- History of injury or earlier surgery on your genitals or scrotum or groin (like hernias).
- History of recent or repeat urinary tract or genital infections.
You will be asked to sign a consent (permission slip) for the procedure. The form will state that you understand vasectomy and its risks. This includes that you understand the procedure isn’t guaranteed (as no medical procedure is or can be). Before you sign this form, make sure that you understand all of these things and that you’re comfortable with your decision. It is important that you resolve any questions or concerns before taking action. Remember that vasectomy is an elective procedure, so you should not proceed with it until you are sure it is the right choice for you.
Do not take any of these products for seven days before surgery unless you are told to do so by your healthcare provider. Taking these medications increases the risk of bleeding. They are:
- Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil®, Motrin®) or naproxen (Aleve®)
- Warfarin (Coumadin®)
- Clopidogrel (Plavix®)
- Ticlopidine (Ticlid®)
- Non-vitamin K oral anticoagulants like dabigatran (Pradaxa®), rivaroxaban (Xarelto®), apixaban (Eliquis®) and edoxaban (Savaysa®, Lixiana®)
Shaving and washing
The night before or the morning of the vasectomy, shave away the hair from the entire scrotum. Remove the hair all the way to the top of the penis, including any pubic hair that seems to fall onto the scrotum. Do not use an electric razor on the scrotum. A single blade disposable razor is the best choice.
To reduce the risk of infection, thoroughly wash the scrotum and groin the day before and the morning of the surgery.
- Several hours before surgery, take any specific preoperative medications as directed.
- Bring a clean athletic supporter (jock strap) or tight pair of compression shorts.
- Eat lightly or stick to liquids before a vasectomy. Don’t eat heavily, but don’t avoid food.
How is the vasectomy procedure done?
There are two types of vasectomies. One is called an incision vasectomy, and the other is called a no-scalpel vasectomy. Both are done in doctors' offices or outpatient surgery centers. Both use local anesthesia to numb the scrotum. The anesthesia is given as a shot.
Both types of vasectomies divide and close off the ends of the vas deferens (the tubes that carry sperm), preventing sperm from getting through. This stops the sperm from mixing with the semen and being released when a man ejaculates during an orgasm.
The surgeon will make an opening in the skin and grasp the vas deferens. The vas deferens is then divided and tied, clipped or cauterized. Cauterizing closes cuts with an electrical current.
There is little discomfort with a vasectomy. The scrotum will be numb, but some men feel a slight "tugging" sensation or a feeling of things moving around. Your surgeon will decide if you need stitches, depending upon how they routinely do the procedure.
What will happen after you have a vasectomy?
- Pain/bruising: Mild discomfort, bruising, and swelling are common after vasectomy. Mild discomfort may be treated with acetaminophen (for example, Tylenol®) every four hours. Ice packs or a bag of frozen vegetables placed over the scrotal supporter and dressing may provide relief, as well. Repeated use of ice packs for the first 36 hours can help keep the swelling down. Always be sure to wrap the ice pack in a towel or put something between it and the skin.
- Dressing: The dressing should be changed when it is stained or soiled. Small sterile gauze squares are available at any drugstore. The dressing can be removed when it is dry or stain-free, usually within a day or so. A small amount of oozing is to be expected. It’s better that this fluid does not build up on the inside, so having it drain out is best.
- Bathing: You can start showering the day after the vasectomy. Avoid baths or swimming for a couple of weeks. To dry the scrotum, pat dry with a towel. Don’t rub.
- Skin separation: Sometimes the skin will separate due to tissue fluid, oozing blood or body fluids. The edges can be pinched together with sterile gauze and your fingers. This will bring the skin together and allow it to heal.
It’s common to have some of these symptoms after a vasectomy. They should go away within 72 hours of surgery. However, if you have an unusual amount of pain, extreme swelling of the scrotum, continued bleeding, or a fever (over 100 degrees Fahrenheit), call your doctor immediately.
What happens to sperm after a vasectomy?
After a vasectomy, the testicles continue to make sperm. When the sperm cells die, they disintegrate and are absorbed by the body. This is the same way the body handles other types of cells that die and are replaced every day.