Vasectomy

What is a vasectomy?

A vasectomy is a surgical procedure that stops sperm from leaving your body, providing permanent birth control (contraception). The procedure closes off the ends of the vas deferens, which are the tubes that carry sperm. Vasectomy is safe and effective for preventing pregnancy, but it doesn’t protect against disease.

Is a vasectomy 100% effective?

The only way to avoid getting pregnant is to avoid sexual intercourse. However, the failure rate of a vasectomy is very low. In rare cases after a vasectomy — roughly 1 in 10,000 cases — it’s possible for sperm to cross the separated ends of the vas deferens. Vasectomy has been a safe and successful birth control method for many years.

Semen samples are routinely checked after a vasectomy to confirm a successful procedure. If your semen samples continue to contain sperm, you may have to have another vasectomy.

But this only happens approximately once in every 10,000 cases, a failure rate far less than for any other form of birth control. For instance, condoms fail about 1% of the time, or 1 out of every 100 times one is used.

How common are vasectomies?

About 50 million men have had a vasectomy — approximately 5% of all married men of reproductive age. More than 500,000 men elect to have vasectomies every year in the U.S.

What happens before a vasectomy?

Before you have a vasectomy, certain things should happen.

Consultation

Before a vasectomy, you should talk with your healthcare provider seriously about the surgery. You should be sure that you don’t want to have any children or more children. You should consider a vasectomy a permanent form of birth control. Although there’s a procedure to reverse a vasectomy, it isn’t always successful.

Your healthcare provider will also talk to you about:

• History of excessive bleeding or blood disorders.
• Allergy or sensitivity to local anesthetics, such as the “caine” drugs or antibiotics. The “caine” drugs include benzocaine or lidocaine or procaine (Novocaine®).
• Skin disease involving your 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.

Consent form

You’ll be asked to sign a consent form stating that you understand vasectomy and its risks. This includes understanding that the procedure isn’t guaranteed (as no medical procedure is or can be).

Before you sign this form, make sure you understand all of these things and that you’re comfortable with your decision. It’s important that you resolve any questions or concerns before taking action. Remember, a vasectomy is an elective procedure. Don’t go ahead with it until you’re sure it’s the right choice for you.

Blood thinners

Don’t take any of these products for seven days before surgery unless you’re 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 your entire scrotum. Remove the hair all the way to the top of your penis, including any pubic hair that seems to fall onto your scrotum. Don’t use an electric razor on your scrotum. A single-blade disposable razor is the best choice.

To reduce the risk of infection, thoroughly wash your scrotum and groin the day before and the morning of the surgery.

Other preparations

• 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 an incision vasectomy, and the other is a no-scalpel vasectomy. Both are done in doctors’ offices or outpatient surgery centers. Both use local anesthesia to numb your 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 semen and releasing when a man ejaculates during an orgasm.

Your surgeon will make an opening in your 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’s little discomfort with a vasectomy. Your 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 on how they routinely do the procedure.

What happens after you have a vasectomy?

Pain/bruising

You’ll probably have mild discomfort, bruising and swelling after the procedure. You can take acetaminophen (for example, Tylenol®) every four hours for the discomfort. You can place ice packs or a bag of frozen vegetables over your scrotal supporter and dressing. Using ice packs repeatedly for the first 36 hours helps keep the swelling down. Always be sure to wrap the ice pack in a towel or put something between it and your skin.

Dressing

Change the dressing when it’s stained or soiled. You can buy small sterile gauze squares at any drugstore. You can remove the dressing when it’s dry or stain-free, usually within a day or so. You can expect a small amount of oozing. Having the fluid drain out is better for you than having it build up on the inside.

Bathing

You can start showering the day after the vasectomy. Avoid baths or swimming for a couple of weeks. To dry your scrotum, pat dry with a towel. Don’t rub.

Skin separation

Sometimes, your skin might separate due to tissue fluid, oozing blood or body fluids. If this happens, you can use sterile gauze and your fingers to pinch the edges together. This’ll bring your skin together and allow it to heal. Scarring is minimal, if it even happens at all.

It’s common to have some of these symptoms after a vasectomy. They should go away within 72 hours of surgery.

However, you should call your healthcare provider immediately if you have:

• An unusual amount of pain.
• Extreme swelling of your scrotum.
• Continued bleeding.
• A fever (over 100 degrees Fahrenheit or 37.7 degrees Celsius).

What happens to sperm after a vasectomy?

After a vasectomy, your testicles continue making sperm. When the sperm cells die, they disintegrate and are absorbed by your body. This is the same way your body handles other types of cells that die and are replaced every day.

What are the risks of a vasectomy?

Complications such as inflammation (swelling), bleeding or infection may occur, but they’re relatively uncommon and not serious. Minor risks include:

Pain

Any procedure can affect nerves and, rarely, there can be residual pain. Your testicles are sensitive organs, so pain can occur in people who have testicles whether they’ve had a vasectomy or not.

It’s not clear whether a vasectomy increases this risk of testicular pain. Post-vasectomy pain syndrome is complex and occurs in 1% to 2% of people after a vasectomy. Researchers don’t understand exactly why these varied symptoms develop, but some people may experience testicular pain, pain with ejaculation and psychological distress.

Sperm granuloma

You may develop a hard, sometimes painful lump about the size of a pea as a result of sperm leaking from the cut vas deferens. The lump isn’t dangerous and is almost always absorbed by your body. Scrotal support and mild pain relievers (like acetaminophen) can help relieve symptoms.

Congestion (in your scrotum)

You may have a sense of pressure caused by sperm in your testes, epididymis (the structure that stores sperm) and lower vas deferens. This discomfort may happen for two to 12 weeks after a vasectomy. Like a granuloma, congestion usually resolves itself over time.

The risks of vasectomy should be weighed against other options and outcomes, including the chance of another pregnancy if you don’t have the vasectomy.

What are the benefits of a vasectomy?

Vasectomy offers many advantages as a method of birth control. The main benefit is effectiveness. A vasectomy is over 99.99% effective in preventing pregnancies. Like tubal ligation in people assigned female at birth (AFAB), a vasectomy is a one-time procedure that provides permanent contraception. Compared to tubal ligation, a vasectomy:

• Is simpler.
• Is more effective.
• Can be performed on an outpatient basis.
• Has fewer complications (is safer for you).
• Is much less expensive.

So, if you’re asking which is better, tubal ligation or vasectomy, vasectomy is better in many ways.

Will I have any unwanted “side effects” after a vasectomy?

This usually means:

• Will I produce less testosterone?
• Will I still want to have sex?
• Will I produce (and ejaculate) less semen?
• Will my semen be different?
• Will my partner be able to tell the difference after a vasectomy?

Basically, the answer to these questions is no. A vasectomy doesn’t affect testosterone production or release. (Testosterone is the hormone that’s responsible for your sex drive, facial hair, deep voice and other traits of people who identify as male.)

A vasectomy doesn’t affect sexuality negatively, either. Your erections and climaxes will be the same. The amount of ejaculate and the taste won’t change. The only difference is that your semen will no longer contain sperm (azoospermia). Often, people who’ve had the procedure find that sex with their partners is more spontaneous and enjoyable because they no longer have to worry about pregnancy or about interrupting sexual activity to deal with contraception.

Are there long-term health risks from a vasectomy?

Many studies have looked at the long-term health effects of vasectomy. The evidence suggests there aren’t any significant risks. Having a vasectomy won’t make you more likely to develop cancer, heart disease or other health problems than someone who hasn’t had a vasectomy. (This information is spelled out in the Vasectomy Guideline of the American Urological Association.)

How long does it take to recover after a vasectomy?

Most people are able to go back to work in under a week. You may need to be out for a full week if your work is strenuous and physical, though.

You can resume everyday activities within a few days (usually 48 hours to 72 hours) after the procedure unless the activities are unusually vigorous. People surveyed after vasectomy report full recovery in an average of eight to nine days.

When is it safe to have sex after a vasectomy?

You can start having sex seven days after a vasectomy, but you should use another form of birth control until your sperm counts show that your semen is free of sperm. Typically, a semen analysis is completed about two to three months after a vasectomy.

After a vasectomy, can I stop using other birth control methods right away?

No. Sperm can remain in your vas deferens above the area of the procedure for weeks or even months after a vasectomy. You’ll have a semen test two to three months after the procedure. If the result meets American Urological Association guidelines, you’re considered sterile. If sperm is seen, the semen test is repeated, usually a month later. Until then, you must continue using other birth control methods to prevent pregnancy.

It’s very important to go back to your doctor and do the semen test. This is the only way to make sure that there’s no sperm in your semen. You can help clear your sperm by ejaculating frequently starting a week after a vasectomy. This can increase your chances of a sperm-free semen analysis.

Can I have a vasectomy reversed later if I choose?

While vasectomy reversal is an option if you decide you want another child, it may also be expensive and isn’t usually covered by insurance.

You might consider storing sperm in a sperm bank before you have a vasectomy. Most requests for reversals come from people in newer relationships who want children with their new partners.

You should consider vasectomy a permanent means of birth control. If you’re married or in a serious relationship, you should talk about vasectomy with your partner. If you’re thinking about a reversal now, you might need more time to decide if a vasectomy is right for you.

Will I last longer after a vasectomy?

A vasectomy shouldn’t change your sexual performance physically, but it might increase your comfort level with sex by reducing stress related to pregnancy.

A note from Cleveland Clinic

If you’re sure you don’t want to have children or any more children, you may decide you want a vasectomy. Discuss this decision with your significant other if you’re in a serious relationship and then with your healthcare provider. Some vasectomies can be reversed, but don’t have the procedure unless you’re very sure it’s what you want. If you decide in favor of a vasectomy, you should know that it’s safe, effective, less costly and more convenient than most other forms of birth control.