Everything you need to know about vasectomy
Sperm is needed to fertilize a woman's egg. By cutting the tubes, a vasectomy prevents the sperm from reaching the semen.
After the procedure, a man can ejaculate, but there will be no sperm.
A vasectomy is a permanent way to prevent pregnancy. It is estimated to be over 99 percent effective. Fewer than 1 in every 100 become pregnant in the first year after her partner has a vasectomy.
A vasectomy is possible at any age.
What to expect
A vasectomy is a permanent severance of the vas deferens, which carries sperm from the testes to the penis.
A vasectomy is an outpatient procedure. It can be carried out in a medical office, a hospital, or a clinic, usually under local anesthesia.
The doctor may or may not use a scalpel.
If the vasectomy involves a scalpel, the surgeon will make two small cuts on both sides of the scrotum.
These allow the surgeon to go in and remove a section of the tubes that transport sperm, called the vas deferens.
The tubes are then sealed, tied, or cauterized using an electric current, and the cuts are closed with stitches.
In a no-scalpel vasectomy, a small clamp holds the vas deferens in place, and the doctor makes a small hole in the skin of the scrotum. The hole is opened up to allow the surgeon to cut a piece out of the vas deferens before sealing it up. There are no stitches.
This procedure is becoming more common because there is a lower risk of complications than with the conventional technique.
It is best to talk with a doctor and determine which type of vasectomy is best.
An incision vasectomy takes around 20 minutes to perform, but a non-scalpel procedure is normally quicker.
Immediately after surgery, vasectomy can have a range of adverse effects on the body.
- mild discomfort or pain
- blood in the semen
- bruised scrotum
- bleeding and clotting inside the scrotum
Consult with a doctor or family planning specialist to gauge which type of vasectomy is best.
The procedure is minimally invasive, so most men do not experience significant pain.
However, some swelling and mild discomfort may persist for a couple of days afterward. An ice pack may help reduce pain and swelling.
There may be blood in the semen for the first few ejaculations after the surgery.
The Centers for Disease Control and Prevention (CDC) recommend waiting at least a week before ejaculating, to allow the wound to heal.
After surgery, the man is advised to wear close-fitting underwear, to support the scrotum. He must also keep the genital area as clean as possible. The doctor will advise about how soon to shower.
Most men can return to work after 1 to 2 days, but they should get plenty of rest and avoid heavy lifting for a week or more.
How does it affect sex?
About a week after the procedure, patients can begin to have sexual intercourse again.
However, the sperm count will still be positive at first. It may take 15 to 20 ejaculations, or 3 months for the sperm count to reach zero, so additional birth control will be necessary for some time.
The man should undergo a sperm count test between 8 and 16 weeks after the operation, before having sex without birth control.
After two clear semen tests, it is generally safe to have intercourse without having to use secondary contraception.
The price of the vasectomy normally covers these tests.
In the long term, the vasectomy should not affect the hormones. There should be no impact on the man's libido, or sex drive, or on sexual activity. There are no long-term health risks.
Anyone who is considering a vasectomy should think carefully about the consequences. After the procedure, it is nearly impossible to father any children. A vasectomy can sometimes, but not always, be reversed.
Vasectomies are not effective in less than 1 percent of cases.
Even if a man is sure that he does not want to have children, Planned Parenthood suggests saving sperm in a sperm bank, just in case. However, sperm that is frozen is not always viable in the future.
Is a vasectomy a good idea?
Good reasons for having a vasectomy are:
- if your family is complete and you are 100 percent sure that you do not want more children
- if you or your partner wants to avoid passing on a hereditary disease
- if a pregnancy would put your partner's health at risk
The following reasons may not be good ones:
- a relationship breakdown
- financial challenges
- pressure from other people
It is important to weigh up the risks and benefits and decide whether a vasectomy is the right next step for you and your partner.
The cost ranges from $0 to $1,000 in the United States. Medicaid and many types of health insurance will cover it, but there may be some age and waiting restrictions. Please check coverage with your insurance supplier.
Risks and complications
Before making the decision to go ahead with a vasectomy, it is worth considering the risks.
A vasectomy is permanent. Reversal is sometimes possible, but the success rate is only around 75 percent if performed within 3 years, 55 percent if done within 3 to 8 years, and 35 percent in 9 to 19 years.
A vasectomy procedure is largely irreversible. Be sure that it is the right decision before proceeding.
- Hematoma: Sometimes a hematoma, or blood clot, can form in the scrotum. This can cause pain and swelling, and it may have to be surgically removed.
- Sperm granulomas: This occurs when sperm starts to leak out of the vas deferens and accumulates in the surrounding tissue, developing into lumps. These lumps are usually relatively small, but they can cause severe irritation and may require surgery.
- Infection: There is a risk of contracting an infection following a vasectomy when bacteria enter the incisions on the scrotum. If the scrotum is red or tender, and if there are signs of a fever, it is important to see a doctor.
- Testicular pain: This may occur straight after the surgery, or it may start a few weeks later. It can last for a while. Persistent pain may be due to a pinched nerve. This will require further surgery.
- Testicles feel full: Some men may feel that their testicles are "full," because they will contain stored sperm. This should pass within a few weeks, as the body makes less sperm.
- Fertility: Very rarely, the vas deferens reconnects, and sperm travels into the semen again. This usually happens within the first few weeks.
- Infection: The site of surgery may become infected.
It is worth remembering that a vasectomy does not protect against sexually transmitted infections (STIs), so men are encouraged to use condoms with new sexual partners to avoid contracting an STI.