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A vasectomy is a procedure that makes a man sterile by blocking sperm. The procedure takes about 15 minutes and is very safe and effective. Complications are rare, and recovery is quick. Because reversal is complicated, though, the decision to have a vasectomy should be made carefully.
What is a vasectomy?
A vasectomy is a safe and highly effective procedure designed to make a man sterile. It's done by blocking sperm from leaving the body. A doctor cuts the two tubes – called the vas deferens – that carry sperm from the testes to the pouch in the pelvis that holds the semen prior to ejaculation.
Men who get vasectomies can still have sex and ejaculate normally, but their semen won't contain any sperm, so it can't fertilize an egg and cause a pregnancy. About one in five men over the age of 35 in the United States has a vasectomy.
Because the procedure is considered permanent, you'll want to think carefully and consult with your doctor before you schedule one.
How much does a vasectomy cost?
Vasectomies cost about $350 to $1000 – far less than surgery to sterilize a woman – and most insurance companies will cover the procedure.
How is a vasectomy performed?
There are two ways the procedure can be performed. Both require only local anesthetic (numbing medicine), take only about 15 minutes, and are usually performed right in the doctor's office. (For men who aren't comfortable having the procedure done while awake, many doctors offer the procedure under a light sedation.)
Talk with your doctor about which procedure would be best for you.
• No-scalpel vasectomy (NSV). Most doctors today use this technique. In this procedure, the doctor gives you a local anesthetic and then uses his fingers to maneuver the vas deferens tubes close to the surface of the skin. Once they're in position, he uses a special instrument to make a tiny hole in the skin. When he sees the tubes through that hole, he cuts them and then seals them (by cauterizing or using clips). You don't need stitches. The small hole will heal on its own.
• Conventional method. Some doctors prefer this approach because they feel it better enables them to see the structures they're working with during the procedure. The doctor gives you a local anesthetic and then makes a small incision on each side of the scrotum. He then lifts the vas deferens tubes to the surface and snips them in two. Then he seals the ends (by cauterizing or using clips) and stitches up the scrotum. The stitches dissolve on their own and don't need to be removed.
After either procedure, you should have someone available to take you home. You'll be asked to limit your activity for the rest of the day.
Recovering from a vasectomy
Recovery from a vasectomy is pretty quick. In a week's time you should be fully recovered, and you'll likely feel better much before then. In the meantime, use these techniques to ease your discomfort:
• Ice. Use an ice pack (or a bag of frozen peas) on your scrotum (on top of your underwear or wrapped in a towel) to reduce swelling. (It's a good idea to bring an ice pack with you to the doctor's office, along with a jock strap to help support your scrotum after the procedure).
• Pain relief. You may feel soreness for a few days afterward. If you're uncomfortable, you can take acetaminophen, but not ibuprofen or aspirin, because these may increase the risk of bruising or bleeding. It's not common, but if you experience strong pain during this time, the doctor will give you pain medication to help control it.
• Rest. Plan to lie around for a few days. You'll need to wait a day or two to bathe or swim, and it's wise to wait a week or so before having sex, lifting heavy objects, riding a bike, jogging, golfing, or engaging in other strenuous activities. If you schedule the operation for a Friday, you can probably return to work Monday, unless your job involves physical labor.
Is a vasectomy effective right away?
No. For the first 20 or so ejaculations following the vasectomy, sperm may be lingering in your tubes. Your doctor will need to check your semen sample at least once after about three months to make sure it's sperm-free. Until then, you'll need to use another form of birth control when you have sex. Following up with your doctor after the procedure is very important to ensure it was successful.
Vasectomy is nearly 100 percent effective. In rare cases – 1 out of 1,000 – the tubes grow back together, and the man becomes fertile again. This is one reason it's important to follow up with your doctor after your vasectomy to confirm the procedure was successful.
Are there any risks from a vasectomy?
A few patients develop minor complications, such as:
• Swelling or bruising. Bleeding under the skin might cause swelling or bruising, a problem that usually clears up on its own within two to three days. If the bruise lingers, put your feet up, apply an ice pack, and get some rest.
• Infection. In rare cases, the incisions or puncture wounds on the scrotum get infected. And sometimes the tubes themselves may become infected. Call your doctor if you notice blood or pus oozing from the site, if you develop a fever over 100 degrees Fahrenheit, or if you experience extreme pain.
• Scar tissue. Some men develop scar tissue within the scrotum that may have to be removed if it becomes painful.
• Sperm granuloma. This is a growth that develops over time in 15 to 40 percent of men who have vasectomies. It happens because the body's immune system reacts to leaking sperm at the end of the cut vas. It's not dangerous and is usually treated with ibuprofen if uncomfortable. Rarely (if it becomes very uncomfortable), it may need to be surgically removed.
More rarely, men who have vasectomies might:
• Develop post-vasectomy pain syndrome. This dull ache in the testes is caused by the buildup of fluid or by damage to the nerves surrounding the vas. It's usually treated with ibuprofen and warm baths. In severe cases, other oral medication, steroid injections, nerve blocks, or surgery might be needed. This syndrome affects between 1 and 2 percent of men who have a vasectomy, and it's always treatable.
• Develop a hydrocele. This is a fluid-filled sac that causes swelling in the scrotum. Treatment usually isn't necessary, but if the hydrocele is large and uncomfortable, it can be surgically removed.
Finally, there's no evidence that the procedure increases your chances of getting prostate cancer, testicular cancer, or developing heart disease, as some people once thought. In fact, there are no known long-term side effects relating to overall health and sexual activity besides those mentioned above.
Will a vasectomy affect my sex life?
No. Men sometimes jokingly use a high-pitched voice when discussing vasectomy. The procedure, however, has no effect on a man's voice, testosterone production, facial hair, sex drive, or sexual functioning. (It doesn't affect your ability to get an erection, ejaculate, or orgasm.)
The vas deferens carries nothing but sperm, so the operation simply keeps these cells out of the semen. (They're then reabsorbed into the body.) The sperm actually make up only a very small part of the semen, with most of the fluid coming from the prostate gland. Therefore, vasectomy won’t make a major change in the amount of fluid that comes out with ejaculation. Unless you carry a microscope and a specimen cup to bed, you'll never notice the difference.
Are vasectomies reversible?
A vasectomy can be reversed, but it's an expensive and much more involved procedure (which can take over three hours, often under general anesthesia.) It's rarely covered by insurance.
The reversal procedure doesn't always work, and the more time that has elapsed since the vasectomy, the smaller the chance that a reversal procedure will make you fertile again. This is partly because the vas deferens may deteriorate over time and partly because some men develop antibodies to their own sperm after a vasectomy, making the sperm less effective.
If you really want a back-up plan, talk to your doctor about putting some of your sperm in a sperm bank.
Is a vasectomy a good choice for postpartum contraception?
If you're absolutely sure that you don't want to conceive any more children, a vasectomy may be a good choice for you and your partner. The main benefits are convenience and freedom: You don't have to put on a condom every time you want to have sex, and your partner won't have to take a pill every day or insert or apply anything before having sex.
Another plus: You'll save money in the long run. Once you've paid for the procedure, you'll have no additional contraceptive expenses.
If you think you might change your mind, this procedure isn't for you. The cost of reversing the procedure is high, and there's no guarantee of success. (If the reversal procedure is unsuccessful, sperm can often be collected from the testicle to use for in vitro fertilization (IVF), but this is also a costly procedure.)
Before you go under the knife, ask yourself some tough questions: How would you feel if you lost your partner to death or through divorce or separation and later decided to have a child with another person? Try to imagine all possible scenarios that might make you change your mind.
Also, sterilization won't protect you from sexually transmitted infections such as HIV, herpes, HPV (genital warts), syphilis, gonorrhea and chlamydia.
You may be wondering about having sex after the baby arrives. How soon is it safe? How will the baby affect your sex life? Our article on sex after the baby will help answer some of your questions.