What is a vasectomy?
Vasectomy is surgery a man may choose to have if he does not want to father any more children. It’s permanent male birth control.
During the surgery, two tubes called the vas deferens are cut and sealed. The vas deferens carry sperm from 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 man who’s had a vasectomy still makes semen and is able to ejaculate, but the semen doesn’t contain sperm. The level of testosterone and all other male sex traits stays the same. For most men, the ability to have an erection is unchanged.
The procedure to reverse a vasectomy doesn’t always work. So this procedure should not be done unless a man is certain he does not want to father any more children.
Types of vasectomy
- Conventional vasectomy. This surgery involves small cuts on each side of the scrotum to reach the vas deferens.
- No scalpel or nonsurgical vasectomy. This method is done through one tiny puncture in the skin. An instrument is used to gently stretch the skin opening so that the vas deferens can be reached. Because no cuts are made, there is little bleeding and no stitches. 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.
- 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 unsure 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 potential 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.
- In rare cases, the vas deferens may grow back together which could cause an unwanted pregnancy
- Pain that lasts long after surgery
- Short-term bleeding, swelling, and bruising
Although a man can often start having sex again soon after vasectomy, another form of birth control 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 usually about 3 months after surgery.
There may be other risks, depending on your specific medical condition. Be sure to 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 test. Read the form carefully and ask questions if anything is not clear.
- Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, or anesthesia.
- Make sure 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. For instance, you may also be told to stop eating and drinking after midnight. 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 medical condition, your healthcare provider may request 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.
Generally, vasectomy follows this process:
- You will be asked to remove any jewelry or other objects that might get in the way during procedure.
- You will remove your clothing and put on a hospital gown.
- You will be asked to empty your bladder.
- You will lie on your back on an exam table.
- Your scrotum may be shaved and cleaned with an antiseptic solution.
- The surgeon will inject a numbing drug into your scrotal area. You will likely be awake for the procedure.
- The surgeon will make a small cut in your upper scrotal area to find the vas deferens.
- You may feel a tugging feeling as the surgeon pulls the vas deferens into the opening.
- Your vas deferens will be cut and small clamps or ties may be used on both ends.
- 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 hole.
- 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 icepack for the first day to reduce pain and swelling. Here is what you may expect during recovery:
- You should rest at home the day after surgery and avoid any strenuous activity.
- Depending on the type of work you do, you may be able to return within 1 to 3 days.
- You should be able to return to most activities within 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.
Tell your healthcare provider if you have any of the following:
- A lump in your scrotum
- Any drainage, bleeding, redness, or swelling
- Fever and/or chills
- Increasing pain or pain that is not relieved by medicine
- Trouble passing urine
Your healthcare provider may give you other instructions after the procedure, depending on your situation.
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 will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure
March 22, 2017
Vasectomy techniques. Clenney, T. American Family Physician. 1999, is. 60, ed. 1, pp. 137-46.
Finke, Amy, RN, BSN,Greenstein, Marc, DO