- Technique
- No-scalpel
- Time
- About 10 to 15 minutes
- Where
- Most in the office, with local anesthesia
- No sex
- For 7 days
- Other birth control
- Until a semen test shows no sperm
What a vasectomy does
A vasectomy is a minor outpatient procedure that blocks or seals the tubes that carry sperm from the testicles. These tubes are called the vas deferens. Afterward, sperm cannot get into the semen or leave the body.
Your testicles still make sperm, but the body simply absorbs them. You still ejaculate, and your sex life is not changed. A vasectomy is one of the most effective forms of birth control available, with a 99.95% success rate in preventing pregnancy.
A vasectomy is meant to be permanent. If you think you may want children one day, look into non-permanent forms of birth control before you decide. A vasectomy also does not protect against sexually transmitted infections.
The procedure
Dr. Su performs most vasectomies in the clinic under local anesthesia. If you want or need to be sedated, it can be done at a surgery center or hospital instead. Whether sedation makes sense depends on your anatomy, how nervous you feel, and whether you need another procedure at the same time.
Cleaning and numbing
Your scrotum is washed with an antiseptic solution, and a local anesthetic is injected to numb the area. You will still be aware of touch, tension and movement, but the anesthetic should block any sharp pain.
Reaching the tubes
With a conventional vasectomy, small cuts are made on each side of the scrotum. Dr. Su uses the no-scalpel technique instead: both tubes are reached through a single tiny opening in the skin, with little bleeding and no stitches.
Blocking the tubes
Each vas deferens is cut, and the ends are sealed or blocked so sperm cannot pass. The whole procedure usually takes about 10 to 15 minutes, and you go home the same day.
Recovery
You may be uncomfortable for a few days. The pain is usually mild, similar to how you feel several minutes after getting hit “down there.” Mild pain medicine usually helps.
- Use an ice pack on the scrotum and wear supportive underwear, such as a jockstrap, to ease swelling and pain.
- Avoid sex, and activities that take a lot of strength, for 7 days.
- Many men with desk jobs go back to work as early as the next day.
- Most men heal fully in less than a week.
A small, harmless lump called a granuloma can form where sperm leaks from the cut end of the vas into the surrounding tissue. It may be sensitive to touch or pressure, but it is not dangerous. Most of the time it does not hurt, and it usually gets better with time.
It does not work right away
After a vasectomy, new sperm cannot reach the semen, but there are still plenty of sperm “in the pipeline” that take time to clear. Keep using another form of birth control until Dr. Su confirms the vasectomy has worked.
A semen test is required. Clearing the remaining sperm usually takes 20 to 25 ejaculations and 6 to 12 weeks. About 1 in 100 men still have sperm at that point and need to wait longer. Do not assume your vasectomy is working until a post-vasectomy semen analysis proves it.
Risks
- Bleeding. Right after surgery there is a small risk of bleeding into the scrotum. Call the office if your scrotum gets much bigger or you are in pain.
- Infection. Call the office if you have a fever, or your scrotum is red or sore.
- Post-vasectomy pain syndrome. About 1 or 2 men out of 100 have ongoing pain after a vasectomy. In many cases the cause is not clear. It is most often treated with anti-inflammatory medicines.
Go to the emergency room if swelling in your scrotum grows quickly or the pain becomes severe and you cannot reach the office.
Questions patients ask
Can my partner tell if I have had a vasectomy?
Sperm adds very little to the volume of semen, so you should not notice any change in your ejaculate. Your partner may sometimes be able to feel the vasectomy site, especially if you have developed a granuloma.
Will a vasectomy change how orgasm feels?
No. Ejaculation and orgasm are not affected by a vasectomy. The exception is the rare man who develops post-vasectomy pain syndrome.
Can I develop erectile dysfunction after a vasectomy?
A vasectomy does not cause erectile dysfunction.
Can a vasectomy fail?
There is a small chance. It happens when sperm leaking from one cut end of the vas deferens find a channel to the other cut end. Once your semen test clears you, showing no sperm, or fewer than 100,000 sperm per milliliter with none moving, the risk of pregnancy is about 1 in 2,000.
Can something happen to my testicles?
In rare cases, the artery to the testicle may be injured during a vasectomy. Other problems, such as a collection of blood (hematoma) or an infection, can also affect the testicles.
Can I have children after a vasectomy?
Yes, but unless you have stored frozen sperm, you will need another procedure. The tubes can be surgically reconnected in a vasectomy reversal. If you do not want a reversal, sperm can be taken directly from the testicle or the epididymis and used for in vitro fertilization. These procedures are costly, may not be covered by your health plan, and do not always work. If you think you may want children one day, consider non-permanent birth control before choosing a vasectomy.
Adapted from the Urology Care Foundation.