Vasectomy: What to Know before You Undergo the Procedure

The first thing you should know about vasectomy is that it is one of the most effective forms of birth control available. Your chances of impregnating a woman after the procedure drop to nearly zero. But like all birth control methods - other than abstinence - it is not guaranteed to work.

Experts estimate that the risk of pregnancy after a vasectomy ranges from about 1 in 2,000 to as little as 1 in 10,000. By comparison, condoms fail 1 in every 100 times they’re used. A vasectomy is meant to be permanent, though it can be reversed in some cases.

What Is a vasectomy?

A vasectomy is a brief procedure in which a surgeon cuts and closes off the vas deferens, the two tubes that carry sperm from your testicles. This prevents sperm from entering your semen and exiting your body when you ejaculate. Instead, your sperm remains in your testicles and eventually gets absorbed into your body.

Nothing else about sex changes after a vasectomy. Your orgasm feels the same, and the amount of semen you ejaculate will not change, either. It will look just like it did before. The only difference will be that your semen does not carry sperm, so it can’t fertilize your female partner’s eggs.

Who should get a vasectomy?

Because a vasectomy is designed to be permanent, consider the procedure only if you do not want to father children - or additional children. If you have a partner or spouse, you should discuss this option together to be sure that it’s right for you as a couple.

You also might consider a Vasectomy if your partner or spouse has a health condition that makes pregnancy risky, such as breast cancer, some types of heart disease, poorly controlled diabetes, and more. Your doctor can review the risks of these and other health conditions and help you decide what to do.

If either you or your partner - or both of you - carries a gene mutation that puts the health of future children at risk, you may want to consider a vasectomy as a way to avoid pregnancy.

What are the risks of a vasectomy?

Like any surgical procedure, a vasectomy is not without risks. However, complications are uncommon and usually minor. They include:

• Swelling, bleeding, or infection may occur, but these side effects are not likely and rarely serious.
• Post-vasectomy pain occurs in about 1 to 2 percent of men and may cause pain in your testicles as well as pain when you ejaculate.
• Sperm granulomas are hard lumps that can develop when sperm leaks from your vas deferens. They can be painful but usually go away on their own.
• Scrotum congestion, or a feeling of pressure, may develop and linger for up to three months after your vasectomy. It should go away without intervention.

Your vasectomy will not boost your risk of future health problems, sexual or otherwise.

There’s not a lot you need to do once you’ve made the decision and scheduled the procedure. If you take a blood thinner medication, tell your doctor. You will likely be told to stop taking it a week before your vasectomy to reduce the risk of bleeding. Blood thinners include:

• Aspirin.
• Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil and Motrin) and naproxen (Aleve).
• Warfarin (Coumadin).
• Clopidogrel (Plavix).

Review these and other medications with your doctor when discussing your vasectomy.

You may be required to shave your scrotum either the night before or in the morning of your vasectomy.

How is a vasectomy performed?

The procedure will take place in a doctor’s office, hospital, or outpatient surgery center. It requires about 10 to 30 minutes. Prior to the procedure, your scrotum will be shaved and numbed. Then, your doctor will perform one of two types of Vasectomy:

1. Conventional Vasectomy. Your doctor will make a small incision or two in your scrotum. That will allow access to the vas deferens, the tubes that carry sperm. Each vas deferens will be cut and a small section removed. This creates a gap between the two ends of the tubes. Your doctor may then tie the ends of each or insert some tissue in between the two ends. Both techniques help prevent sperm from crossing the gap created between each vas deferens.
2. No-scalpel Vasectomy. In this procedure, your doctor will puncture your scrotum to make a small hole. The vas deferens are then pulled out through the hole so that they can be cut and then tied or seared shut before being put back. This method takes less time to heal and has a lower risk of complications such as infections.

What does recovery from a vasectomy involve?

You can go home immediately after your procedure. You likely will have some pain and discomfort as well as bruising and swelling. Your doctor will show you how to ice your scrotum to minimize swelling. Expect to ice for about 36 hours after your vasectomy.

Call your doctor right away if you have signs of infection, such as a fever, blood or pus from the cut in your scrotum, or excessive pain or swelling in your scrotum or around your testicles. But don’t worry too much. Recent research shows that infections are quite uncommon and usually mild when they do occur.

To help with healing, avoid strenuous lifting, sports, and heavy work for about a week after surgery.

Can I have sex right after my vasectomy?

No. To help with the healing process, you should not ejaculate for a week after your procedure.

Also, your semen won’t be sperm-free for the first few months after your vasectomy, so you should plan to use other forms of birth control during this period. Why is this the case? Sperm produced prior to your vasectomy needs to be cleared from your system first. This can take about three months. Ejaculating 20 times also should clear any remaining sperm.

You want to be sure that no sperm is ejaculated during sex. Your doctor will schedule an analysis to determine whether your semen is free of sperm. If it’s not, you may need to wait a little longer before you discontinue other forms of birth control. In rare cases, you may need to undergo a second vasectomy if the first one proves unsuccessful or your vas deferens grows back together.

Can my vasectomy be reversed?

It’s possible but not guaranteed. Recent research shows that reversals are successful in over 90 percent of men. However, reversals are expensive and your health insurance may not cover them.

Does my vasectomy offer protection from sexually transmitted diseases?

No. Your vasectomy prevents unwanted pregnancies, but you must use other forms of protection, such as a condom, to prevent STDs.