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Vasectomy

By

Megan Freedman

What is a vasectomy?

A vasectomy is a minor surgery for male sterilization, or permanent birth control. In a vasectomy, a urologist cuts and closes off the two vas deferens. The vas deferens are tubes that carry sperm from the testicles to the urethra. The sperm are ejaculated in the semen during intercourse. After a man has a vasectomy, he will still produce sperm, but the sperm do not move out of the testicles.

A vasectomy is considered permanent contraception. A urologist can reverse a vasectomy by reattaching the ends of the vas deferens in a procedure called a reverse vasectomy, but it is more complicated than a vasectomy and not as likely to be successful. 

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Types of vasectomy

The types of vasectomy include:

  • Conventional vasectomy involves making one or more small cuts in the scrotum (sac that holds the testicles) to access and cut the vas deferens.

  • No-scalpel vasectomy involves making a small puncture in the scrotum. The urologist then pulls the vas deferens out of the small puncture hole to cut it. 

Why is a vasectomy performed? 

Your doctor may recommend a vasectomy for permanent birth control. A vasectomy is an option if:

  • You are finished having children.

  • You do not want to have children.

  • You and your partner have a genetic incompatibility preventing you from having healthy children. 

Who performs a vasectomy?

A urologist will perform your vasectomy. A urologist is a doctor who specializes in diseases and conditions of the urinary tract and the male reproductive organs. 

How is a vasectomy performed?

The procedure is performed in your doctor's office, an outpatient surgery center, or hospital. It takes less than a half hour and generally includes these steps:

  1. You undress from the waist down and wear a surgical gown over your lap.

  2. You will most likely recline on a procedure table. The urologist may move or tilt the table during your procedure. Some men prefer to stand during the procedure.

  3. A member of the surgical group shaves your scrotum if you have not already shaved it prior to the procedure.

  4. A member of the surgical group washes your scrotum with antiseptic solution to prevent infection.

  5. Your urologist injects your scrotum with local anesthesia to prevent you from feeling pain. However, you will still feel some pulling and tugging sensations during the procedure. You may also have a sedative to help you stay relaxed and comfortable.

  6. If you are having a conventional vasectomy, your urologist makes one or two small cuts in your scrotum. If you are having a no-scalpel vasectomy, your urologist feels your scrotum to find the vas deferens. A small puncture is made in the scrotum to access the vas deferens.

  7. Your urologist cuts out a small portion of the vas deferens and cauterizes (burns) and tie off the open ends.

  8. Your urologist stitches the incisions (or puncture) or may leave them to close on their own.

Will I feel pain?

Your comfort and relaxation is important to both you and your care team. A vasectomy may involve relatively minor pain when the anesthetic needle enters your scrotum, as well as some discomfort caused by slight tugging and pulling sensations during the procedure. Take a few long, deep breaths to help yourself relax. Tell a member of your healthcare team if the pain does not pass quickly.

What are the risks and potential complications of a vasectomy?  

The vast majority of vasectomy procedures are successful. However, complications of a vasectomy can occur and become serious. Complications of vasectomy may include:

  • Anesthesia reaction, such as an allergic reaction and problems with breathing

  • Bleeding of the incision or bleeding into the scrotum

  • Granuloma, a lump that develops from leakage of sperm from cut vas deferens into the scrotum

  • Infection and septicemia, which is the spread of a local infection to the blood

  • Post-vasectomy pain syndrome, which is chronic pain following a vasectomy

How do I prepare for my vasectomy?

If you dread the thought of undergoing a vasectomy, you are not alone. A vasectomy is generally a safe procedure for the majority of men who have it. Because a vasectomy can cause some anxiety and uncertainty, you may want someone to accompany you to the procedure. 

Your doctor may ask you to clean and shave your scrotum before your procedure.

Questions to ask your doctor

Preparing for any medical procedure can be stressful. It is common for patients to forget some of their questions during a doctor’s office visit. You may also think of other questions after your appointment. Contact your doctor with any questions and concerns before the procedure and between appointments. 

It is also a good idea to bring a list of questions to your appointment. Common questions include:

  • Why do I need a vasectomy? Are there any other options for preventing pregnancy?

  • How long will the procedure take? When can I go home?

  • When and how will I know that the vasectomy has been successful? When will I be sterile?

  • What kind of restrictions will I have after the surgery? When can I return to work and other activities?

  • When can I return to sexual activity? 

  • What kind of assistance will I need at home?

  • What medications will I need before and after the surgery? 

  • How will you manage my pain?

  • When should follow up with you? 

  • How should I contact you? Ask for numbers to call during and after regular office hours.

What can I expect after my vasectomy?

Knowing what to expect after a vasectomy can help you get back to your everyday life as soon as possible.

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