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.
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.
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:
You undress from the waist down and wear a surgical gown over your lap.
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.
A member of the surgical group shaves your scrotum if you have not already shaved it prior to the procedure.
A member of the surgical group washes your scrotum with antiseptic solution to prevent infection.
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.
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.
Your urologist cuts out a small portion of the vas deferens and cauterizes (burns) and tie off the open ends.
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.
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
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.
Knowing what to expect after a vasectomy can help you get back to your everyday life as soon as possible.
How will I feel after the vasectomy?
Your scrotum will probably feel sore and swollen for a few hours to a few days after a vasectomy. Wearing snug-fitting underwear, icing your scrotum, and taking mild pain medication will help. Your doctor will likely recommend that you rest for the remainder of the day. Men can generally return to non-strenuous work the next day and all their normal activities within a week.
You may resume sexual activity about a week after a vasectomy, but you may still have sperm in your ejaculate for up to three months. It’s important to use another effective form of birth control during this time.
Your doctor will ask you to provide a semen sample a few weeks to a few months after your vasectomy to test for the presence of sperm. Your vasectomy is considered successful and complete when your sample shows that no sperm are present.
When can I go home?
In most cases, you will go home immediately after the vasectomy is complete.
When should I call my doctor?
It is important to keep your follow-up appointments after a vasectomy. Call your doctor right away or seek immediate medical care if you have:
A new lump near your testicles
Bleeding from your incision that will not stop
Rapidly enlarging scrotum
Significant discomfort in your scrotum
Swelling that keeps getting worse