For men seeking an effective, permanent contraception, a vasectomy may be the answer. But as with any medical procedure, there are pros and cons to consider.
If you decide that a vasectomy is right for you, it’s important to understand what happens during the procedure and its recovery.
How It Works
A vasectomy blocks the tubes (vas deferens) that carry sperm from your testicles to your penis. You will still be able to have erections and ejaculate semen, but it won’t contain sperm. This is one of the most reliable ways to prevent pregnancy, and it doesn’t affect your testosterone levels or sex drive. It’s also less expensive and less risky than having a woman’s tubal ligation done (a procedure called a hysterectomy).
The surgery is almost always done under local anesthesia, which means that only the area around your penis and scrotum are numb. It is usually performed in an outpatient setting, meaning you go home the same day.
Your doctor will ask you to lie on your back and remove your underwear. Your scrotum is then shaved and cleaned with an antiseptic solution. You’ll probably be given a hospital gown to wear. Then, the surgeon will put a small amount of numbing medicine into your scrotal sac. After your scrotum is numb, the surgeon will use either a scalpel or a no-scalpel method to cut the end of each of your sperm-carrying tubes. The surgeon may place surrounding tissue between the ends of the tube to increase the odds that it will seal.
After the procedure, your scrotum will be covered with a sterile dressing. Your doctor will change the dressing when it becomes stained or soiled, usually after a few days. You should also wash your scrotum frequently to keep it clean. You should avoid taking aspirin, ibuprofen (such as Advil, Motrin, or Nuprin), naproxen (brand name Aleve), or ketoprofen (Orudis) for a week before the procedure because these medications can thin your blood and cause more bleeding during surgery. You should also avoid strenuous activity for a few days after the procedure. Ice packs and acetaminophen (such as Tylenol) can help ease pain and swelling.
You can usually start having sex again about a week after your vasectomy, but you should continue to use another form of birth control until your doctor tests your semen and tells you it is completely free of sperm. This can take up to three months.
Preparation
A vasectomy is a minor surgery that blocks the tubes where sperm are created. The procedure is done in a doctor’s office or surgical facility, usually under local anesthesia. Some family medicine or general practice doctors do vasectomies, but most are performed by urologists, who specialize in conditions affecting the urinary tract and male reproductive system.
Before the procedure, you’ll need to sign a consent form giving your provider permission to perform the surgery. You’ll also be told that a vasectomy isn’t guaranteed to prevent pregnancy, so you’ll still need to use other forms of birth control (such as condoms) until your doctor tells you that your semen is free of sperm.
On the day of the surgery, take a shower or bath, and clean the area around your penis. Trim any hair that may be growing in that area and remove jewelry or piercings from the genital region. You’ll need to arrange for someone to drive you home after the procedure because movement and pressure on the surgery area can make the pain worse.
It’s important to be calm and clear-headed when discussing vasectomy with your healthcare provider, so ask any questions you have. Then, plan to have the procedure at a time when you won’t be busy and will have plenty of downtime afterward to relax. March Madness or multi-day golf tournaments are popular times for men to get their vasectomies, but you can choose any time that suits your schedule.
You’ll want to avoid sexual activity for about a week after your vasectomy because it will take that long for your doctor to test your semen and make sure that there is no sperm left in it. You’ll be able to start using other forms of birth control after your doctor tells you that your vasectomy is successful.
While a vasectomy is an effective form of birth control, it won’t protect you from sexually transmitted infections like HIV or chlamydia. You’ll still need to use condoms if you have multiple sexual partners.
During the Procedure
A vasectomy is a surgical procedure to permanently prevent pregnancy in men. It’s usually done in a doctor’s office, but sometimes in a hospital or clinic. Before the procedure, you’ll need to sign a consent form. You must also tell your provider if you take blood thinners, such as dabigatran (Pradaxa), rivaroxaban (Xarelto), or apixaban (Eliquis).
During the procedure, you’ll lie on your back. Your provider will inject an anesthetic into your scrotum or lower groin area. Then your provider makes 1 or 2 small cuts (incisions) in your scrotum. They may use a scalpel or a pointed clamp that doesn’t cut the skin (no-scalpel method). Then they break open and remove the testicles from their tubes, called the vas deferens, and cut them. The provider will then close the incisions with stitches or skin glue.
After the procedure, your scrotal sac will probably be swollen and painful. You can take medicine, such as acetaminophen (Tylenol), to help with the pain. You should wear a supportive undergarment like a jockstrap for a few days after surgery to help with the swelling. You should avoid sexual activity until your doctor says it’s OK, about a week after the surgery. You’ll need to use a different form of birth control until your provider tests your semen and confirms that it’s free of sperm.
Once your provider confirms that you’re sterile, you can stop using birth control. But a vasectomy doesn’t protect you against sexually transmitted infections (STIs), so you still need to use protection with each sex partner.
Because vasectomy is permanent, you should only get it if you’re 100% sure that you want to be sterile for the rest of your life. You should discuss the pros and cons with your doctor before deciding to have it. You should never have a vasectomy without your doctor’s permission because that would be considered forced sterilization. Vasectomies can be reversed, but it’s hard and less likely the longer it’s been since the surgery. If you’re unsure whether you want to be sterile, consider alternatives like tubal ligation.
Post-Procedure
You will leave the office once your doctor closes the incision at the surgery site with stitches or glue. To help reduce swelling, you can wear a tight-fitting jock strap or an athletic supporter for the first few days after the procedure. You may also use an ice pack to help ease pain and discomfort.
Some sperm can still be present in your semen after a vasectomy, but it will take time and many ejaculations to make sure they are all gone. Because of this, you must continue to use some form of birth control until your doctor tests your semen and confirms that it is sperm-free.
You can start sexual activity again about a week after the procedure. Your doctor will recommend you use a condom during sexual intercourse until your semen is tested and shows no sperm in it.
Your scrotal area will likely be sore and tender for a few days after your vasectomy, but over-the-counter pain medications should provide you with sufficient relief. You can try ibuprofen (Advil or Motrin) or acetaminophen (Tylenol).
The most common side effects of a vasectomy are pain, swelling, and a burning sensation in the scrotal sac. These symptoms should not last more than a few days; if they do, call your doctor.
A very rare complication of a vasectomy is bleeding from the incision site. If it does occur, contact your doctor right away, as it could indicate an infection or a hematoma (collections of blood) in the scrotal sac.
Vasectomy is a safe and effective way to prevent pregnancy. However, it is not foolproof and may fail. In about 1 in 1,000 vasectomy cases, the ends of the vas deferens will find a way to connect to one another again. This does not happen often, but you can get pregnant if it occurs. It is important to discuss your decision and plans for your future with a partner before having a vasectomy. A few men who have a vasectomy regret it later in life, but this is usually due to having unrealistic expectations about how their sex life will change after the operation.