Men's Health

Men’s Health Questions Answered: Vasectomy

Men’s health topics are important to discuss with a doctor, but for many men it is difficult to have these conversations with their health care provider. Discussing sex, prostate health and hormonal imbalance can be uncomfortable, but understanding these conditions and how they affect overall health is critically important for every man.

Arnold Bullock, MD, Professor of Urologic Surgery at Washington University School of Medicine in St. Louis, specializes in men’s health. He encourages men to ask their questions and engage in honest conversations with their doctors. To help start this conversation, Bullock answers some of the questions regarding a common men’s health procedure: Vasectomy.

Vasectomy: Frequently Asked Questions

What is a Vasectomy?

A vasectomy is a simple, in-office procedure that makes a man sterile. The procedure makes it possible to have sex without worrying about pregnancy.

The procedure is very straightforward. A man’s testicles produce sperm cells, which fertilize an egg, resulting in pregnancy. The sperm produced in the testicles must travel through tubes called vas deferens to reach the prostate, where most of the ejaculate fluid is produced. By making a small, quarter-inch incision, a urologist can isolate the vas, remove a small piece of the tube and cauterize or stitch the ends. This makes it so that sperm cells can no longer get from the testicles to the prostate.

A “no-scalpel” vasectomy is started by anesthetizing a small area of the scrotum (the skin sac that the testes are in) and then making a very small opening in the skin between the base of the penis and the scrotum. This is accomplished after local anesthetic is injected under the skin. The surgeon makes the small opening with a special tool that spreads the skin open rather than cutting the skin. This technique allows quicker healing and less bleeding. The surgeon then moves each vas to the opening, removes a small piece and then seals the ends using heated cautery or a stitch.

What are the reasons for having a Vasectomy?

Men have vasectomies for a variety of reasons. Some of the common reasons are:

  • You want to enjoy sex without worrying about pregnancy.
  • You do not want to have more children than you can care for and support.
  • Your partner has health problems that might make pregnancy difficult.
  • You don’t want to risk passing on a hereditary disease or disability.
  • You and your partner don’t want to, or can’t, use other kinds of birth control.
  • You want to save your partner from the surgery—and expense—of having her tubes tied.

Because vasectomy is meant to make a man infertile, you must be absolutely sure that you don’t want to father a child under any circumstances. You should talk to your partner about this decision, since it affects your ability to conceive a child together. I always encourage men to talk about other types of birth control and talk to friends or relatives who have had a vasectomy. A vasectomy might not be for you if you are young; your current relationship is not permanent; you are having a vasectomy just to please your partner and you don’t really want it; you are under a lot of stress; or you are counting on reversing the procedure at a later time.

As with all men’s health topics, having an open and honest conversation with your partner and your doctor is important. Your health is our priority at Washington University.

Does it hurt?

When the local anesthetic is injected into the skin of the scrotum, it’s uncomfortable, but as soon as it takes effect, you shouldn’t feel anything. Afterwards, you’ll be sore for a couple of days and may want to take Tylenol.

Most vasectomies take less than 15 minutes. The patient is awake, and we’ll be having a conversation about sports or a TV show. In many cases, I’ll tell the patient the procedure is finished, and he’ll say: “That’s it?”

Many men come to the office alone. It’s perfectly reasonable for you to drive yourself to and from the office for the procedure.

You don’t even have to avoid eating the night before or morning of the procedure. We don’t want you to have chewing gum in your mouth while we’re operating, but you can have a normal breakfast before coming to the office.

In most cases, you can return to work the next day. I tend to do most vasectomies on Fridays, and those men are able to return to work Monday morning without any issue.

Will the Vasectomy change me sexually?

No.

The only thing that changes is that you won’t be able to make your partner pregnant. Your body will continue to produce the same hormones that provide your sex drive. You will make the same amount of semen. Vasectomy won’t change your beard, muscles, sex drive, erections, climaxes or voice. Some men say that without the worry of accidental pregnancy, sex is more relaxed than before.

When can I have sex again?

A man is not immediately sterile after a vasectomy. Some sperm is already on its way to the prostate. This sperm can still cause a pregnancy like normal. One week after the vasectomy, the patient can have sex. You’ll still need to use protection to avoid pregnancy until two negative sperm counts have been recorded to be sure the last of the sperm is gone.