Vasectomy is a form of male birth control that eliminates the supply of sperm to the semen.
Vasectomy is done in the doctor’s office under local anesthesia and recovery usually requires only a few days.
Vasectomy is a practical solution for men who do not want to have children or whose partner’s health would make a pregnancy risky or complicated. Additionally, if there is a risk of passing on a hereditary disease or disability, a vasectomy can help prevent this. For those who either cannot use or prefer to avoid other forms of birth control, a vasectomy offers a reliable solution.
Men’s health experts at WashU Medicine
Urologists specializing in men’s health at WashU Medicine see patients at Barnes-Jewish Hospital, one of the top hospitals in the nation, as well as convenient locations across the region.
Schedule online>>
What is a vasectomy?
A vasectomy is a minor surgical procedure that involves cutting and sealing the vas deferens, the tubes that carry sperm from the testicles to the urethra. By interrupting this pathway, sperm are prevented from mixing with semen, rendering a man sterile and unable to cause pregnancy.
Reasons for choosing vasectomy
There are a number of reasons a person might choose to have a vasectomy. Generally, a vasectomy can be an effective form of birth control for men who know they do not want to have children.
Permanent contraception
- Decisive family planning: Ideal for individuals or couples who are certain they do not want more children or any children at all.
- Less need for ongoing contraception: Eliminates the need for other contraceptive methods such as condoms, oral contraceptives, or intrauterine devices (IUDs) for birth control. It’s important to note that vasectomy does not eliminate the need for protection from sexually transmitted infections (STIs).
Safety and effectiveness
- Highly effective: Vasectomy is over 99% effective in preventing pregnancy.
- Low risk: It is a safe procedure with a low risk of complications compared to other permanent sterilization methods.
Simplification
- Simpler for the partner: Relieves the female partner from the potential side effects and responsibilities of hormonal contraceptives or tubal ligation.
Anatomy
Understanding the male sexual anatomy can help with understanding how a vasectomy works. There are a few key terms that a person should know when learning about vasectomy.
Terms
- Vas: The tube that transports sperm from the testes
- Vasectomy: Removal of a small portion of the vas
- Testes: The egg-shaped glands in the scrotum that make sperm and male hormones
- Epididymis: The small gland, outside of the testes, where sperm matures before entering the vas
- Prostate: The gland that makes seminal fluid. When mixed with sperm from the testes, it makes semen
What you need to know
Sperm is produced in the testes.
From there, sperm travels into a small gland that is located just outside of the testes, called the epididymis. It is here that the sperm stays for as long as six weeks to mature.
The tubes of the epididymis join together at the very end of the epididymis to form one common tube called the “vas” or “vas deferens.”
It is the vas that transports the sperm into the body where it enters the prostate gland.
The prostate gland is responsible for making the seminal fluid that carries the sperm.
The sperm from the testes plus the seminal fluid from the prostate join together to make semen. The semen is then ejaculated through the penis.
Types of vasectomy procedures
Conventional vasectomy
- Procedure: Involves one or two small incisions in the scrotum to access the vas deferens. The tubes are then cut, and the ends are either tied, clipped, or sealed with heat (cauterized).
- Stitches: The incisions are closed with stitches.
No-scalpel vasectomy
- Procedure: Instead of making incisions, the surgeon uses a special instrument to make a tiny puncture in the scrotum to access the vas deferens. The tubes are then cut, tied, or sealed as in the conventional method.
- Advantages: Less invasive, typically resulting in less bleeding, a lower risk of infection, and a quicker recovery time.
Open-ended vasectomy
- Procedure: One end of the vas deferens is left open while the other is sealed. This technique is designed to reduce the risk of post-vasectomy pain due to pressure buildup.
- Advantages: May reduce complications related to pain and discomfort in some patients.
The vasectomy surgical process
Preoperative preparation
- Consultation: Comprehensive discussion with the health care provider about the procedure, benefits, risks, and alternatives. The decision should be made with the certainty of not wanting future biological children.
- Medical history and examination: Reviewing the patient’s health history and conducting a physical examination to ensure suitability for the procedure.
- Instructions: Patients may receive specific instructions regarding shaving, cleaning the scrotal area, and avoiding certain medications before the procedure.
In many cases, you can schedule a vasectomy for the same day as the office visit if you know you want to have a vasectomy.
Ready to talk to a urologist?
Urologists at WashU Medicine in St. Louis can help you learn more about vasectomy. You can even schedule an office visit and procedure for the same day if you’re ready.
Schedule an appointment online>>
Call: 314-362-8200
Procedure steps
- Anesthesia: Local anesthesia is administered to numb the scrotal area to ensure the procedure is pain-free.
- Accessing the vas deferens: Depending on the method (conventional or no-scalpel), the surgeon makes an incision or puncture to access the vas deferens.
- Cutting and sealing: The vas deferens is cut, and the ends are tied, clipped, or sealed to prevent sperm from entering the semen.
- Closing the incisions: In conventional vasectomy, the small incisions are closed with stitches, while no-scalpel vasectomy usually does not require stitches.
Duration
- Timeframe: The procedure typically takes about 15-30 minutes.
Post-operative care and recovery
Immediate care
- Rest: Patients are advised to rest for a day or two following the procedure.
- Ice packs: Application of ice packs to the scrotal area to reduce swelling and discomfort.
- Pain management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage any post-operative pain.
Hygiene and activity
- Hygiene: Keeping the surgical area clean and dry to prevent infection. Gentle washing after 24 hours is usually allowed.
- Avoid heavy lifting and physical exertion: Patients should avoid strenuous activities, heavy lifting, and sexual activity for about a week to allow proper healing.
Follow-up and confirmation
- Follow-up visit: A follow-up appointment to check the healing process and address any concerns.
- Semen analysis: Multiple semen tests a few months post-procedure to confirm the absence of sperm in the ejaculate. Until sperm-free semen is confirmed, alternative contraception should be used.
Potential risks and complications
Common risks
- Pain and swelling: Mild pain or discomfort and swelling in the scrotal area, which usually resolves with proper care.
- Bruising: Minor bruising around the scrotum.
Specific complications
- Infection: Risk of infection at the site of the incision or puncture.
- Hematoma: Rare formation of a blood clot inside the scrotum.
- Sperm granuloma: A small lump that can form due to sperm leakage from the cut vas deferens. It is usually harmless and resolves on its own.
Long-term complications
- Chronic pain: Rare cases of persistent pain in the testicles or scrotum.
- Recanalization: Very rare cases where the cut ends of the vas deferens may spontaneously rejoin, leading to the potential for fertility.
Psychological impacts
- Regret: Some individuals may experience regret after the procedure, which highlights the importance of thorough counseling and certainty before undergoing a vasectomy.
Benefits of vasectomy
Effectiveness
- Permanent solution: Provides a permanent form of birth control with a high success rate.
Increased spontaneity
- No need for contraceptive planning: Allows for spontaneous sexual activity without the worry of contraception for birth control, though vasectomy does not protect against STIs.
Health impact
- Minimal impact on sexual health: Does not affect sexual drive, erection, or ejaculation.
Limitations
- Irreversibility: Although vasectomy reversal is possible, it is not always successful and can be complicated and expensive. Doctors recommend that people are absolutely certain they will not want their vasectomy reversed before having the procedure.
- Does not protect against STIs: Vasectomy does not provide protection against sexually transmitted infections (STIs); condom use is still necessary for protection.
A vasectomy is a reliable and effective method of permanent contraception for individuals certain they do not want to father children in the future. Understanding the types, procedure, post-operative care, benefits, and potential risks is essential for informed decision-making. Consulting with a health care provider can help address any concerns and provide personalized advice tailored to your specific needs.
Frequently asked questions about vasectomy
A vasectomy is a minor surgical procedure for male sterilization or permanent contraception. It involves cutting and sealing the vas deferens, the tubes that carry sperm from the testicles to the urethra, to prevent sperm from mixing with semen.
Vasectomy is over 99% effective in preventing pregnancy. It is considered one of the most reliable forms of permanent birth control.
The procedure typically takes about 15-30 minutes.
There are two main types: conventional vasectomy, which involves making small incisions in the scrotum, and no-scalpel vasectomy, which uses a small puncture to access the vas deferens. Both methods involve cutting, tying, or sealing the vas deferens.
No, vasectomies are usually performed under local anesthesia, which numbs the scrotal area while you remain awake.
Vasectomy should be considered a permanent form of contraception. Although reversal procedures are available, they are complex, expensive, and not always successful.
You may experience mild pain, swelling, and bruising in the scrotal area. These symptoms generally resolve with rest, ice packs, and over-the-counter pain relievers.
It is advisable to rest for a day or two after the procedure. Avoid heavy lifting, strenuous activities, and sexual activity for about a week.
Most men can return to work within 1-2 days, particularly if their job is not physically demanding. Be sure to consult with your health care provider about your plan to return to work.
You should wait about a week before resuming sexual activity to allow for proper healing. Be sure to follow any instructions from your health care provider.
No, a vasectomy should not affect your sex drive, ability to have erections, or your sexual performance.
You should continue using alternative contraception until a semen analysis confirms that there are no sperm in your ejaculate, usually after 2-3 months or 15-20 ejaculations.
Yes, you will still produce sperm, but they will be absorbed by the body since they cannot travel through the vas deferens.
No, ejaculation (the fluid released during orgasm) will look and feel the same. The only difference is the absence of sperm in the semen.
The procedure itself is not painful because it is done under local anesthesia. Some discomfort or mild pain may be experienced during recovery.
Follow your health care provider’s instructions, which may include shaving the scrotal area, cleaning the area thoroughly, and avoiding certain medications before the procedure.
The cost of a vasectomy can vary depending on the health care provider, location, and insurance coverage. It is generally considered an affordable and cost-effective contraceptive option.
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. Urologic surgeons at WashU Medicine answer questions about vasectomy and vasectomy reversal.
