Vasectomy
Vasectomy is an effective birth control procedure that helps prevent over 99.99 percent of pregnancies.

A vasectomy is a form of male contraception that prevents sperm from reaching your semen. To accomplish this, the tubes (vas deferens) that carry sperm are cut and sealed.

Vasectomy has a low risk of complications and is frequently done under local anesthesia in an outpatient setting.

  • According to the American Urological Association (AUA), 500,000 men in the United States undergo a “little snip” or vasectomy.
  • Puneet Masson, MD, Director of the Male Fertility Program at Penn Medicine reported that male sterilization with vasectomies is the fourth most popular form of birth control in the United States.

What is a vasectomy?

A vasectomy is a surgical procedure that permanently prevents sperm from leaving your body, giving long-term birth control (contraception). The treatment seals off the ends of the sperm-transporting vas deferens. Although a vasectomy is a safe and reliable method of preventing conception, it does not offer any disease protection.

A vasectomy has a very low failure rate.

Sperm can pass the vas deferens after vasectomy in about 1 in 10,000 cases. Semen samples are frequently examined following a vasectomy to ensure that the treatment is effective. You might need another vasectomy if your semen samples continue to contain sperm.

There are three types of vasectomy:

  1. Conventional vasectomy: To access the vas deferens, small cuts are performed on either side of the scrotum.
  2. No scalpel vasectomy: This method is used with only a tiny skin incision. Using a tool to gently widen the skin opening enables access to the vas deferens. Due to the lack of incisions, there is minimal bleeding, and are no stitches. Because the wound heals quickly, scarring is minimal or nonexistent.
  3. Vas clip vasectomy: The vas deferens will be revealed using one of the two ways. Special clips will be used to encircle each vas deferens and are then tightened. Once the clamps are in place, sperm flow will be stopped.

How is a vasectomy performed?

Vasectomies are often carried out in a clinic or doctor's office. During your initial appointments with your urologist, your doctor will discuss whether you require full sedation for the procedure.

  • For most vasectomies, local anesthesia is used to numb the surgical site. However, general anesthesia could be used in more complex cases.
  • Your doctor will recommend you avoid aspirin, blood thinners, and nonsteroidal anti-inflammatory drugs, such as ibuprofen, for at least 48 hours before the procedure to reduce your chance of bleeding. When taking any medications, you should always discuss them with your doctor.
  • Before surgery, your scrotum will be shaved and washed with an antiseptic solution. If a local anesthetic is being used, it will be injected to numb the area and reduce any extreme discomfort.
  • Your doctor will make a small incision on each side of your scrotum to remove the vas deferens, the tube via which sperm travels from the testicles to the urethra. The doctor divides the vas deferens into two tubes, joins the ends of each tube, and then, inserts them back into the scrotum. Scrotal wounds are either sutured shut or allowed to heal naturally.
  • After the treatment, many people go back to their homes. It is typical to experience some soreness for a couple of days. You can get relief by taking over-the-counter medications, such as Motrin, Aleve, or Tylenol. Applying an ice pack for 20 minutes at a time can help to reduce swelling and pain. For one to two weeks, it is advised to use a jockstrap or scrotal support to elevate the scrotum.
  • After the surgery, stay away from sexual activity and ejaculating for a week. Use backup birth control for at least 12 weeks or longer after you start having sex depending on your doctor's advice. Most men can return to work the next day, but you should avoid physically demanding activities for about a week, such as running and strength training.

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What are the risks of a vasectomy?

Although a vasectomy is relatively safe, all surgeries have some risks.

The following are possible risks of vasectomy:

  • Sperm granuloma is a painful lump under the skin caused by an inflammatory response to sperm that spill during surgery.
  • After a vasectomy, epididymitis or orchitis (painful, swollen, and tender epididymis or testis) may develop. This typically happens within the first year following surgery.
  • Infection
  • Rarely, the vas deferens may knit itself back together. This might result in an unintended pregnancy.
  • Long-lasting discomfort following surgery.
  • Hemorrhage, edema, and bruising, which subside quickly.

What are the benefits of vasectomy?

Vasectomy is a very effective birth control procedure. It helps prevent over 99.99 percent of pregnancies. A vasectomy, which is a one-time treatment that provides permanent contraception, is like tubal ligation in females.

Compared to tubal ligation, a vasectomy is the following:

  • Easier
  • More effective
  • Can be done without hospitalization
  • Less complicated (is safer for you)
  • Significantly more affordable

Therefore, if you are deciding between tubal ligation and vasectomy, vasectomy is superior in many aspects.

Is a vasectomy reversible?

A vasectomy usually has a permanent effect. Although re-joining the vas tubes is occasionally achievable, it does not always mean you will be able to have future children. As time passes following the procedure, the likelihood of success declines.

If you have had a vasectomy and wish to have additional kids, you might be able to have your sperm extracted directly from your testicles for assisted reproductive procedures, such as in vitro fertilization.

If you have not had a vasectomy but believe you might desire children in the future, you can ask to have some sperm stored. Before scheduling the procedure, discuss it with your doctor.

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Medically Reviewed on 11/2/2022
References
Image Source: iStock image

Vasectomy. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/vasectomy

Vasectomy. https://my.clevelandclinic.org/health/treatments/4423-vasectomy

Vasectomy: Safe, effective, affordable birth control for men. https://utswmed.org/medblog/vasectomy-birth-control/

Vasectomy: How it Works. https://med.virginia.edu/urology/for-patients-and-visitors/mens-health/vasectomy-how-it-works/

Vasectomy. https://www.mayoclinic.org/tests-procedures/vasectomy/about/pac-20384580

7 Things You Didn’t Know About Vasectomies. https://www.pennmedicine.org/updates/blogs/health-and-wellness/2019/march/7-things-about-vasectomies