A vasectomy is a simple and usually permanent form of birth control. It is the most effective method of contraception aside from abstinence. During the brief procedure, a surgeon cuts and seals the vas deferens, the tubes that carry sperm from the testicles to the semen. This prevents sperm from entering the semen during ejaculation. Without sperm leaving the body, you cannot fertilize your partner’s egg. You can still have orgasms and ejaculate normally. A vasectomy only prevents pregnancy and does not protect you or your partner from sexually transmitted infections (STIs).
About 500,000 people in the United States choose to have a vasectomy each year. Both vasectomy and tubal ligation are surgical procedures for permanent birth control. Tubal ligation involves cutting and tying the fallopian tubes to prevent eggs from traveling through them, so sperm cannot reach and fertilize them. The key difference is that a vasectomy is a much simpler procedure. Most vasectomies are done on an outpatient basis using local anesthesia, with relatively easy and quick recovery, low risk of complications, and much lower cost. Tubal ligation is a hospital-based surgery requiring general anesthesia. It is more complex, significantly more expensive, longer recovery time, and carries a higher risk of complications.
Before getting a vasectomy, you should speak with your doctor. It is permanent. Although there is a procedure to reverse a vasectomy or retrieve sperm for use in in vitro fertilization, these are not always successful and can be costly. Therefore, you should be certain you do not want children (or more children, if you are already a parent) before scheduling the procedure. It does not make you immediately sterile. It usually takes about two to four months for your semen to become sperm-free. To ensure you and your partner do not get pregnant, you need to use another form of birth control or avoid sex until a post-vasectomy semen analysis confirms no sperm are present. It is not always 100% effective. No form of birth control is foolproof, including vasectomy. Avoid ejaculation for about a week after the procedure. This is necessary for proper healing.
Most vasectomies are performed by urologists. Urologists are doctors who specialize in diagnosing and treating conditions of the urinary tract and reproductive organs, including the kidneys, bladder, urethra, and male reproductive system.
Since blood thinners may increase the risk of bleeding, your doctor will likely instruct you to stop taking them at least 7 days before the procedure. Examples include aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve), clopidogrel (Plavix), oral anticoagulants like dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), and edoxaban (Savaysa, Lixiana), ticlopidine (Ticlid), and warfarin (Coumadin). Your doctor may ask you to shave all hair from your scrotum the night before or the morning of surgery. Alternatively, they may shave and clean the area just before the procedure. Take any medications your surgeon prescribes in preparation for the vasectomy. Bring supportive athletic shorts and compression underwear to wear after the surgery. You can usually eat before the procedure, but it should be a light or liquid meal.
Each testicle has a tube called the vas deferens that carries sperm to the semen. During a vasectomy, the vas deferens are tied, cut, clipped, or sealed to prevent sperm from entering the semen. With no sperm in the semen, you cannot fertilize an egg, thus preventing pregnancy.
There are two main types. In a conventional vasectomy, the doctor makes one or two small incisions in the scrotum to access both vas deferens. A small section of each tube is removed, leaving a small gap between the ends. The ends are then sealed by cauterization (burning), clamping, or tying. You may receive dissolvable stitches to help healing, or the incisions may heal without them. In a no-scalpel vasectomy, the doctor locates each vas deferens under the scrotal skin and holds it in place with a clamp. A small puncture is made in the skin, which is stretched open. Each vas deferens is pulled through, cut, and sealed or tied, then returned to its original position. This method typically results in less bleeding, fewer complications, and faster healing.
Like tubal ligation in women and people assigned female at birth (AFAB), a vasectomy is a one-time procedure that provides permanent contraception. However, it offers several advantages over tubal ligation. It is highly effective (over 99.99% effective at preventing pregnancy when successful). It is a much simpler procedure since the testicles and vas deferens are externally accessible. General anesthesia is not required, and recovery is relatively easy. It can be done on an outpatient basis. It has a lower risk of complications. It is significantly less expensive.
The rate of accidental pregnancy after vasectomy is about 0.1% per year. A vasectomy is more effective than other male or people assigned male at birth (AMAB) birth control methods such as condoms and withdrawal. For example, condoms have an accidental pregnancy rate of about 15%-20% per year, and withdrawal has a rate of about 25%-30% per year. However, it does not work immediately. Some sperm remain in the semen and may take about two to three months to clear. While you can resume sexual activity within days, you should continue using another form of birth control until a semen analysis confirms no sperm are present. This test is usually scheduled around three months after the vasectomy, though timelines vary, and it may take longer for your semen to be completely clear of sperm. The failure rate of vasectomy is less than 1%, or about 1 in 10,000 procedures. In rare cases, sperm may still cross the separated ends of the vas deferens, potentially leading to pregnancy.
Vasectomies are generally very safe, but like any surgery, there are some risks. Many people experience no side effects. If they do occur, they are usually mild and temporary, including bleeding or bruising in the scrotum, mild pain or discomfort, blood in the semen, infection at the incision site, and swelling. Many people worry about how a vasectomy might affect their sex life and overall health. However, aside from preventing pregnancy, it typically has little to no impact. It is not severely painful. You may feel some discomfort during or after the procedure, but severe pain is rare. It does not lower your testosterone levels. It does not reduce your libido, erectile function, or ability to orgasm. It does not affect the volume or quality of your semen. It does not increase your risk of prostate cancer or testicular cancer. It does not increase your risk of heart disease.
Most people return to work within a few days. However, if your job is physically demanding, your doctor may recommend taking a full week off. In general, you should take it easy for two to three days before resuming normal daily activities. Wait longer before engaging in strenuous activities such as sports or heavy lifting. If unsure, discuss your routine with your doctor to determine when you can safely return to your preferred activities. Most people report feeling fully recovered within about eight to nine days.
Your doctor may ask you to wear a bandage on your scrotum and supportive, tight-fitting underwear for several days after surgery. You can apply an ice pack or a sealed bag of frozen vegetables intermittently for about 5–10 minutes at a time to help reduce swelling. Watch for signs of infection. Call your doctor if you experience blood draining from the surgical site, fever above 100.4°F (38°C), increasing redness, or pain and swelling that worsen instead of improve. Generally, you can shower the day after surgery. However, you should avoid baths or swimming for about two weeks. Do not rub the area dry. Gently pat your scrotum with a towel to avoid tearing stitches or damaging the skin. Your doctor may advise waiting about a week before resuming sexual activity. Be sure to use another form of birth control until your semen is tested and confirmed to be free of sperm. This test is usually done about two to three months after the procedure.
Your doctor will test your semen about three months after the procedure (or after about 20 ejaculations) to check for the presence of sperm. About 1% of people still have sperm in their semen and may need more time for it to clear. Do not assume your vasectomy is effective until the test confirms no sperm. Continue using backup contraception until the analysis comes back clear. If sperm are still present after several months, you may need a second vasectomy.
Serious complications are rare, and when they do occur, they are usually minor. Possible complications include dull pain caused by fluid buildup in the testicle, sperm granuloma (a hard lump caused by inflammation from leaking sperm), spermatocele (a cyst in the tube that collects sperm), and hydrocele (a fluid-filled sac around the testicle that causes scrotal swelling). If you have a conventional vasectomy, there may be a small scar at the incision site. This is usually barely noticeable. A no-scalpel vasectomy typically results in little to no scarring. About 1%–2% of people who have a vasectomy continue to experience pain. This is called post-vasectomy pain syndrome and causes a dull ache in the testicles. The pain may start right after surgery or months or even years later. It may be constant or come and go. The exact cause is not well understood. Your doctor may suggest pelvic floor exercises (Kegels) to help relieve symptoms. They may also recommend pain relievers such as NSAIDs, gabapentin, or antidepressants. Complementary approaches like acupuncture or biofeedback may also help. If these do not work, a reversal procedure or other surgery may relieve the pain. Surgery helps about 90% of people, but it may restore fertility.
The cost of a vasectomy varies depending on factors such as your insurance type, coverage, and location. Many health insurance plans cover the procedure, as does Medicaid if you qualify. Your plan may cover the full cost, including follow-up tests. Discuss costs with your doctor and check with your insurer about what is covered. Estimated costs range from about $1,000 to $3,000. A vasectomy can often be reversed, but the procedure is complex and may not succeed. The chance of a successful reversal decreases the longer it has been since the vasectomy. Reversal is successful about 60%–95% of the time. However, success rates decline after about 15 years. Insurance typically does not cover reversal, so you may have to pay out of pocket. Estimates range from $6,000 to $16,000, depending on the type of reversal procedure.
A vasectomy is one of the most effective forms of birth control. It is a safe and quick procedure with few complications. While it can sometimes be reversed, there is no guarantee of restored fertility. Make sure you do not want to become a parent before getting a vasectomy.
No. You still need to use condoms to best protect against HIV and other STIs. Research has produced mixed results. The American Cancer Society notes that some studies suggest a slightly higher risk of prostate cancer after a vasectomy, while others have found no link. The most recent evidence indicates that vasectomy does not increase the risk of prostate cancer and should not be a reason to avoid the procedure.
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