What is Vasectomy

Vasectomy is a procedure in which the tube that carries sperm from the testicle to the urethra (vas deferens) is tied. It may also be cut. The procedure blocks sperm from going through the vas deferens and penis during ejaculation. This ensures that sperm does not go into the vagina during sex. Vasectomy does not affect your sexual desire or performance, and does not prevent sexually transmitted diseases.

Vasectomy is considered a permanent and very effective form of birth control (contraception). The decision to have a vasectomy should not be made during a stressful situation, such as after the loss of a pregnancy or a divorce. You and your partner should make the decision to have a vasectomy when you are sure that you do not want children in the future.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding and swelling of the scrotum.
• Allergic reactions to medicines.
• Failure of the procedure to prevent pregnancy. There is a very small chance that the cut ends of the vas deferens may reconnect (recanalization), meaning that you could still make a woman pregnant.
• Pain in the scrotum that continues after healing from the procedure.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• You may be asked to shower with a germ-killing soap.
• Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your scrotum will be washed with soap.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative). You may be instructed to take this a few hours before the procedure.
  • A medicine to numb the area (local anesthetic).
• Your health care provider will feel (palpate) for your vas deferens.
• To reach the vas deferens, one of two methods may be used:
  • A very small incision may be made in your scrotum.
  • A punctured opening may be made in your scrotum, without an incision.
• Your vas deferens will be pulled out of your scrotum, and may be:
  • Tied off.
  • Cut and possibly burned (cauterized) at the ends to seal them off.
• The vas deferens will be put back into your scrotum.
• The incision or puncture opening will be closed with absorbable stitches (sutures). The sutures will eventually dissolve and will not need to be removed after the procedure.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You will be monitored to make sure that you do not experience problems.
• You will be asked not to ejaculate for at least 1 week after the procedure, or as long as directed.
• You will need to use a different form of contraception for 2–4 months after the procedure, until you have test results confirming that there are no sperm in your semen.
• You may be given scrotal support to wear, such as a jock strap or underwear with a supportive pouch.
• Do not drive for 24 hours if you were given a sedative to help you relax.

Summary

• Vasectomy is considered a permanent and very effective form of birth control (contraception). The procedure prevents sperm from being released during ejaculation.
• Your scrotum will be numbed with medicine (local anesthetic) for the procedure.
• After the procedure, you will be asked not to ejaculate for at least 1 week, or for as long as directed. You will also need to use a different form of contraception until your health care provider examines you and finds that there are no sperm in your semen.

Vasectomy: What to Expect

How is a vasectomy done?

A vasectomy is usually done in your doctor’s office or in an outpatient surgery center. The operation takes about one half hour. You’ll be awake during the procedure. Your doctor will give you a local anesthetic to numb your scrotum.

After you’re numb, your doctor will make a very small puncture (hole) on one side of your scrotum and pull out part of the vas deferens on that side. You may feel some tugging and pulling. A small section of the vas deferens is removed. The ends of the vas deferens will be sealed with small clamps. Your doctor will then do the same thing on the other side.

The puncture is so small that it heals without stitches.

How effective is a vasectomy in preventing pregnancy?

Vasectomy may be the safest, most effective kind of birth control. Only about one or two out of 1,000 couples get pregnant the first year after a vasectomy.

Are there any reasons I shouldn’t have a vasectomy?

Don’t have a vasectomy unless you’re absolutely sure you don’t want to have children in the future. You may need to wait to have a vasectomy, or may not be able to have one, if you have an infection on or around your genitals or if you have a bleeding disorder.

Can a vasectomy be reversed?

Some vasectomies can be undone, or “reversed,” but the surgery is difficult, expensive, and must be performed in a hospital.

How should I prepare for the operation?

On the day of the procedure, bring a jockstrap (an athletic supporter) with you and make sure your genital area is clean. Your doctor may give you instructions on how to clean the area before you come in. Your doctor may suggest you bring someone to drive you home after surgery.

What can I expect after the operation?

You may have some pain, swelling, and bruising in the area of the surgery. The bruises should slowly lighten and be gone in about two weeks. Your doctor will give you instructions to follow after surgery. The instructions may include:

You should feel back to normal within a couple of weeks.

• Wearing tight-fitting underwear or a jock strap to support your scrotum
• Using an ice pack to help with the pain and swelling
• Getting plenty of rest
• Limiting yourself to light activity until you heal

Is it okay to take medicine?

Don’t take aspirin, ibuprofen (brand names: Advil, Motrin, Nuprin), ketoprofen (brand name: Orudis), or naproxen (brand name: Aleve) for one week before the procedure. All of these can thin your blood and increase bleeding. Ibuprofen and naproxen can be taken after the procedure, but you shouldn’t take aspirin for another week. You can also try acetaminophen (brand name: Tylenol) to relieve pain.

When can I go back to work?

If you have a desk job, expect to return to work after a couple of days. If you do physical labor, or walk or drive a lot, talk with your doctor about when you can go back to work.

Will the vasectomy work right away?

No. You’ll need to ejaculate as many as 15 to 20 times or wait up to three months before the sperm will be cleared from both of the vas deferens. For that reason, keep using birth control. Your doctor will ask you to bring in samples of your ejaculation two or three months after the procedure. Only after you have a sperm-free sample will you be considered unable to get a woman pregnant.

What are the risks of a vasectomy?

Problems that might occur after your vasectomy include bleeding, infection, and a usually mild inflammatory reaction to sperm that may have gotten loose during the surgery (called sperm granuloma).

Another risk is that the ends of the vas deferens may find a way to create a new path to one another. This doesn’t occur very often. But if it does, you could be able to get a woman pregnant.

Call your doctor if:

• You have a fever.
• You have swelling that won’t go down or keeps getting worse.
• You have trouble urinating.
• You can feel a lump forming in your scrotum.
• You have bleeding from an incision that doesn’t stop even after you’ve pinched the site between two gauze pads for 10 minutes.

What happens to the sperm?

Once sperm can’t get through the vas deferens, your testicles will begin making fewer sperm. Your body will absorb the sperm that are made.

Will a vasectomy affect my sex life?

After you have healed from the vasectomy, your sex life shouldn’t change at all. You’ll still ejaculate almost the same amount of semen as you did before, and you won’t notice a change in your sex drive.

Care After Vasectomy

Here is the information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After your procedure, it is common to have:

• Mild pain, swelling, redness, or discomfort in your scrotum.
• Some blood coming from your incisions or puncture sites for one or two days.
• Blood in your semen.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Avoid taking NSAIDs such as aspirin and ibuprofen, because these medicines can make bleeding worse.

Activity

• For the first 2 days after surgery, avoid physical activity and exercise that require a lot of energy. Ask your health care provider what activities are safe for you.
• Do not participate in sports or perform heavy physical labor until your pain has improved, or until your health care provider says it is okay.
• Do not ejaculate for at least 1 week after the procedure, or as long as directed.
• You may resume sexual activity 7–10 days after your procedure, or when your health care provider approves. Use a different method of birth control (contraception) until you have had test results that confirm that there is no sperm in your semen.

Scrotal support

• Use scrotal support, such as a jock strap or underwear with a supportive pouch, as needed for one week after your procedure.
• If you feel discomfort in your scrotum, you may remove the scrotal support to see if the discomfort is relieved. Sometimes scrotal support can press on the scrotum and cause or worsen discomfort.
• If your skin gets irritated, you may add some germ-free (sterile), fluffed bandages or a clean washcloth to the scrotal support.

General instructions

• Put ice on the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Check your incisions or puncture sites every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Leave stitches (sutures) in place. The sutures will dissolve on their own and do not need to be removed.
• Keep all follow-up visits as told by your health care provider. This is important because you will need a test to confirm that there is no sperm in your semen. Multiple ejaculations are needed to clear out sperm that were beyond the vasectomy site. You will need one test result showing that there is no sperm in your semen before you can resume unprotected sex. This may take 2–4 months after your procedure.
• Do not drive for 24 hours if you were given a sedative to help you relax.

Contact a health care provider if:

• You have redness, swelling, or more pain around your incision or puncture site, or in your scrotum area in general.
• You have bleeding from your incision or puncture site.
• You have pus or a bad smell coming from your incision or puncture site.
• You have a fever.
• Your incision or puncture site opens up.

Get help right away if:

• You develop a rash.
• You have difficulty breathing.

Summary

• After your procedure it is common to have mild pain, swelling, redness, or discomfort in your scrotum.
• Avoid physical activity and exercise that requires a lot of energy for the first 2 days after surgery.
• Put ice on the injured area. Leave the ice on for 20 minutes, 2–3 times a day.
• Do not drive for 24 hours if you were given a sedative to help you relax.