Vasectomy

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  What Is Vasectomy?

  Vasectomy is a form of birth control for men that is meant to be permanent.

  During vasectomy, a health care provider closes or blocks the tubes that carry sperm. When the tubes are closed, sperm cannot leave a man's body and cause pregnancy.

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  How Does Vasectomy Work?

  Sperm are made in the testicles. They pass through two tubes called the vasa deferentia to other glands and mix with seminal fluids to form semen. Vasectomy blocks each vas deferens and keeps sperm out of the seminal fluid. The sperm are absorbed by the body instead of being ejaculated. Without sperm, your "cum" (ejaculate) cannot cause pregnancy.

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  How Effective Is Vasectomy?

  Effectiveness is an important and common concern when choosing a birth control method. Vasectomy is the most effective birth control for men. It is nearly 100 percent effective.

  However, vasectomy is not immediately effective. Sperm remains beyond the blocked tubes. You must use other birth control until the sperm are used up. It usually takes about three months. A simple test — semen analysis — shows when there are no more sperm in your ejaculate.

  How Is Semen Analysis Done? You will provide a sample of your semen by masturbating or by using a special condom during sexual intercourse. The semen will be examined under a microscope to see if there are any sperm.

  Very rarely, tubes grow back together again and pregnancy may occur. This happens in about 1 out of 1,000 cases.

  Keep in mind that vasectomy offers no protection against sexually transmitted infection. Sexually transmitted infections can be carried in ejaculate, whether or not it contains sperm. Latex or female condoms can reduce your risk of infection.

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  What Are the Types of Vasectomy?

  There are different ways for men to be sterilized. One type does not require an incision — a cut. The other types of vasectomy require an incision. Incision methods take about 20 minutes. The no-incision method takes less time.

  INCISION METHODS

  Usually, a local anesthetic is injected into the pelvic area. Then, the doctor makes an incision on each side of the scrotum to reach each vas deferens — the tubes that carry sperm. Sometimes a single incision is made in the center. Each tube is blocked. In most procedures, a small section of each tube is removed. Tubes may be tied off or blocked with surgical clips. Or, they may be closed using an instrument with an electrical current.

  NO-INCISION METHOD

  With the no-incision ("no-scalpel") method, the skin of the scrotum is not cut. One tiny puncture is made to reach both tubes. The tubes are then tied off, cauterized, or blocked. The tiny puncture heals quickly. No stitches are needed, and no scarring takes place.

  The no-scalpel method reduces bleeding and decreases the possibility of infection, bruising, and other complications.

   

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  How Safe Is Vasectomy?

  Most men can have a vasectomy safely. But like any medical procedure, there are risks. Talk with your health care provider about whether vasectomy is likely to be safe for you.

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  What Are the Benefits of Vasectomy?

  Vasectomy is safe and, because it lasts for life, it is simple and convenient. It allows women and men to enjoy sex without worrying about pregnancy.

  Vasectomy does not change your hormones or masculinity. And it will not affect your ability to get and stay erect. It also will not affect your sex organs, sexuality, and sexual pleasure. No glands or organs are removed or altered. Your hormones and sperm continue being produced. Your ejaculate will look just like it always did. And there will be about the same amount as before.

  Vasectomy may be right for you if

  • You want to enjoy having sex without causing pregnancy.
  • You don't want to have a child biologically in the future.
  • Other methods are unacceptable.
  • You don't want to pass on a hereditary illness or disability.
  • Your partner's health would be threatened by a future pregnancy.
  • You and your partner have concerns about the side effects of other methods.
  • You and your partner agree that your family is complete, and no more children are wanted.
  • You want to spare your partner the surgery and expense of tubal sterilization — sterilization for women is more complicated and costly.

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  What Are the Disadvantages of Vasectomy?

  Vasectomy may not be a good choice for you if you

  • may want to have a child biologically in the future
  • are being pressured by a partner, friends, or family
  • want to use it to solve problems that may be temporary — such as marriage or sexual problems, short-term mental or physical illnesses, financial worries, or being out of work

  Considering Other Birth Control Options It is important to consider other methods before you choose vasectomy, like condoms, outercourse, withdrawal, and abstinence. Women have other options. IUDs and the implant are as effective as vasectomy, simple to use, offer long-term protection, but are not permanent.

  You should consider any possible life changes, such as divorce, remarriage, or death of children. You don't need your partner's permission to have a vasectomy, but it may be helpful to discuss it with your partner or anyone else who could be part of the decision-making process.

  Saving Sperm in Sperm Banks If you're thinking of getting a vasectomy and banking sperm just in case you change your mind, vasectomy may not be the best choice for you. Sperm banks collect, freeze, and thaw sperm for alternative insemination. However, some men's sperm do not survive freezing. And it is generally easier for a woman to get pregnant with fresh sperm than frozen sperm.

   

  Can Vasectomy Be Reversed? If you are thinking about reversal, vasectomy may not be right for you. Sometimes it is possible to reverse the operation, but there are no guarantees. Reversal involves complicated surgery and costs thousands of dollars. Success in restoring fertility is uncertain. The success of reversal surgery depends on the length of time since the vasectomy was performed whether or not antibodies to sperm have developed the method used for vasectomy and the length and location of the segments of vas deferens that were removed or blocked

   

  Possible Risks of Vasectomy

  There are risks with any medical procedure, including vasectomy. Major complications with vasectomy are rare and are usually caused by infection.

  Complication rates for vasectomy are generally lower for the no-incision method than for methods that include cutting the skin.

  After you've had a vasectomy, look for signs of infection:

  • a fever over 100° F
  • blood or pus oozing from the site of the incision
  • excessive pain or swelling

  See a health care provider if you have signs of infection. You may need an antibiotic.

  Other potential problems include

  • bruising, which usually clears up on its own
  • hematomas — swellings that contain blood. They usually clear up by themselves, or with bed rest or ice packs. In rare cases, they need to be drained by a health care provider.
  • hydroceles — swellings that contain fluid and tenderness near the testicles. They usually clear up in about a week. Applying heat and wearing an athletic supporter can help. In rare cases, they need to be drained with by a health care provider.
  • granuloma — sperm that leaks from the tubes and causes a small lump under the skin near the site of the surgery. This usually clears up by itself. Surgical treatment is sometimes required.
  • pain or discomfort in the testicles. This is usually temporary, but in about 2 out of 100 cases the pain may be chronic and severe. Most of the time, pain is relieved by taking anti-inflammatory drugs or other medications. Very rarely, an injection called a spermatic cord block can be used to deaden the pain temporarily. Vasectomy reversal is very rarely needed to relieve pain permanently.
  • Very rarely, the cut ends of a tube grow back together. This most often happens within four months of the operation and may allow pregnancy to happen.
  • Decreased sexual desire or an inability to have an erection occurs in 4 out of 1,000 cases. The most likely cause is emotional — there is no physical cause for sexual dysfunction associated with vasectomy.

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  What Are the Risks of Vasectomy?

  Major complications with vasectomy are rare and are usually caused by infection.

  Complication rates for vasectomy are generally lower for the no-incision method than for methods that include cutting the skin.

  After you've had a vasectomy, look for signs of infection:

  • a fever over 100° F
  • blood or pus oozing from the site of the incision
  • excessive pain or swelling

  See a health care provider if you have signs of infection. You may need an antibiotic.

  Other potential problems include

  • bruising, which usually clears up on its own
  • hematomas — swellings that contain blood. They usually clear up by themselves, or with bed rest or ice packs. In rare cases, they need to be drained by a health care provider.
  • hydroceles — swellings that contain fluid and tenderness near the testicles. They usually clear up in about a week. Applying heat and wearing an athletic supporter can help. In rare cases, they need to be drained with by a health care provider.
  • granuloma — sperm that leaks from the tubes and causes a small lump under the skin near the site of the surgery. This usually clears up by itself. Surgical treatment is sometimes required.
  • pain or discomfort in the testicles. This is usually temporary, but in about 2 out of 100 cases the pain may be chronic and severe. Most of the time, pain is relieved by taking anti-inflammatory drugs or other medications. Very rarely, an injection called a spermatic cord block can be used to deaden the pain temporarily. Vasectomy reversal is very rarely needed to relieve pain permanently.
  • Very rarely, the cut ends of a tube grow back together. This most often happens within four months of the operation and may allow pregnancy to happen.
  • Decreased sexual desire or an inability to have an erection occurs in 4 out of 1,000 cases. The most likely cause is emotional — there is no physical cause for sexual dysfunction associated with vasectomy.

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  Does Vasectomy Hurt?

  Your health care provider will give you medicine to make it as comfortable as possible. Numbing medication and/or sedatives will be used. The choice depends on your health and the method of sterilization being used. Conscious sedation allows you to be awake but deeply relaxed. Local anesthesia blocks the feeling of pain in a certain area of your body. It is much safer than general anesthesia.

  General anesthesia is entirely painless. It allows you to sleep through the procedure.

  When you get local anesthesia, you may feel brief discomfort. You may also feel some pain when the tubes are brought out through the incision.

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  How Will I Feel After Vasectomy?

  As with any surgery, there's some discomfort after the operation. It will be different for each man. However, most men say the pain is "slight" or "moderate" and not "excessive." An athletic supporter, ice bag, and non-aspirin pain reliever may help ease the pain. Avoid strenuous physical work or exercise for about a week. There seems to be less pain associated with no-incision procedures.

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  How Long Does Recovery Take After Vasectomy?

  That depends on your general health and lifestyle. Most men lose little or no time from work. A few need a day or two to rest. You will have to avoid strenuous work or exercise for about a week.

  Rare complications may require more days at home. However, prompt medical attention usually clears up any problems.

  For most men, sexual activity can begin again within a week. Others have sex sooner. Some wait longer. But remember, after the procedure, it takes about three months to clear sperm out of your system. Use another form of birth control for vaginal intercourse until a semen analysis shows there are no longer any sperm in your seminal fluid.

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  How Do I Get a Vasectomy? How Much Does a Vasectomy Cost?

  If you are interested in getting a vasectomy, talk with a health care provider. Contact your local Planned Parenthood health center, your family doctor, a local hospital, a local public health department, or a urologist. A vasectomy can be performed in a medical office, hospital, or clinic.

  Nationwide, the cost of a vasectomy ranges from $350–$1,000, including the follow-up sperm count. (Sterilization for women costs up to six times as much.) Some clinics and doctors use a sliding scale according to income.

  There may be state or federal requirements for sterilization, such as age restrictions or waiting periods. Ask if there are any restrictions when you make an appointment.

  Planned Parenthood works to make health care accessible and affordable. Some health centers are able to charge according to income. Most accept health insurance. If you qualify, Medicaid or other state programs may lower your health care costs. 
  
  Call your local Planned Parenthood health center to get specific information on costs.

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