Vasectomy

What Is It?

A vasectomy is a minor surgical procedure that is done to make a man sterile (unable to father children). A vasectomy works by cutting or blocking the vas deferens, the tube that carries sperm away from the testicles to be added to the liquid components of semen. Once the vas deferens is cut or blocked, sperm cannot pass out of the body. After a vasectomy, a man can continue to have normal sexual intercourse with ejaculation of semen, but this sperm-free semen cannot make his sexual partner pregnant.

About 500,000 vasectomies are performed each year in the United States. This procedure usually takes only 15 to 20 minutes, and almost all vasectomies are done in a doctor’s office or outpatient operating room.

A vasectomy is intended to produce permanent sterilization. Special microsurgery can reverse a vasectomy and restore fertility in some cases. However, this delicate procedure is expensive and is successful in only about 70 percent of cases. If you have even the slightest doubt about ending your chances for future fatherhood, then you should consider using another form of birth control. Although a husband does not need his wife’s consent to have this surgery, it is appropriate for him to discuss his vasectomy with her beforehand.

What It’s Used For

A vasectomy is used for male sterilization. Following a vasectomy, a man can continue to have sexual intercourse, but he will not be able to father children.

Preparation

Because vasectomy is almost always an outpatient procedure that is done with local anesthesia, no special dietary restrictions or preoperative tests are required. If for some special reason your vasectomy must be done under general anesthesia (you are unconscious during the procedure), your doctor will tell you not to eat or drink for a specific amount of time beforehand.

How It’s Done

After a local anesthetic is used to numb the area where the procedure will be done, the vasectomy is performed using one of two methods:

•Traditional vasectomy – Using a scalpel, the surgeon makes one or two small incisions (cuts) in the skin of the scrotum near the base of the penis (one incision to reach the vas deferens from each testicle). Once the vas deferens is exposed, it is cut or blocked in some way. Options include cutting the vas and tying the two ends, burning the vas with a hot tool, or blocking the vas with surgical clips. The two small incisions in the scrotum are then closed with three or four small sutures (stitches).
• No-scalpel vasectomy – In this less-invasive approach, only tiny incisions are necessary. The surgeon makes one or two punctures to access the vas deferens. The puncture is widened slightly, then the surgeon cuts or blocks each vas deferens. The puncture site can be covered with a tiny dressing. No sutures are needed.

Follow-Up

After your vasectomy, you may feel some mild discomfort in the area. This usually can be relieved with an athletic support, an ice pack and nonprescription pain medication. Many men choose to avoid strenuous activity for two to three days to lessen their discomfort. Your doctor also may advise you to abstain from sex for several days.

After your vasectomy, it will take from one to six months for all living sperm to pass out of your reproductive tract. Therefore, you will need to use a reliable form of birth control until your doctor confirms that you are sterile. This will be done by checking a semen sample for the presence of moving sperm. Your doctor will tell you when your semen is sperm-free.

Risks

Most men recover from a vasectomy without any problems. Occasionally, minor complications can occur, including infections, bleeding, bruising or swelling. A few men will develop fluid accumulation near the testicle or a small pocket of sperm under the skin. Rarely, the vasectomy will fail to produce complete sterilization, and repeat surgery will be needed.

A few older studies have raised the concern that vasectomy could increase a man’s risk of prostate cancer. However, recent research has failed to demonstrate any relationship between prostate cancer and vasectomy.

When To Call A Professional

After vasectomy, call your doctor immediately if:

• You develop a fever
• Your vasectomy site leaks blood or pus
• You develop significant pain or swelling at the vasectomy site

Although a vasectomy should not interfere with a man’s sexuality, a few men experience psychological difficulties that affect sexual performance. If this happens to you, don’t be embarrassed to discuss the situation with your doctor.