A vasectomy is considered a permanent method of birth control. A vasectomy prevents the release of sperm when a man ejaculates. During a vasectomy, the vas deferens from each testicle is clamped, cut, or otherwise sealed. This prevents sperm from mixing with the semen that is ejaculated from the penis. An egg cannot be fertilized when there are no sperm in the semen. The testicles continue to produce sperm, but the sperm are reabsorbed by the body. This also happens to sperm that are not ejaculated after a while, regardless of whether you have had a vasectomy. Because the tubes are blocked before the seminal vesicles and prostate, you ejaculate about the same amount of fluid. A vasectomy is a permanent method of birth control. Only consider this method when you are sure that you do not want to have a child in the future. Vasectomy is a very effective (99.85%) birth control method. Only 1 to 2 women out of 1,000 will have an unplanned pregnancy in the first year after their partner has had a vasectomy.
It usually takes several months after a vasectomy for all remaining sperm to be ejaculated or reabsorbed. You must use another method of birth control until you have a semen sample tested and it shows a zero-sperm count. Otherwise, you can still get your partner pregnant.
During a vasectomy, your testicles and scrotum are cleaned with an antiseptic and possibly shaved, each vas deferens is located by touch, and a local anesthetic is injected into the area. Your doctor makes two small openings in your scrotum. Through an opening, each vas deferens tube is cut. The two ends of the vas deferens are tied, stitched or sealed. Electrocautery and sutures may be used to seal the ends. Scar tissue from the surgery also helps to block the tubes. The vas deferens is then placed inside the scrotum and the skin may be closed with stitches that dissolve and do not have to be removed. The procedure takes about 20 minutes and is performed in the office.
What to do before the Procedure:
- Wear compression shorts to the procedure. These can be purchased at a local sporting goods store (such as Dick’s Sporting Goods) or online. This is very important as compression of the area will minimize swelling, bleeding and pain. The shorts should be worn continuously for at least 48 hours after the procedure.
- Start taking Tylenol 500mg every six hours (starting the night before the procedure and continuing for 48 hours afterward). This will help with pain control.
- Valium will be prescribed to be taken one hour prior to the procedure. This helps decrease anxiety and improve relaxation during the procedure. If you choose to take the medication, you must have someone drive you to and from the procedure. It is also recommended that you do not drive or make important decisions for the rest of the day. If you choose not to take valium, you may drive yourself to and from the procedure.
What to Expect After Surgery
Your scrotum will feel numb for 1 to 2 hours after the vasectomy. You may have some swelling, bruising and minor pain in your scrotum for several days after the surgery. Unless your work is strenuous, you will be able to work in 2 or 3 days. Avoid heavy lifting for a week. You can resume sexual intercourse as soon as you are comfortable, usually in about a week. However, you can still get your partner pregnant until your sperm count is zero.
You must use another method of birth control until you have a follow-up sperm count test 2 months after the vasectomy (and/or after 10-20 ejaculations over a shorter period of time.) Once your sperm count is zero, no other birth control method is necessary. To obtain the sperm count test after the procedure, go to www.spermcheck.com.
A vasectomy will not interfere with your sex drive, ability to have erections, sensation of orgasm, or ability to ejaculate. Typically, there is no noticeable change in the ejaculate volume. You may have occasional mild aching in your testicles during sexual arousal for a few months after the surgery.
Risk of Failure
Pregnancy may occur after a vasectomy because of failure to use another birth control method until the sperm count is confirmed to be zero. It usually takes 10 to 20 ejaculations to completely clear the sperm from the semen. Also, spontaneous reconnection of a vas deferens or an opening in one end that allows sperm the mix with the semen again. This is very rare.
The risk of complications after a vasectomy is very low. Complications may include, but are not limited to the following:
- hematoma formation (a large bruise)—which sometimes requires surgery
- chronic pain (pain that lasts for a long time or forever)
- sperm granuloma (sperm leaking from a vas deferens into the tissue around it and forming a small lump called a sperm granuloma. This condition is usually not painful, and it can be treated with rest and pain medication. Occasionally, surgery may be needed to remove the granuloma)
- Inflammation of the tubes that move sperm from the testicles called congestive epididymitis.
- In rare cases, the vas deferens grows back together, called recanalization, and the man becomes fertile again, which would require the vasectomy procedure to be repeated