Most Frequently Asked Questions about Vasectomies

For couples who don’t want children, or whose families are complete, a vasectomy is a reliable and effective means of birth control. It is a permanent solution with 99.85 percent efficacy – a near guarantee against unwanted pregnancies. 

That said, both partners in a relationship may have concerns about the vasectomy process and its subsequent physical and emotional effects on their sex life and relationship. The following frequently asked questions (and answers) should help clarify doubts and provide information before you make this very important decision. 

What is a Vasectomy?

A vasectomy is a safe and effective method of permanent birth control for men. It is an outpatient surgery that renders a man sterile. The vas deferens – tubes carrying sperm from the testicles – are cut, stitched and sealed. Thus, sperm is blocked from being ejaculated in the semen, preventing conception. 

Does a Vasectomy Hurt?

The outpatient procedure is conducted under anesthesia, usually local. You may feel a sensation of pulling on your scrotum. Post-procedure, there may be some swelling, bruising and mild discomfort for up to a week.

How Effective is a Vasectomy?

Vasectomies are more than 99 percent effective. It is one of the most foolproof forms of birth control. A vasectomy “fails” very rarely, when the ends of the vas deferens reattach, allowing pregnancy. Only one to two women out of every 1,000 has reported a pregnancy in the first year after their partner had a vasectomy.

Are Vasectomies Immediately Effective?

Vasectomies are not immediately effective. Sperm may remain in the tubes and be carried out in the ejaculate. It may take a few months and 15-20 ejaculations before that sperm is completely ejected or reabsorbed into the body.

During this time, a man remains fertile. Alternate methods of birth control are necessary until a man receives the all-clear after a sperm-count test (usually given three months post-procedure, and one every few weeks thereafter until a complete absence of sperm is noted). 

How Long Does Recovery Take?

Recovery time varies, but usually, any pain or soreness fades after a few days. Physical activities like exercise and lifting heavy objects could be resumed after a week, although you should consult with your doctor to be sure. Minor swelling, sensitivity, or discomfort in the scrotum may continue for up to two weeks.

Will a Vasectomy Affect My Sex Life?

There should not be any changes in your sex drive,  achieving or maintaining erections, ejaculating, or orgasms. No sex organs are removed or altered during a vasectomy, and the body continues producing male hormones after a vasectomy. Some men have reported an improved sex life after the procedure because the fear of pregnancy is no longer present during sex. 

Does a Vasectomy Affect Ejaculate?

Semen consists of sperm, and fluid from the seminal vesicles and the prostate gland. Sperm makes up only 2 to 5 percent of the ejaculate. A vasectomy is performed only on the vas deferens, not the seminal vesicles or prostate, so sperm is the only thing missing from the ejaculate. Removing sperm has little or no effect on ejaculate volume, appearance, color, or consistency. 

When Can Sexual Activity be Resumed?

Sexual activity may be resumed when the swelling and tenderness in the scrotum reduces – usually within a week.  

Are There Risks or Complications?

A vasectomy is a very low-risk procedure. Common, minor side effects include swelling, bruising or bleeding in the scrotum, bloody semen, or infection at the site of the incision. Sometimes the vas deferens leak sperm that forms lumps called granuloma, which may require medication or surgery.

There is no increased risk of prostate or testicular cancer after a vasectomy.

What are the Advantages of a Vasectomy over Tubal Ligation?

Tubal ligation is the tying of the fallopian tubes to prevent sperm from fertilizing an egg. It is a complex, inpatient procedure requiring hospitalization. Performed under general anesthesia, there’s a risk of complications such as the development of scar tissue and bleeding. Tubal litigation has a  longer recovery period (1 - 3 weeks or longer) than a vasectomy. 

A vasectomy is a much simpler 15- to 20-minute procedure performed in an ambulatory surgery center or doctor’s office using local anesthesia. Discomfort and side effects are minimal. 

What are the Advantages of a Vasectomy?

A vasectomy has many advantages:   

  • It offers lifelong protection for a one-time procedure
  • It is safe, simple, and quick
  • It has few risks and side effects
  • It saves money, as other repetitive birth control won’t be needed 

And the Reasons Against a Vasectomy?

The main reason against having a vasectomy is if you are unsure about having children in the future.  

A vasectomy may not be a good idea for men who have:  

  • A history of bleeding or blood disorders
  • Allergies or sensitivities to anesthetics (such as lidocaine or novocaine) or antibiotics
  • Skin conditions of the scrotum
  • Had past injury or surgery on the genitals
  • Recent or repeat urinary tract or genital infections

Does Insurance Cover Vasectomies?

Vasectomies are often covered by health insurance. Plan deductibles and co-insurances vary, so check with your insurance company first.

Can a Vasectomy be Reversed?

Vasectomies should be considered permanent, but reversal may be possible depending on the state of the vas deferens tubes, fluid samples, and time elapsed since the vasectomy. 

Two techniques are used in vasectomy reversal:

  • Vasovasostomy involves directly reattaching the severed ends of the vas deferens at the site of the vasectomy.
  • Vasoepididymostomy connects the vas deferens to the epididymis - the tube that connects a testicle to a vas deferens. 

At Urology Specialists of Milford, we understand that a vasectomy is a major life decision. We provide answers to a broad range of questions on the issue. For more information, call (508) 473-6333 to request an appointment with board-certified urologist Dr. Jeffrey Steinberg.

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