When it comes to permanent, complete birth control, the vasectomy is the reigning all-time champ. It’s a simple outpatient procedure that involves very little pain during surgery and only some slight discomfort afterwards. Fortunately, with a few days of doctor-mandated couch time, you’ll be back to full strength in about a week. Frankly, you’ll probably spend more time deciding whether or not to get a vasectomy than for the actual surgery and recovery.
As a urologist, I’ve performed thousands of vasectomies and helped even more patients understand whether a vasectomy was right for them. In this post, I’ll give you a quick rundown of what a vasectomy is, what it involves, and the advantages and risks of getting one. I’ll also give you some questions to ask yourself about whether or not it’s right for you. Finally, I’ll share what to expect during a vasectomy, how to prepare, how to recover and what steps to take if you decide to get one.
What is a vasectomy?
Let’s start with the basics. Sperm serve as one of the two building blocks necessary to create human life. Men produce sperm in their testicles. Then, the sperm travels down small tubes, called vas deferens, to combine with semen – the fluid that provides nutrients for sperm to make and survive their journey to the female egg.
A vasectomy literally takes out a small piece of the vas deferens (the “vas” in vasectomy). By taking out a part of the travel tube and sealing off the ends, the vas deferens is permanently closed, keeping sperm in the testicles. With no sperm, there’s no conception and no pregnancy.
A quick, but important note: A vasectomy is for birth control only. It doesn’t affect your ability to receive and spread sexually transmitted diseases. Even after a vasectomy, you may still want to use protection if you’re sexually active.
Let’s start with the biggest advantage – a vasectomy is around 99.85% effective at preventing pregnancy. By completely removing the only way for your sperm to get out of your testicles, you have taken away any chance for them to leave your body.
There are other advantages to getting a vasectomy:
Permanent, single procedure birth control
Taking out a small, physical piece of tube from your reproductive system is a one-and-done procedure with permanent effects. Your only return trip to the doctor is to make sure you’ve completely cleared out all the sperm from your reproductive system. Once you’re clear, your need for additional birth control is forever done.
A vasectomy is minimally invasive, meaning it only takes a few cuts to get the job done. The only thing you’ll feel during the procedure is a sting from an injection of numbing medicine, along with some sensations of heat and pressure. Afterward, you might feel some discomfort and swelling, but it’s nothing that ice and ibuprofen can’t fix. For the vast majority of men that receive vasectomies, there’s no sharp or long-lasting pain at all.
Safe now, safe in the future
A vasectomy is the safest form of permanent birth control. The procedure itself is very routine with almost zero risks. As far as long-term effects, your body will absorb whatever sperm you have left over time, something that your body knows how to do. Your reproductive system will continue to exist safely, it just won’t be able to reproduce.
Zero effect on sex
While a vasectomy will put an end to your fertility, that’s the only thing that it affects regarding sex. A vasectomy doesn’t touch any other part of your reproductive system – only the tubes that carry sperm. So, all other parts of the sexual experience will be intact. You still produce the same amount of testosterone, which will keep your sex drive running as normal. You will also continue to produce semen, so you’ll still be able to ejaculate. The only difference now is that your semen won’t contain any reproductive sperm. And all other sensitivities will remain the same, so a vasectomy won’t affect your ability to orgasm.
Mandated couch time for a quick recovery
The recovery time for the procedure is typically just a couple of days. Even though the initial tenderness after the procedure goes away quickly, you’ll need to take it easy for about a week to make sure you don’t strain your groin and cause bleeding or other damage to your reproductive system. Even if you feel great, that means no sex or heavy lifting (yard work, shoveling, etc.) for about two weeks at the most.
Most likely covered by insurance
Vasectomies are covered by most health insurance policies. That includes both the procedure and the follow-up semen analysis. To see if your health insurance will cover your vasectomy, go to your health insurance provider’s website or call the member services phone number on the back of your health insurance card.
While a vasectomy is 99.85% effective at preventing pregnancy, urologists are always asked about the other .15%. While failure is possible, it’s extremely rare – only one or two cases of failure out of 1,000 procedures. For more details on how it can happen and what you can do to reduce the already rare risk, check out urologist Dr. Stephen Lukasewycz’s post about vasectomy failure.
All that said, there really aren’t many other disadvantages of getting a vasectomy. However, there are a few worth mentioning:
It isn’t instant birth control
A vasectomy is permanent and effective, but it’s not immediate. Even though the source of your sperm is cut off, there can still be sperm in your system for about three months. To make sure all remaining sperm are clear, your doctor will recommend regular ejaculation, every week or so, for those three months. (You’ll also still need to use additional birth control if you have sex.) After that, you’ll revisit your urologist to deliver a semen sample that’ll be tested for any leftover sperm. If it’s zero, that means the procedure worked and you’re 100% in the clear.
Reversibility isn’t guaranteed
I get asked about the possibility of reversing a vasectomy a lot. While it’s possible in most cases, there’s no certainty that it will work. The truth is that a vasectomy is designed to be 100% permanent, with practically zero chance that the body can repair the vas deferens tube. So, if there’s even a slight chance that you’ll want to have children in the future, a vasectomy may not be the right choice for you.
Longer-term discomfort is possible
For the vast majority of men that get a vasectomy, any discomfort usually ends within a few days at most. However, for about 1% of men who get a vasectomy, there’s a small risk of getting post-vasectomy pain syndrome. This is a rare condition where there’s mild pain in the testicles for several months or longer. Fortunately, over-the-counter pain relievers like ibuprofen are usually all that’s needed to take care of it.
Getting a vasectomy is a very personal decision. Again, it’s a completely safe and common procedure – one in six men over the age of 35 has had one, and it can be done regardless of age or health condition.
But, as we mentioned earlier, it is a very permanent decision. Having a vasectomy reversed is not guaranteed to be successful, nor is the procedure covered by most health insurance. That said, if there is even the slightest possibility that you might want to have children created by your own sperm sometime in the future, I strongly recommend that you not get a vasectomy.
Again, this is a very personal decision. You know yourself the best. Give yourself enough time to reflect and look forward – enough so that you’re sure the decision you make is the right one for you.
The vasectomy process: Before, during and after
Once you’ve made your decision to get a vasectomy, the first step is deciding who you want to see and when to have it done. Then it’s a matter of having a consultation, preparing for the procedure, getting it done and recovering.
Choosing a doctor for your vasectomy
The key is to find a doctor that is experienced in vasectomies and is in your network. Ideally, you should search for a urologist. Every urologist is a trained surgeon who has expert knowledge of the male reproductive system, with some having performed literally thousands of vasectomies.
While a vasectomy is simple and safe, the act of performing a vasectomy is actually one of the most difficult procedures for a surgeon to get really good at doing – there are many nuances when it comes to performing an effective procedure. Fortunately, urologists know multiple vasectomy techniques so they can tailor the technique to each person’s anatomy and preferences. Looking for a urologist in your network is your best bet for quickly finding an experienced doctor you can trust.
Preparing for your vasectomy
After you choose a doctor for your vasectomy, you’ll want to schedule a consultation. During this appointment, your doctor will confirm your decision and talk with you about what to expect. You might also discuss the need for you to take anti-anxiety medication before the procedure. (If you do, you’ll need to make sure you have a ride to and from the clinic.) Then, you’ll schedule a time for the vasectomy itself.
It’s a good idea to plan ahead – aim to have your vasectomy done when you know that it’ll be okay for you to have some down time. If you’re glued to the screen every March for the NCAA college basketball tournament, you’ll know why this month is a prime time for men to have vasectomies. Same with multi-day golf tournaments like the Masters in early April. Any time that you know that you can sit and relax for a few days is a perfect window of time to recover.
Vasectomy day and beyond
When it comes to getting ready for the big day, your doctor will give you the prep instructions you need well in advance. At most, you’ll need to stop taking any blood thinners and avoid aspirin a week before the procedure. Same with aspirin-like pain relievers such as ibuprofen and naproxen 48 hours before your vasectomy. If you’re prescribed anti-anxiety medication, you’ll also want to take that before your procedure.
For the vasectomy itself, you’ll arrive at your doctor’s office or clinic. Once you get settled, your doctor will use a numbing medicine to keep you comfortable. You may feel a light sting and heat when the numbing medicine is injected. During the procedure, you’ll feel a little pressure, similar to a slight squeeze, throughout.
All told, everything takes about 30 minutes. Afterwards, your scrotum might feel a little achy, but the pain can usually be managed with ice and ibuprofen. Then, it’s rest time for a few days, and a sperm count three months later. Once your urologist confirms the vasectomy worked as expected, you’re good to go.
Your next steps
Whether you have questions about the procedure or already know you want one, I recommend that you schedule a vasectomy consultation with an urologist – which can be done conveniently through urology video visits. We’ll answer your questions and help you know what to expect.
Want more information on vasectomies? Check out our discussion with urologist Dr. Thomas Stormont on our For Health’s Sake podcast.
You can also learn more about vasectomies and clinics that perform the procedure at HealthPartners and Park Nicollet Urology.