In my time as a urologist, I’ve performed thousands of vasectomies and helped even more patients understand whether a vasectomy was right for them. If you’re considering a vasectomy, I’ll help you weigh the pros and cons by covering the factors to consider before scheduling a vasectomy. I’ll briefly explain how the surgery works and I’ll also preview what to expect during the procedure.

How does a vasectomy work?

A vasectomy works by keeping sperm out of the semen. After sperm is created in the testicles, it uses the vas deferens (ducts that connect the testicles to the urethra) as a highway to travel through your reproductive system and mix with the semen. A vasectomy permanently closes this highway by cutting the vas deferens, keeping sperm in the testicles.

Should I get a vasectomy?

Getting a vasectomy is one of the most important sexual health decisions a person can make. It’s a fairly common procedure here in the United States, where about one in six men over 35 has had a vasectomy.

A vasectomy is a personal decision. The only person who knows if it’s the best choice for you, is you. I tell my patients that if there is even a remote chance they might want kids in the future, a vasectomy isn’t the right choice.

If you’re on the fence about whether you want a vasectomy, here are some of the pros and cons to consider:

Pros of a vasectomy

Highly effective

One of the top pros of a vasectomy is that it’s the most effective form of birth control. It successfully prevents pregnancies 99.85 percent of the time. And a vasectomy is permanent. So once you have it done, you won’t have to worry about using a different form of birth control in the future.

It’s safe

A natural function of your body is to absorb sperm that isn’t ejaculated. This is true whether you’ve had a vasectomy or not. Since your body is used to absorbing sperm, a vasectomy has no long-term effects on your health. This makes it the safest form of permanent birth control.

Another common misconception I hear is that a vasectomy increases your risk of prostate cancer. This isn’t true.

Doesn’t affect your sex drive

Testosterone, a hormone that affects the male sex drive, is made in your testicles. A vasectomy only alters your vas deferens, leaving your testicles untouched. This means that the amount of testosterone you produce is unchanged.

It’s also a myth that after a vasectomy you won’t ejaculate. This isn’t true, either. Your body will continue to develop semen. The only difference is that your semen will no longer contain sperm.

Quick recovery

Patients always want to know how long it takes to recover after a vasectomy. Luckily, the recovery is quick.

You might feel a little tender immediately after the procedure and you’ll need to take it easy for about a week. During that time, no sex, heavy lifting, yard work, shoveling or anything else that will strain your groin. This isn’t a recommendation to take lightly, even if you feel great after your procedure. Straining your groin can cause bleeding or other damage to your reproductive system.

Almost painless

A vasectomy is minimally invasive and almost painless. You may experience mild discomfort that can be managed with ice and ibuprofen.

Typically covered by insurance

Cost is always an important consideration when deciding if a procedure is right for you. Vasectomies are covered by insurance most of the time, including the follow-up semen analysis.

If you have questions about what’s covered by your insurance, call the number on the back of your insurance card.

Cons of a vasectomy

Isn’t immediately effective

Many people think that a man is sterile right after he has a vasectomy. It actually takes about three months to “clear the pipes.” While vasectomies are almost always successful, we can’t assume it worked without testing. Three months after your appointment, you’ll deliver a semen sample to your urologist’s office. The team will check your semen for sperm and confirm that the procedure was effective. Until then, be sure to use birth control when having sex.

Not always reversible

Patients often ask me whether a vasectomy is reversible. In some cases, it’s possible to reverse a vasectomy. But because a vasectomy is designed to be a permanent form of birth control, it’s not always reversible. If there’s even the slightest chance you’ll want to have kids in the future, don’t get a vasectomy.

Possibility of long-term discomfort

While discomfort caused by a vasectomy is usually short lasting, there’s a small risk of post-vasectomy pain syndrome. This is a condition where testicle pain can last several months or longer. The discomfort is mild – over-the-counter medicines like ibuprofen will usually take care of it. This condition is rare, only affecting about one percent of men who get a vasectomy.

What type of doctor should I see for a vasectomy?

A vasectomy is one of the most difficult procedures to get really good at. There are many nuances when it comes to performing an effective procedure, so choosing an experienced doctor is important. Every urologist is a trained surgeon who has expert knowledge of the male reproductive system. Some have performed thousands of vasectomies. Urologists also know multiple vasectomy techniques so they can tailor the technique to each patient’s anatomy and preferences. Personally, I use five different techniques.

Some primary care doctors also have vasectomy expertise. If you’d prefer to see your primary care doctor, just ask them if they feel comfortable performing the procedure or if they’d recommend a specialist.

What to expect before and during your vasectomy

First, you’ll have a consultation. During this appointment, your doctor will talk to you about what to expect and confirm whether a vasectomy is right for you. If you decide to go ahead with the vasectomy, we’ll help you schedule the procedure.

Vasectomies are typically performed in your doctor’s office or clinic. You’ll come in, get settled, and we’ll use a numbing medicine to keep you comfortable during the procedure. You may feel a light poke and a slight heat when the numbing medicine is applied. During the procedure, you’ll feel a little pressure, like a slight squeezing of your testicles. All told, everything only takes about 30 minutes. Afterwards, your scrotum might feel a little achy, but the pain can usually be managed with ice and ibuprofen.

Three months after your vasectomy, we’ll perform a semen analysis to confirm it worked as expected. Then you’re good to go!

If I want to schedule a vasectomy, what are my next steps?

Whether you have questions about the procedure or already know you want one, I recommend that you schedule a vasectomy consultation with a urologist – which can be done conveniently through urology video visits. We’ll answer your questions, help you know what to personally expect and help you decide if a vasectomy is the best choice for you.