Vasectomy

Vasectomy is a form of male birth control that cuts the supply of sperm to your semen. It’s done by cutting and sealing the tubes that carry sperm. Vasectomy has a low risk of problems and can usually be performed in an outpatient setting under local anesthesia.

Before getting a vasectomy you need to be certain you don’t want to father a child in the future. Although vasectomy reversals are possible, vasectomy should be considered a permanent form of male birth control.

Vasectomy offers no protection from sexually transmitted infections.

Why it’s done

Vasectomy is a safe and effective birth control choice for men who are certain they don’t want to father a child in the future.

• Vasectomy is nearly 100 percent effective in preventing pregnancy.
• Vasectomy is an outpatient surgery with a low risk of complications or side effects.
• The cost of a vasectomy is far less than the cost of female sterilization (tubal ligation) or the long-term cost of birth control medications for women.
• A vasectomy means you won’t need to take birth control steps before sex, such as putting on a condom.

Risks

A potential concern with vasectomy is that you might later change your mind about wanting to father a child. Although it might be possible to reverse your vasectomy, there’s no guarantee it will work. Reversal surgery is more complicated than vasectomy, can be expensive and is ineffective in some cases.

Other techniques also are available to father a child following vasectomy, such as in vitro fertilization. However, these techniques are expensive and not always effective. Before you get a vasectomy, be certain you don’t want to father a child in the future.

If you have chronic testicular pain or testicular disease, you’re not a good candidate for a vasectomy. For most men, a vasectomy doesn’t cause any noticeable side effects, and serious complications are rare.

Side effects right after surgery can include:

• Bleeding or a blood clot (hematoma) inside the scrotum
• Blood in your semen
• Bruising of your scrotum
• Infection of the surgery site
• Mild pain or discomfort
• Swelling

Delayed complications can include:

• Chronic pain, which can happen for 1% to 2% of people who have surgery
• Fluid buildup in the testicle, which can cause a dull ache that gets worse with ejaculation
• Inflammation caused by leaking sperm (granuloma)
• Pregnancy, in the event that your vasectomy fails, which is rare.
• An abnormal cyst (spermatocele) that develops in the small, coiled tube located on the upper testicle that collects and transports sperm (epididymis)
• A fluid-filled sac (hydrocele) surrounding a testicle that causes swelling in the scrotum

Unfounded concerns

Many men worry that a vasectomy could cause serious problems — but these fears are unfounded. For example, a vasectomy won’t:

• Affect your sexual performance. A vasectomy won’t affect your sex drive or your masculinity in any way other than preventing you from fathering a child. Men have even reported higher sexual satisfaction after a vasectomy.
• Permanently damage your sexual organs. There’s very little risk that your testicles, penis or other parts of your reproductive system will be injured during surgery. In extremely rare cases, injury to the blood supply can lead to the loss of a testicle, but that is unlikely to happen if your surgeon is skilled.
• Increase your risk of certain cancers. Although there have been some concerns about a possible link between vasectomy and testicular or prostate cancer in the past, there’s no proven link.
• Increase your risk of heart disease. As with cancer fears, there doesn’t appear to be any link between vasectomy and heart problems.
• Cause severe pain. You might feel minor pain and pulling or tugging during surgery, but severe pain is rare. Likewise, after surgery you might have some pain, but for most men the pain is minor and goes away after a few days.

Results

A vasectomy doesn’t provide immediate protection against pregnancy. Use an alternative form of birth control until your doctor confirms there are no sperm in your semen. Before having unprotected sex, you’ll need to wait several months or longer and ejaculate 15 to 20 times or more to clear any sperm from your semen.

Most doctors do a follow-up semen analysis six to 12 weeks after surgery to be certain that no sperm are present. You’ll need to give your doctor sperm samples to examine. To produce a sperm sample, your doctor will have you masturbate and ejaculate into a container or use a special condom without lubrication or spermicide to collect semen during intercourse. Your semen is then examined under a microscope to see whether sperm are present.

Vasectomy is an effective form of birth control, but it won’t protect you or your partner from sexually transmitted infections, such as chlamydia or HIV/AIDS. For that reason, you should use other forms of protection such as condoms if you are at risk of acquiring a sexually transmitted infection — even after you have a vasectomy.