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Vasectomy

Definition

A vasectomy is surgery to cut the vas deferens, the tubes that carry a man’s sperm from his scrotum to his urethra. The urethra is the tube that carries sperm and urine out of the penis. After a vasectomy, sperm cannot move out of the testes. A man who has had a successful vasectomy cannot make a woman pregnant.

Alternative Names

Sterilization surgery – male; No-scalpel vasectomy; NSV

Description

Vasectomy is usually done in the surgeon's office using local anesthesia. You will be awake but not feel any pain.

• After your scrotum is shaved and cleaned, your surgeon will give you a shot of numbing medicine into the area.
• Your surgeon will then make a small surgical cut in the upper part of your scrotum, and tie off and cut apart the vas deferens. Your surgeon will use stitches or a skin glue to close the wound.

You may have a vasectomy without a surgical cut. This is called a no-scalpel vasectomy (NSV).

• Your surgeon will find the vas deferens by feeling your scrotum and then give you numbing medication.
• The surgeon will then make a tiny hole in the skin of your scrotum and seal off the vas deferens. The surgeon will usually pull your vas deferens through the tiny hole in order to tie off and cut it apart. You will not need stitches.

Why the Procedure Is Performed

Vasectomy may be recommended for adult men who are sure they want to prevent future pregnancies. A vasectomy makes a man sterile (unable to get a woman pregnant).

A vasectomy is not recommended as a short-term form of birth control. The procedure to reverse a vasectomy is a much more complicated operation.

Vasectomy may be a good choice for men who:

• Are in a relationship, and both partners agree they have all the children they want. They do not want to use, or cannot use, other forms of birth control.
• Are in a relationship, and their partner has health problems that would make pregnancy unsafe for her
• Are in a relationship, and one or both partners have genetic disorders that they do not want to risk passing on to their children

Vasectomy may not be a good choice for men who:

• Are in a relationship, and one partner is unsure about their desire to have children in the future
• Are in a relationship that is unstable, going through a stressful phase, or is very difficult in general
• Are thinking about having the operation just to please their partner
• Are counting on fathering children later by storing their sperm or by reversing their vasectomy
• Are young and still have many life changes ahead
• Are single when they want to have a vasectomy. This includes men who are divorced, widowed, or separated.
• Do not want, or have a partner who does not want, to be bothered by having to use other forms of birth control during sexual activity

Risks

There is no serious risk to vasectomy. Your semen will be tested in the months after the operation to make sure it does not contain sperm.

As with any surgical procedure, infection, swelling, or prolonged pain can occur. Careful following of aftercare instructions reduces these risks significantly.

Very rarely, the vas deferens can grow back together again. If this happens, sperm can mix with semen. This would make it possible for you to make a woman pregnant.

Before the Procedure

Two weeks before your vasectomy, tell your doctor all of the medicines, even ones you bought without a prescription, vitamins, supplements, and herbs you are taking. You may need to limit or stop taking aspirin, ibuprofen (Advil, Motrin), and other medicines that affect blood clotting for 10 days before your surgery.

On the day of your surgery, wear loose, comfortable clothes. Clean your scrotum area well. Take the medicines your doctor told you take.

Bring a scrotal support with you to the surgery.

After the Procedure

You should be able to return home as soon as the procedure is done. You can return to work the next day if you do not do heavy physical work. Most men return to work within 2 to 3 days. You should be able to return to your normal physical activities in 3 to 7 days. It is normal to have some swelling and bruising of the scrotum after the procedure. It should go away within 2 weeks.

You should wear a scrotal support for 3 to 4 days after the procedure. You can use an ice pack to prevent or reduce swelling. Pain medicine, such as acetaminophen (Tylenol), may help relieve discomfort. You can have sexual intercourse as soon as you feel ready, usually about a week after the surgery.

Outlook (Prognosis)

Vasectomy does not affect a man's ability to have an erection or orgasm, or ejaculate semen. A vasectomy does NOT prevent the spread of sexually transmitted diseases (STDs).

Your sperm count gradually decreases after a vasectomy. After about 3 months, sperm are no longer present in the semen. You must continue to use birth control to prevent pregnancy until your semen sample is totally free of sperm.

Most men are satisfied with vasectomy. Most couples enjoy not having to use birth control.

References

Nagler HM, Jung H. Factors predicting successful microsurgical vasectomy reversal. Urol Clin North Am. 2009 Aug;36(3):383-90.