Should I Get A Vasectomy?

Many forms of birth control exist for both men and women, and one of the most effective and permanent is called a vasectomy. A vasectomy is a procedure for males that stops the release of sperm during ejaculation, which prevents fertilization of the female egg.

Because of the permanence of the procedure and some of the risks involved, getting a vasectomy is a big decision for any man. Here’s what you need to know to help you make the decision if the time comes.

Why It’s Done

A vasectomy is typically chosen by men or couples who have had issues with other forms of birth control, or who desire a more permanent solution. Its permanent nature means that this procedure is for people who are 100 percent certain they do not want to have children at any point in the future.

During the Procedure

The vasectomy procedure follows a few basic steps:

Cleaning: Both the testicles and scrotum will be cleaned with antiseptic, and shaved if needed.
Medication: In some cases, your doctor will give an oral or intravenous medication to reduce anxiety and increase sleepiness. This medication often causes people to lose their memory of the vasectomy.
Location: Each vas deferens (the tube that connects the testicles to the urethra) is located by touch.
Anesthetic: A local anesthetic is injected into that area.
Openings: The doctor makes one or more small openings in the scrotum, and then cuts the two vas deferens tubes. From here, the two ends of the vas deferens are either tied, stitched or sealed together. In some cases, a procedure called electrocautery will be used to seal the ends of the vas deferens, and scar tissue will also help block the tubes.
Replacement: The vas deferens is then placed back inside the scrotum, and the skin is closed with stitches. These will dissolve on their own and do not need to be removed.

The entire procedure takes about 20 to 30 minutes in most cases. There are forms of vasectomy where no incision is used to enter the scrotum, which is accessed instead using a clamp to poke through the skin of the scrotum—these are called no-scalpel vasectomies. They are just as effective as normal vasectomies for people who choose them, and can reduce risks like bleeding, infection and bruising.

After the Procedure

You should expect numbness in the scrotum for a couple hours after surgery, along with swelling and minor pain for a few days. Cold packs, snug clothing and lying on your back as often as possible can help reduce pain and swelling. Avoid heavy lifting for a week or more; if heavy lifting isn’t part of your job, you can return to work in one or two days.

It’s important to remember that your ability to get your partner pregnant does not go away immediately after the vasectomy. It often takes several months for all the remaining sperm in the body to be ejaculated or reabsorbed, and using another form of birth control to prevent pregnancy is required until this sperm count is at zero. This is determined using a sample of semen, which can be tested for sperm count. Only when this count is zero can you stop using other forms of birth control.

This sperm count test, along with a basic examination, is generally advised a couple months after the vasectomy. Home tests are also available for sperm count.

A vasectomy will not interrupt your body’s sex drive or its ability to get an erection, have an orgasm or ejaculate.

Risks and Complications

There are a few risks involved with vasectomies. The success rate for birth control through this method is 99.85 percent, but there are two unlikely outcomes that could lead to a pregnancy after a vasectomy:

Failure to use outside birth control in the weeks or months directly after a vasectomy. On average, it takes between 10 and 20 ejaculations to fully clear sperm from male semen.
In rare cases, the spontaneous reconnection of a vas deferens, or an opening that allows sperm to mix in with semen can occur.

The risk of complications with vasectomies is quite low, but these rare complications include:

Bleeding or infection: Swelling or bruising can take place under the skin where the incision was made, which can also become infected. In rare cases, infections can develop inside the scrotum. Inflammation of the tubes that transport sperm from the testicles.
Recanalization: This is the medical term for cases where the vas deferens grows back together again and allows the man to become fertile.
Leaking sperm: Sperm may leak from the vas deferens into tissue around it, forming a lump called a sperm granuloma. This is usually a mild condition that clears up with rest and pain medication, but in some cases it may require another surgery.

Vasectomy: Making the Choice

Vasectomy is a big choice in life, and you need to consider all your options. Speak with your partner about the advantages and disadvantages, and remember that vasectomies do not prevent STDs or other conditions—only pregnancy.

If you arrive at the conclusion with your partner that vasectomy is the right choice, be sure to also speak to your doctor and make sure the procedure is safe and right for you.