The Vasectomy Guidebook: Decision Making Process, Procedure, and Recovery

Over 500,000 men in the United States each year will undergo a vasectomy, a surgical procedure that makes them sterile by stopping the flow of sperm from the testicles to the penis. As many as one in 20 American males of reproductive age choose to undergo a vasectomy as a means of safe and effective birth control.

In a vasectomy procedure, vas deferens – the tubes that carry sperm – are cut and tied to prevent pregnancy. It’s a quick, relatively painless, and most importantly, 99 percent effective birth control procedure for men. This outpatient, in-office procedure is routinely performed by the urology team at Puyallup Surgical Consultants, and is a popular option for those who do not plan to have any more children.

Traditionally, vasectomies have been most common in older men who have already had children, but there’s an increasing movement of younger men undergoing the procedure, as well.

Reasons Men Get Vasectomies

A vasectomy can be beneficial to both men and women. While it is a personal decision to undergo this procedure, and the benefits depend largely on your unique circumstances, here are some of the primary reasons men choose to have a vasectomy.

Effectiveness and Reliability 
A vasectomy is more effective than any other form of birth control, including the pill. Risk of unwanted pregnancy is almost completely eliminated. The only method more reliable is total abstinence. Once you’ve been tested and cleared, you won’t need other forms of birth control.

Quick and (Mostly) Painless
Usually, the vasectomy procedure is very quick. Most patients can expect to be in the doctor’s office for not much more than an hour, from start to finish. ​​​​​​Most vasectomies are performed in your doctor’s office and are relatively straightforward. Your procedure will call for the use of a local anesthetic, 1-2 small incisions, and an absorbable suture. Most men recover completely in less than a week. Everyday activities can be resumed the day after surgery with the exception of vigorous exercise or heavy lifting.

Fewer Complications and Risks vs. Other Birth Control Options
Many men opt for a vasectomy to take the contraception burden off of their female partners. The birth control options for women largely involve hormonal solutions that can create unwanted side effects. Other birth control methods can be an ongoing hassle. Tubal ligation (the procedure to block a woman’s fallopian tubes) is more invasive, more expensive, and comes with more risk of complications than a vasectomy.

Vasectomies are Very Cost-Effective
The average vasectomy costs $1,000-$2,000, and insurance often can help cover it. Over time the costs of a vasectomy are less than regular birth control, such as the pill, an IUD, or over-the-counter condoms.

Vasectomies Do Not Impact Sexual Function or Desire
After a full recovery from a vasectomy, there should be no impact on sexual function. Having a sperm count of zero does not affect how the sexual organs work. There should be no changes in the enjoyment of sex or reductions in sex drive. In fact, research has indicated that men experience an uptick in sexual function and libido following the procedure. Many men find that their confidence to engage in sexual activity increases without concerns of unplanned pregnancies on their mind.


The “Traditional” Vasectomy Process

Traditional vasectomy is performed by making one or two incisions in the scrotum, each less than one inch long. The surgeon then frees each vas from surrounding tissue, excises a segment of the vas and ties the open ends. The skin is then closed with sutures.

Depending on the situation, there is usually one midline incision on the scrotum less than one inch long or two smaller incisions on the side of the scrotum. Most men are able to return to an office type of work within one to two days. Small sutures fall out on their own after 1-2 weeks.


No-scalpel, No-needle Vasectomy

While a no-scalpel, no-needle vasectomy will provide the same outcome as a traditional vasectomy, the preferred technique will be discussed at your consultation. 

How Do I Prepare for a Vasectomy?

Your doctor will go over your health history as it relates to vasectomy, and you will receive a brief physical examination. Please be sure to advise us if you have any of the following:

  • History of excessive bleeding or blood disorders.
  • Allergy or sensitivity to local anesthetics, such as the "caine" drugs or antibiotics.
  • Skin disease involving the scrotum, especially infected pimples.
  • Regular use of aspirin or medicines that contain aspirin for a week before vasectomy.
  • History of injury or earlier surgery on the genital organs.
  • History of recent or repeat urinary tract or genitalia infections.

Other preparations that may be required prior to undergoing vasectomy include the following:

  • Avoid anti-inflammatory drugs, such as ibuprofen and aspirin for 2 weeks prior to the procedure. (These medications "thin" the blood and can cause excessive bleeding.)
  • Wash and shave the scrotum to help prevent infection.
  • Bring a pair of tight-fitting underwear or athletic supporter to support the scrotum and minimize swelling.
  • Arrange for a ride home to minimize exertion and movement that can exacerbate swelling.


What Are the Risks of a Vasectomy?

Major risks associated with vasectomies are very uncommon, though complications such as inflammation (swelling), bleeding, or infection may occur. Other minor risks include:

  • Pain. Any surgical procedure can affect nerves, and rarely there can be residual pain. The testicles are sensitive organs, so such pain is common in men whether they have had a vasectomy or not. It is not clear whether vasectomy increases this risk.
  • Sperm granuloma. A hard, sometimes painful lump about the size of a pea may form as a result of sperm accumulation from the cut vas deferens. The lump is not dangerous and is almost always reabsorbed by the body. Scrotal support, and mild pain relievers can help relieve symptoms.
  • Congestion. A sense of pressure caused by sperm in the testes, epididymis (the structure that stores sperm), and lower vas deferens may cause discomfort for two to 12 weeks after a vasectomy. Like a granuloma, congestion usually resolves itself over time.

The risks of vasectomy must be weighed against other options, including the chance of another pregnancy if sterilization is not achieved.


Tips for a Quick Recovery After a Vasectomy

Tips to aid recovery from a vasectomy include:

  • Using ice packs: Applying an ice pack to the wound for 20 minutes can reduce swelling and pain. Wrap the ice pack to keep it from making direct contact with the skin.
  • Lying down: During the first few days following a vasectomy, it is advisable to lie down as much as possible. This precaution reduces strain on the wound.
  • Avoiding heavy lifting: This can strain muscles around the scrotum and cause further harm.
  • Wearing supportive underwear: Wearing briefs that cup the testicles can reduce pressure on the wound. A jockstrap provides additional support and reduces friction in the area.
  • Cleaning regularly: It is essential to gently clean the wound every day. This routine will help to prevent infections.

When is it Safe to Have Sex After a Vasectomy?

Sexual activity can be resumed within a few days after a vasectomy, but precautions should be taken against pregnancy until sperm counts show that the semen is free of sperm.

Sperm can remain in the vas deferens above the area of the procedure for weeks or even months after a vasectomy. A semen test is done three to four months after the procedure. If the result meets American Urological Association guidelines, you are considered sterile. If sperm are seen, the semen test is repeated. Until then, you must continue to use other birth control to prevent pregnancy.


Can a Vasectomy Be Reversed?

While vasectomy reversal can sometimes be an option, vasectomy should be considered a permanent means of birth control, as vasectomy reversals are very expensive, can cause more serious complications and aren’t always effective.

Men who are married or in a serious relationship also should discuss this issue with their partners. If you're thinking about a reversal now, perhaps you should take more time to decide whether a vasectomy is right for you.




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