Vasectomy is a surgical procedure that renders a man sterile, that is, no longer able to father children. The procedure is safe and effective, and about 500,000 men undergo vasectomy each year in the United States. The procedure itself takes between 10 and 30 minutes, and recovery is quick and in most cases uneventful.

A vasectomy is a method of stopping sperm from entering a man’s ejaculate by cutting or blocking the vas deferens. The vas deferens is the tube that allows sperm to travel from the epididymis, where the sperm are stored, into the semen. There are two common methods of blocking sperm this way: the conventional surgery and the newer “no-scalpel” technique. The no-scalpel technique, which has been used in the U.S. since the late 1980s, is a popular option because it requires no stitches, heals quickly, and results in fewer complications than the standard surgery.

Vasectomy is an effective form of birth control but does not protect against sexually transmitted diseases. Contrary to popular belief, it does not affect a man’s testosterone levels or sexual performance. It is, however, a serious decision, since in most cases, it is a permanent method of sterilization. Reversing a vasectomy is complicated, requires hospitalization, and is not often successful. For this reason, professional counseling is recommended for men who wish to undergo a vasectomy.

Safe and Effective, but Difficult to Reverse

Vasectomy is a common, safe method of contraception chosen by about 5% of married couples. The procedure has been performed on about 50 million men, which translates to about one of every six men over age 35. Vasectomy is a somewhat routine procedure because it is relatively easy to perform, does not require hospitalization, has a short healing time, causes very little discomfort, and is effective. The drawback of vasectomy is essentially its permanence, because it is difficult to reverse successfully. Therefore, the decision to undergo vasectomy should not be taken lightly and requires careful evaluation on the part of the patient and his partner.

Standard and No-Scalpel Techniques

The vasectomy itself is a relatively simple outpatient procedure, requiring only a local anesthetic. The standard surgical vasectomy used routinely in this country involves one or two small incisions through the skin of the scrotum, where the vas deferens is located. A small cut or piece of the vas deferens is removed, and the ends are tied off. Finally, a few stitches are used to close the scrotal skin. This procedure is then repeated on the opposite side, and the entire surgery takes less than 30 minutes. A more recently developed procedure known as the “no-scalpel vasectomy” has gained popularity in this country. This technique requires the doctor to locate the vas deferens by feeling under the scrotal skin. Once it is located, a tiny clamp is used to hold it while a small hole is made in the skin and stretched. The doctor can then cut and tie off the vas deferens through this tiny hole, which does not require stitches. The no-scalpel technique takes an average of 10 minutes, and it has the advantages of less bleeding, no stitches, less pain, quicker healing, and therefore fewer complications.

Side Effects

Complications or risks of vasectomy are few. Most men experience some degree of soreness for a day or two and are advised to wear an athletic supporter, apply ice packs to the area, and rest for at least 24 hours after the procedure. Acetaminophen (Tylenol) is appropriate for pain control, if desired. The most common complications of vasectomy are swelling, bruising, or infection of the scrotal area; the doctor should be contacted if any of these symptoms develop. These minor complications usually clear up quickly on their own. A small number of patients continue to have painful testicles after vasectomy; the pain is usually treated with nonsteroidal anti-inflammatory drugs or nerve blocks. Men may develop antibodies to their sperm after vasectomy, stimulating the immune system to treat sperm as invaders. This reaction leads to concerns about whether vasectomy may cause an increased risk of immunerelated illnesses, such as heart disease, diabetes, rheumatoid arthritis, prostate cancer, or other conditions. Although the relationship between these diseases and vasectomy has been studied repeatedly, most researchers agree there is little, if any, increased risk associated with the procedure. Future research will hopefully confirm that no such risk exists between vasectomy and immune diseases.

Sexual activity can be resumed when it is comfortable, typically within a few days of the procedure. However, semen may still contain sperm for up to 20 or so ejaculations, so samples of ejaculate must be tested on one or more return visits to confirm that sterility has been achieved.