Many are familiar with vasectomy — a common birth control procedure for men — but not necessarily aware of what it entails. 

Let’s discuss what to expect in the lead-up to a vasectomy, what to expect during the procedure and recovery.

What is a vasectomy?

In general terms, a vasectomy is a minor surgical sterilization procedure for men. 

The procedure ensures a man can no longer father children. It is a safe and popular procedure that stops sperm from leaving the body by closing off the ends of the vas deferens — the tubes that carry sperm from the testes — preventing sperm from mixing with semen and releasing during ejaculation. 

While vasectomy is an effective form of birth control, it does not protect against sexually transmitted infections (STIs). To reduce the risk of STIs, you will still need to use a condom during sex. 

It’s also important to note that the failure rate for vasectomy is low, but in rare cases some men have still fathered children after undergoing the procedure. The procedure is also potentially reversible should a man wish to father children later. 

Preparing for a vasectomy

Before undergoing a vasectomy, you and your partner should speak with your healthcare provider about the procedure. You should be absolutely sure that you do not want to father children. While there are options to reverse a vasectomy, they’re not always successful. 

You will sign consent forms acknowledging that this procedure will sterilize you and that you fully understand those ramifications. (Often, your partner will also be asked to sign a consent.) The consent forms will also note that, like all surgical procedures, the procedure is not always 100% effective — vasectomy has a 99.99% rate of effectiveness. A medical history will also be taken.

How a vasectomy is performed

The vasectomy itself is a quick and relatively painless procedure. It is performed as an outpatient procedure in the physician’s office. The patient is often given mild sedation prior to the procedure, or conscious sedation in rare cases. 

After the scrotum is cleansed and prepped, a local anesthetic is injected over the vas deferens and over the cord itself to provide more pain control. The patient may be aware of movement and pressure, but the sedation and anesthetic relieve pain during the procedure and for several hours afterward.

The healthcare provider will cauterize the vas lumen and tie or place titanium clips on the ends. Small dissolvable stitches are then used to close the surgical area.

What to expect after a vasectomy

Most men experience some post-surgical discomfort, including a heaviness in the testicles, but this usually resolves within two to three weeks.  Swelling and bruising is also common, but the use of a scrotal support or tight underwear can help relieve those effects. Most men can return to work or a normal daily routine the day after surgery. If your profession involves physical labor, it may be two or three days before you are cleared to work. 

Other ways to support recovery include:

• Lie down and rest as much as possible the first 24 hours after the procedure.
• Avoid strenuous activity until your healthcare provider clears you to do so. This includes lifting children, heavy bags, etc.
• If you have been prescribed pain medication, use it as directed and do not drive.
• You may shower if your doctor has approved it.
• Before resuming sexual activity, ask your healthcare provider. You will still need to use an alternative birth control method until your sperm count is zero.
• Contact your healthcare provider immediately if you experience an unusual amount of pain, extreme swelling, a fever over 100 degrees Fahrenheit or continuous bleeding.

Long-term expectations after a vasectomy

Some men are reluctant to undergo the procedure because they worry about the effects on normal sexual function. A vasectomy does not affect testosterone production, erections, the ability to climax or the amount of ejaculate. 

Most men who have had the procedure find that sex is more enjoyable since pregnancy is no longer a concern. It also allows for more spontaneity as sexual activity does not have to be interrupted to handle contraception. 

The same has also been said for women who have undergone a tubal ligation. When comparing the two sterilization options, the vasectomy is easier, less expensive, requires less recovery time and has a lower risk of complications than a tubal ligation.

Sexual activity after a vasectomy can be resumed once your healthcare provider has cleared you to do so, but as mentioned above, you must use an alternative form of birth control until your sperm count is zero. Typically, a man will have a semen test two to three months after the procedure. If sperm is still present, you will be tested again each month until it reaches zero. 

Once your sperm count hits zero, it will be safe to stop using other birth control methods. It is important for you to follow up with your healthcare provider for these tests — it’s the only way to ensure that you can no longer father a child.

Vasectomy reversal

If you do change your mind after a vasectomy, the procedure is potentially reversible. 

This procedure is not usually covered by insurance and can be costly. There is also no guarantee that the procedure will be successful. Time is also a factor: the longer it has been since the vasectomy, the less likely the reversal will work.

While rare, a small percentage of vasectomies do fail. Colloquially known as a “natural reversal,” vasectomies can fail due to re-canalization, which is when the body re-grows the sperm channels.