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What to expect with a vasectomy

Questions like ‘how effective is a vasectomy?’ or ‘can a vasectomy be reversed?’ are commonly asked by patients
Vasectomy-Vasectomies. A man is holding two weights and standing in a field.Vasectomy-Vasectomies. What to expect after a vasectomy? A man is holding two weights and standing in a field.

A vasectomy, or male sterilization, is a very effective, relatively simple option for permanent birth control. It requires only a minor surgical procedure and has one of the lowest failure rates across all birth control. Robert Pope, MD, primary care physician with the Texas A&M Family Medicine Residency Program and clinical assistant professor at the Texas A&M College of Medicine, performs vasectomies in his primary care practice and explains what you need to know before you get one.

What is a vasectomy?

A vasectomy is a minor surgical procedure that interrupts the pathway the sperm takes to travel from the testicles to the penis. The procedure will cut the tubes and separate them, so the sperm cannot flow past that point.

Roughly, 42 to 60 million men worldwide have had a vasectomy. They are notably less risky and more effective than female sterilization like from a tubal ligation.

How to prepare for a vasectomy

Prior to getting a vasectomy, many providers will bring you in for a pre-operative interview. In this appointment, your provider will explain the procedure, answer questions and address any concerns.

Your provider may emphasize the permanence of a vasectomy. “One of the most important ways a man can prepare for a vasectomy is mentally confirming the decision,” Pope said. “A vasectomy is potentially a life-long decision, so if they have any doubt about whether they want children in the future, then this procedure is not for them.”

Additionally, the provider may discuss your family’s approach for family planning. “As a provider, I do not want either partner to feel pressured into permanent sterilization,” Pope said. “We need to make sure he and his partner are on the same page. The partner needs to understand the type and permanence of the procedure as well.”

Is a vasectomy painful?

Most vasectomies require the use local anesthesia to numb the area, which is an advantage to this choice of contraception. This type of procedure does not have the risks that come with general anesthesia and the actual procedure itself is relatively painless.

“The only pain a man might feel during the procedure is from the administration of the numbing shot,” Pope said. “On average, most men rated the vasectomy procedure on a pain scale as a 3 out of 10.”

What does recovery from a vasectomy look like?

“The recovery is usually very short,” Pope said. “Most men with desk jobs usually can go back to work after one to two days. Men with more physical jobs are usually back to work after a few days.”

Some men may feel a mild ache for a day or two after the procedure, but any pain is usually well controlled with an over-the-counter pain medication.

What is the effectiveness rate of vasectomies?

To determine if the vasectomy was successful, patients usually need to deliver a semen sample to their provider. Then, provider analyzes the sample to see if any sperm remain in the semen. If the semen is clear of sperm, then the procedure is deemed successful.

However, like all methods of birth control, a vasectomy can fail at any time.

Because the vasectomy procedure cuts and separates vans deferens—the tubes the sperm takes to travel from the testicles to the penis—the operating physician will make a permanent interruption to the flow of sperm. However, sometimes the body may try to repair the separation or the scar tissue may create small holes which sperm may use to travel.

A vasectomy has a failure rate of 0.15 percent, or roughly a 1 in 1,000 chance to fail. Most vasectomies that fail will do so very shortly after the procedure. However, others will fail years later.

“Once a pregnancy occurs after a vasectomy, then you have to assume that all semen from then on would contain active sperm and potentially create future pregnancies,” Pope said. “Most men who do have failures get a second procedure done just to reinforce what was done the first time.”

Can you reverse a vasectomy?

A vasectomy is reversible. However, according to Pope, the success rate for a vasectomy reversal is only 60 percent due to the challenging nature of the procedure.

Many men opt for a vasectomy reversal due to the death of a child, divorce and remarriage, a change in financial situation or simply for a new desire for more children. A vasectomy reversal is a relatively safe procedure with low risks.

“Even though the reversal is a possibility, men should not make the decision to get a vasectomy on the understanding that it can be reversed. A reversal is not guaranteed,” Pope said. “Also, men need to be aware of the potential cost. Many insurance companies do not cover the cost of a vasectomy reversal, when they covered the cost of the initial vasectomy.”

Are there any possible complications after a vasectomy?

While relatively rare, hematomas have been known to occur after a vasectomy. A hematoma is abnormal collection of blood in the body. They can happen in any part of the body and are often a side effect of a broken blood vessel.

A hematoma can occur because occasionally a smaller vessel will break open and leak tiny amounts of blood under the skin in the scrotum. Your provider may need to drain the hematoma, but they will more than likely tell you to wait a few days to see if it resolves itself.

“Generally, hematomas after a vasectomy will resolve itself in a short period of time,” Pope said. “They usually do not impact the success or failure of the procedure itself.”

People with a blood disorder or that take medications which make them more prone to bleeding may be more likely to form a hematoma.

Why are vasectomies popular?

Vasectomies are a low-risk, relatively painless procedure that offers one of the lowest failure rates across all birth controls. Plus, a vasectomy has no effect on male hormones or the sensation of intercourse.

If you are considering a vasectomy, or are interested in learning more about your family planning options, then speak with your health care provider. “As a primary care physician, I frequently help men, and women, consider their options,” Pope said. “We can help you decide what is the best course of action for you, and your family.”

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