A vasectomy works by preventing sperm from mixing with semen during ejaculation. Without sperm in his semen, a man cannot impregnate his partner. To keep sperm from entering the ejaculate fluid, the urologist performing the vasectomy ties or seals off the vas deferens (the tubes carry sperm). After the operation, the testes will continue to produce sperm, but the sperm can no longer pass through the vas deferens. Instead, the sperm die and are absorbed into the body.

Most vasectomies are performed in a urologist’s office while the patient is awake and alert. The doctor administers a local anesthesia to numb the scrotal area. Then he performs the quick procedure. Many men comment that undergoing a vasectomy was easier than having a dental procedure.

After a vasectomy, a man can expect minor discomfort, bruising or tenderness at the site of the incision, but most pain can be managed with by applying cold packs to the area and taking over-the-counter medications. Although the patient may not need it, many doctors provide a prescription for more powerful pain medications, which the patient can fill if necessary. Men are instructed to avoid exercise, heavy lifting and sexual intercourse for three days after the procedure. With few exceptions, men who have a vasectomy on Friday are back to work and normal activities on Monday.

While vasectomies are more than 99 percent effective, the procedure does not work right away. It takes approximately two months or 15 to 20 ejaculations for sperm in the semen to clear. During this time, the couple must use another form of birth control. After the suggested amount of time has elapsed, the man should bring a semen sample to his doctor’s office for analysis. Once the doctor has confirmed the semen is sperm-free, no other birth control method is necessary.

The only change a vasectomy should make in a man’s life is that he will no longer be fertile. A vasectomy will not interfere with a man’s sex drive, ability to have erections, sensation of orgasm or ability to ejaculate.

While billboards and websites may advertise otherwise, vasectomy is considered a permanent sterilization technique. Surgery to reconnect the vas deferens (vasectomy reversal) is available, but the reversal procedure is difficult and may not always work. Furthermore, most insurances do not cover vasectomy reversal, which can cost from $7,500 to $10,000. For these reasons, doctors advise men and their partners to carefully consider which form of contraceptive is most appropriate for their family.

Reviewed by David R. Talley, M.D.  Wednesday, June 20, 2007