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What is a vasectomy?

Vasectomy is a minor surgical procedure to disrupt the flow of sperm as a method of birth control The testicle has 2 functions: it produces the male hormone testosterone that goes directly in the bloodstream. This function will continue after a vasectomy, therefore a vasectomy will not interfere with libido. The second function of the testicle is the production of sperm which is collected thru tubules into a larger tube called the epididymis, a structure behind the testicle that eventually becomes the vas. This tube goes all the way up the scrotum into the inguinal canal and joins other structures such as the seminal vesicles and prostate and together are expelled during ejaculation. It is between the testicle and the inguinal canal that the vas is cut or tied off thru a small opening in the skin. This can be easily performed under local anesthesia using the no-scalpel technique. Both the right and left side can be done thru the same opening to minimize discomfort. Some doctors remove a portion of the vas and ligate both ends of the vas, while others put a small clip on it.

Vasectomy complications

Although a minimally invasive procedure, a vasectomy can have all the possible complications of a more major operation, such as bleeding and infection. This is especially true because the scrotum (sac) is a loose structure that accommodates a large amount of bleeding /oozing because it does not compress or tamponade the bleeding site. Therefore it is important to refrain from heavy lifting or straining immediately after a vasectomy, this includes driving a car. Mild compression using a jockstrap and ice packs is recommended to reduce the possibility of bleeding. Infection can happen anytime, but is usually a rare occurrence. There will be some redness of the incision site which is normal. Some doctors put a stitch in the incision site which will be dissolve spontaneously. Some do not require it at all if the no scalpel technique is used. A small amount of drainage is normal unless it is purulent. If this happens, especially if fever is present, contact your doctor for a checkup and if needed, some antibiotics. Because the flow of the sperm is cut off, there might be a slightly higher incidence of epididymitis, although this condition is seen starting from pubertal boys all the way to elderly men, and is a common condition. (This is an infection of the structure behind the testicle, which will become enlarged and tender, sometimes years after a vasectomy)

Do I still have sperm immediately after a vasectomy?

Yes, you are still a loaded gun for several ejaculations. It is best to bring a semen sample to your doctor to assure there are no more "stragglers" in your semen. It is also possible to buy a home kit called Alere Spermcheck to check it yourself a month after a vasectomy, or even 2 years after.

Is a vasectomy guaranteed to be successful?

It is by far the most successful method of birth control, however it is not 100% successful. The body has the ability to repair itself, and sometimes tries to preserve its function. In these instances, the cut tube reconnects itself, sometimes years later, and produces sperm again. This is estimated to be 1 in a thousand vasectomies. Some of the so called failures of vasectomy that happened in the first 3 months following the procedure are actually "leftover" sperm, which is why it is imperative to check before stopping other methods of contraception.

Does vasectomy cause cancer?

A recent article linked a modest increased risk of prostate cancer in vasectomized men, although it is unclear whether this is a causal relationship. It is possible that vasectomized men tend to have more regular checkups.

Can a vasectomy be reversed?

A request of a vasectomy reversal is usually by men in their second marriage, with a spouse who does not have children of her own, or believes that having children will strengthen the relationship with her husband. The success rate of the vas reversal is somewhat dependent on the time it was performed, the possibility that the body produces antibodies against its own sperm, the skill of the surgeon (micro surgeon). Before this is performed the wife should be evaluated also, as a problem in the wife can magnify the condition, who should also be cautioned that success is not guaranteed. This is especially true for women who feel their biologic clock ticking, and might cause great stress in the relationship. A reversal is usually not covered by insurance and may cost thousands of dollars.

Can vasectomy cause impotence?

Because a vasectomy does not cause an interruption of the production of the male hormone testosterone, it does not cause any changes in libido and erectile ability. However, if a man is misinformed or has misconception about a vasectomy, it might cause psychological problems ("cutting my manhood") causing erectile dysfunction. The contrary might also be true, where the man is freed from the possibility of impregnating a woman, and might feel more liberated and promiscuous after a vasectomy.

Will a vasectomy reduce my semen volume?

The actual amount of sperm is a minute amount of the ejaculated semen which is mostly produced by the prostate and the seminal vesicles, that it will not be noticeable after a vasectomy. The amount of semen produced will slowly decline with age and is not a result of the vasectomy.

Can a vasectomy cause premature ejaculation?

No, it does not.

When can I resume sexual activity after a vasectomy?

Because ejaculation is a "violent" contraction of the reproductive tract to expel the sperm and semen, it is best to withhold activity for at least 3 days, with optimum being 1 week.

What is the best method of birth control?

There are numerous options of birth control, more limited for males who has to rely on the female partner for adequacy and accuracy of birth control. Vasectomy is still considered the best permanent form of birthcontrol although nasal male birth control sprays are in the works.

Contact The Writers

Dr Paul M.

Senior Medical Staff Columnist


Dr Paul M. is a board certified surgeon with over 35 years of experience. He has held the title Chief of Staff at several hospitals and maintained a private practice for many years.