Vasectomy is a type of surgery that prevents a man from being able to get a woman pregnant. It is a permanent form of birth control.

A vasectomy works by cutting the tubes that carry the sperm out of the testicles. The surgery usually takes no more than 30 minutes. Most men go home the same day. In most cases, recovery takes less than a week. Having a vasectomy does not affect your sex life.

It takes about three months before it is effective. Your doctor will test your semen to make sure that there are no sperm in it.

Vasectomies can sometimes be reversed, but not always. Having a vasectomy does not protect against sexually transmitted diseases, such as HIV/AIDS. Men who have had a vasectomy should still practice safe sex to avoid STDs.

A vasectomy is a surgical procedure performed as a method of birth control. It involves cutting the vas deferens to close off the tubes that carry sperm from the testicles (there is one vas deferens per testicle). If a man has a successful vasectomy, he can no longer get a woman pregnant.

Sperm are made in the two testicles, which are inside the scrotum. Sperm is stored in a tube attached to each testicle called the epididymis. When a man ejaculates, the sperm travel from the epididymis, through the vas deferens, and then mix with seminal fluid to form semen. The semen then travels through the urethra and out the penis.

Before a vasectomy, semen contains sperm and seminal fluid. After a vasectomy, sperm are no longer in the semen. The man's testicles will make less sperm over time, and his body will harmlessly absorb any sperm that are made.

Sterilization Surgery for Men (Vasectomy)

This method is for men who are sure they never want to have a child or do not want any more children. If you are thinking about reversal, vasectomy may not be right for you. Sometimes it is possible to reverse the operation, but the likelihood of reversal decreases the more time passes between vasectomy and reversal. Reversal involves complicated surgery that might not work.

What is it?

• This is a surgery a man needs only once.
• It is permanent.

How does it work?

• The surgery blocks a man’s vas deferens (the tubes that carry sperm from the testes).
• After this surgery, the semen (the fluid that comes out of a man’s penis) has no sperm in it.
• It takes about three months to clear sperm out of a man’s system. You need to use another form of birth control until a test shows there are no longer any sperm in the seminal fluid.

How do I get it?

• This is surgery.
• Local anesthesia is used.

Chance of getting pregnant with typical use (Number of pregnancies expected per 100 women who use this method for one year)

• Out of 100 women whose partner has had a vasectomy, less than 1 may get pregnant.

Some Risks

• Pain
• Bleeding
• Infection

The success of reversal surgery depends on:

• The length of time since the vasectomy was performed.
• Whether or not antibodies to sperm have developed.
• The method used for vasectomy
• Length and location of the segments of vas deferens that were removed or blocked.

Does it protect me from sexually transmitted infections (STIs)? No.

A vasectomy is usually performed in the office of urologist, a doctor who specializes in the male urinary tract and reproductive system. In some cases, the urologist may decide to do a vasectomy in an outpatient surgery center or a hospital. This could be because of patient anxiety or because other procedures will be done at the same time.

There are two ways to perform a vasectomy. In either case, the patient is awake during the procedure, but the urologist uses a local anesthetic to numb the scrotum.

With the conventional method, the doctor makes one or two small cuts in the scrotum to access the vas deferens. A small section of the vas deferens is cut out and then removed. The urologist may cauterize (seal with heat) the ends and then tie the ends with stitches. The doctor will then perform the same procedure on the other testicle, either through the same opening or through a second scrotal incision. For both testicles, when the vas deferens has been tied off, the doctor will use a few stitches or skin "glue" to close the opening(s) in the scrotum.

With the "no-scalpel" method, a small puncture hole is made on one side of the scrotum. The health care provider will find the vas deferens under the skin and pull it through the hole. The vas deferens is then cut and a small section is removed. The ends are either cauterized or tied off and then put back in place. The procedure is then performed on the other testicle. No stitches are needed with this method because the puncture holes are so small.

After a vasectomy, most men go home the same day and fully recover in less than a week.

Vasectomy is one of the most effective forms of birth control. In the first year after a man has a vasectomy, a few couples will still get pregnant. But the number is far lower than the rates of pregnancy among couples using condoms or oral contraceptive pills.

However, a vasectomy is not effective right away. Men still need to use other birth control until the remaining sperm are cleared out of the semen. This takes 15 to 20 ejaculations, or about 3 months. Even then, 1 of every 5 men will still have sperm in his semen and will need to wait longer for the sperm to clear.

A health care provider will check a man's semen for sperm at least once after the surgery. Once the sperm count has dropped to zero, it is safe to assume that the vasectomy is now an effective form of birth control. Until that time, men need to use another form of birth control to make sure their partner does not become pregnant.

Although vasectomy is safe and highly effective, men should be aware of problems that could occur after surgery and over time.

Surgical Risks

After surgery, most men have discomfort, bruising, and some swelling, all of which usually go away within 2 weeks. Problems that can occur after surgery and need to be checked by a health care provider include:

• Hematoma. Bleeding under the skin that can lead to painful swelling.
• Infection. Fever and scrotal redness and tenderness are signs of infection.

Other Risks

The risk of other problems is small, but they do occur. These include:

• A lump in the scrotum, called a granuloma. This is formed from sperm that leak out of the vas deferens into the tissue.
• This is called postvasectomy pain syndrome and occurs in some men.
• Vasectomy failure. There is a small risk that the vasectomy will fail. This can lead to unintended pregnancy. Among 1,000 vasectomies, 11 will likely fail over 2 years; and half of these failures will occur within the first 3 months after surgery. The risk of failure depends on a number of factors. For example, some surgical techniques are more likely to fail than others. Additionally, there is a very small risk that the two ends of the vas deferens will grow back together. If this happens, sperm may be able to enter the semen and make pregnancy possible.
• Risk of regret. Vasectomy may be a good choice for men and/or couples who are certain that they do not want more or any children. Most men who have vasectomy, as well as spouses of men who have vasectomy, do not regret the decision. Men who have vasectomy before age 30 are the group most likely to want a vasectomy reversal in the future.

Vasectomy will not affect your sex life. It does not decrease your sex drive because it does not affect the production of the male hormone testosterone. It also does not affect your ability to get an erection or ejaculate semen. Because the sperm make up a very small amount of the semen, you will not notice a difference in the amount of semen you ejaculate.

A vasectomy does not protect you from getting or passing on any sexually transmitted disease (STD), including HIV. You must still use condoms or another barrier method to protect yourself from STDs.

Research shows that vasectomy does not increase a man’s risk of cancer. Some studies in the 1990s found that men who had undergone vasectomy had higher rates of prostate cancer. But findings from more recent studies have conclusively shown no link between vasectomy and prostate cancer. Indeed, men who have vasectomy are no more likely to get prostate cancer than men who do not have vasectomy. Vasectomy also does not increase a man’s risk of testicular cancer.

Almost all vasectomies can be reversed. In a reversal, the cut ends of the vas deferens are surgically reattached. Or, one end of the vas deferens is surgically connected to the part of the testicle where mature sperm are stored.

Vasectomy reversal is usually done in an outpatient surgery center or the outpatient area of a hospital. The surgeon may use general anesthesia.

To reverse a vasectomy, the surgeon makes a small cut in the side of the scrotum and finds the closed ends of the vas deferens. Then a fluid sample is taken from the end closest to the testicle to test for the presence of sperm. If sperm is found in the fluid, the two closed ends of the vas deferens can be reattached.

Many doctors perform the reversal using a microsurgical approach. Here, a high-powered microscope is used to magnify the ends of the vas deferens. It allows the surgeon to use smaller stitches—as small as an eyelash—which reduces scarring. Microsurgery returns sperm to the semen in the majority of reversals.

If no sperm is found in the fluid, there is a blockage in the epididymis or vas deferens. The surgeon gets around this by attaching the upper part of the vas deferens to the epididymis in a place that bypasses the blockage. This procedure is more involved but has nearly as high a success rate as a standard reversal.

Recovery from a reversal usually takes 1 to 3 weeks. As with vasectomy, complications from surgery are possible. Most men who undergo vasectomy reversal report the same or less discomfort during recovery than they had after vasectomy.

Sperm start appearing in the semen about 3 months after the surgery. However, if the surgeon has to work around a blockage, it can take as long as 15 months for sperm to reappear.

On average, it takes 1 year to achieve a pregnancy after a vasectomy reversal. However, a successful reversal (sperm is returned to the semen) does not guarantee pregnancy. The chance of restored fertility and pregnancy is highest when the reversal is performed not long after the vasectomy. The likelihood of restored fertility and pregnancy decreases as more time elapses between the vasectomy and the vasectomy reversal.