Vasectomy How It Works and What to Expect

A vasectomy is one way men can prevent their partners from becoming pregnant—without affecting sexual function or the ability to orgasm.

A vasectomy is a noninvasive surgery that prohibits sperm from being delivered to a partner by cutting off the small tubes in a man’s scrotum that carry sperm. The procedure is quick and effective—in fact, it prevents pregnancy nearly 100 percent of the time. Let’s go through some of the questions patients commonly ask us about this safe, effective birth control procedure and get some answers.

LISTEN: Dr. Venkatesan discusses vasectomies in the Medical Intel podcast.

Who is a candidate for vasectomy?

Practically all sexually active men are good candidates, although we most often treat those in their 30s to early 50s. These men typically have children and are in stable relationships where they’ve mutually agreed with their partner to have a vasectomy. We occasionally see single fathers, however, who have decided they don’t want any more children.

Rare cases when men aren’t considered candidates include those who have had surgery to their testicles, either to bring an undescended testicle down during childhood or to fix their spermatic cord (which supports the testicle in the scrotum), and those who have had a hernia surgery, as they can cause the surgery to be less effective.

At MedStar Washington Hospital Center, we perform at least 50 to 100 vasectomies per year. The popularity likely is due to the fact that vasectomies allow patients to:

• Go home the same day of surgery with minimal pain
• Stop using other less convenient forms of birth control, such as oral contraceptive pills or condoms
• Receive a much easier treatment than a female partner could have, such as a tubal ligation surgery, or when women have their “tubes tied”

How does a vasectomy work?

A vasectomy involves six steps:

1. Identify the vas deferens—a tube that delivers sperm from the testicles to the urethra—which starts at the top of the scrotum.
2. Bring the vas deferens out through a small incision in the skin.
3. Cut out a small segment of it.
4. Burn each side of the vas deferens on the inside.
5. Tie off each end and fold them away from each other.
6. Put them back into the scrotum in different tissue layers to help ensure the tubes don’t reconnect.

Although a vasectomy can be reversed, it is intended to be permanent. Only select surgeons have experience doing reversals, and it’s usually not covered by insurance.

What can I expect during recovery from a vasectomy?

Sperm count

Men must understand that they aren’t immediately sterile after surgery. Because the body constantly produces sperm, some sperm will remain from where we cut the vas deferens. As a result, patients should refrain from sexual intercourse for two weeks. After that, they can resume sexual activity but must use contraception—condoms or oral contraceptives with their partner—for another six weeks.

At the eight-week mark, patients usually will have a doctor’s visit to ensure they’ve healed and provide a semen sample to make sure they have no sperm count. If this checks out OK, patients are cleared to stop birth control if they desire.

Pain and activity restrictions

Recovery is relatively easy in terms of pain and getting back to everyday activities. We’ll typically do vasectomies later in the week so patients can recover over the weekend. Patients might be sore for a few days, but they generally resume all activities one to two weeks after the procedure.

Patients might need medication, but it depends on their pain tolerance. Oftentimes, Tylenol or ibuprofen can be sufficient, but narcotic pain medication also is available if needed. Additionally, we recommend that men put ice packs on their incisions for the first few days to help them feel more comfortable.

Are there any risks from having a vasectomy?

A vasectomy has some risks, just like any other surgery. This includes the risk of infection and bleeding, as well as injuring organs, nerves, or veins, which could result in chronic pain in the testicle. Patients also could become fertile again if the two ends of the vas deferens somehow remain connected or find their way back to each other and reconnect. However, it’s important to understand that these risks are very low.

Birth control can come in many forms. However, not all options can provide nearly 100 percent accuracy like a vasectomy.