What Is a Vasectomy & How Is It Performed?

By BSc, MSc (embryologist), (embryologist), MD, MSc (gynecologist), MD (gynecologist), BSc, MSc (embryologist) and (invitra staff).
Last Update: 12/02/2020

Vasectomy is a method of male sterilization that involves the section and ligation of the male's vas deferens through a surgical procedure.

This is a permanent method of contraception, as it prevents the sperm from leaving with the ejaculate and therefore prevents pregnancy.

The effectiveness of vasectomy is very high and has few side effects. In addition, in most cases, it is reversible through a so-called vasovasostomy. However, its effectiveness will depend on the way the vasectomy was performed and the time that has elapsed.

How is vasectomy done?

Vasectomy is a surgical procedure that involves blocking the vas deferens (channels that carry sperm ) of the male reproductive system so that sperm is stopped from passing from the testicles to the urethra.

After ejaculation, the sperm will be stored in the epididymis instead of coming out, and will eventually be reabsorbed by the body itself.

Vasectomy does not alter sperm production (spermatogenesis) or hormone production. It only prevents the sperm from leaving the semen in order to avoid pregnancy.

To perform a vasectomy, surgical intervention is necessary that lasts about 20 minutes and can be carried out in two basic ways that are discussed in the following section.

Types of vasectomy

There are two ways to perform a vasectomy on a male, an incisional method and a non-incisional method. Each of the possibilities is detailed below:

Scalpel Vasectomy
through a cut in the scrotum (pouch of the testicles), the surgeon accesses the vas deferens, binds it and cuts it, thus blocking the passage of the sperm. You can also cauterize them with an electric scalpel.
Vasectomy without scalpel
instead of using the scalpel to make a cut, simply make a small hole with special pliers to reach both vas deferens. First, the surgeon will look for the vas deferens by palpation of the scrotum and will hold it in place with ring-shaped forceps. Then, with sharper tweezers, a tiny puncture is made to allow access to the vas deferens to bind or cauterize it.

In both cases, local anesthesia is used to do the procedure. Finally, the remaining hole is sealed with a stitch or surgical rubber.

The operation without a scalpel is less uncomfortable for the patient since the size of the hole made is smaller, bleeding is less and it takes less time to heal. Also, the risks of infection or other complications are less.

After vasectomy

Recovery from vasectomy surgery is rapid. The man will only need to rest for a few days for the wound to heal properly.

Some men have described feeling discomfort, some pain or swelling in the testicles. However, these symptoms are not intense.

In addition, before the vasectomy is performed, the man should be aware that this method of definitive sterilization also has other advantages and disadvantages that may arise in the future.

Advantages

Vasectomy effectiveness is close to 100%. Once 3 months have passed since the operation and it is proven that the man has no sperm in his semen through a seminogram, the possibility of pregnancy will be almost nil.

This will allow the couple to enjoy sex more, as concerns about a possible unwanted pregnancy disappear.

It should be noted that vasectomy does not prevent ejaculation. The semen will have the same volume and composition from the secretions of the prostate and the seminal vesicle. However, the vasectomized male will go into a situation of azoospermia, that is, the total absence of sperm in the semen.

Vasectomy is a simpler, safer, and more effective procedure than tubal ligation for women. In addition, it is also cheaper and, for all this, it is the preferred option among couples who do not wish to have more children.

Vasectomy also does not influence a man's sexuality or masculinity. Vasectomized men have the same sexual desire and erection capacity as they had prior to the operation.

Another advantage of vasectomy is that it is a simple procedure, with negligible side effects and few risks.

Disadvantages

The effectiveness of vasectomy is not immediate. In order to guarantee the complete absence of spermatozoa in the ejaculate, a period of about three months or more than 20 ejaculations is required after the operation.

To check that the semen is indeed already free of sperm, it will be necessary to perform a post-vasectomy control semen analysis. Although it is a simple surgical operation, it is not totally risk-free. There are specific situations in which the man may feel a swelling or more acute discomfort in the testicular area, as well as being able to suffer from orchitis.

Another disadvantage as a contraceptive method is that it does not protect against sexually transmitted diseases. Therefore, it is recommended to use a condom in case of casual sex with different women.

Finally, something that is an advantage for some and a disadvantage for others is that it is permanent. While it is true that vasectomy can be reversible, this option is more complicated and does not always allow for the recovery of reproductive capacity.

Post-vasectomy treatment

As we have said, vasectomy is a simple operation, but it can cause some discomfort in the first few days. Therefore, it is recommended that the patient not make great efforts, especially in cases of vasectomy with a scalpel.

If the man has a job that involves heavy physical exertion or a lot of walking, he may need to take time off work for about a week. If the scrotal area is quite painful, it is recommended to apply ice for about 15 minutes and take painkillers, except for aspirin, which is an anticoagulant.

On the other hand, it is recommended that the wound be treated about twice a day, as indicated by the specialist. Normally, the cure is done with saline, betadine and gauze.

It is advisable to be careful when showering and to avoid baths. It is also important to wear loose-fitting clothing and underwear to avoid testicular swelling.

Finally, it is important to avoid ejaculation for at least the first 7 days, as it can be painful and cause bleeding from the wound.

Vasectomy and pregnancy

As we have already mentioned, vasectomy is a surgical contraceptive method that prevents pregnancy permanently. It is therefore essential that the man who is to undergo this intervention should be clear that he does not wish to have any more children.

Despite this, there are many men who change their minds and, after a while, want to reverse the vasectomy so they can become parents.

The operation to recanalise the vas deferens and allow sperm to pass back into the urethra is known as vasovasostomy. It's more complex and lasts longer than a vasectomy. In addition, its success will also depend on the way the vasectomy was performed and the time that has passed since the surgery.

The probability of regaining fertility after vasovasostomy is high and many men have achieved natural pregnancy again. Still, this has not always been possible.

There are other options related to assisted reproduction so that men with the vasectomy done can be parents again. Below, we are going to detail reproductive alternatives:

If you need to undergo IVF to become a mother, we recommend that you generate your Fertility Report now. In 3 simple steps, it will show you a list of clinics that fit your preferences and meet our strict quality criteria. Moreover, you will receive a report via email with useful tips to visit a fertility clinic for the first time.

Although all these techniques allow pregnancy to occur again, it is always advisable to think through the decision to have a vasectomy.

You may also want to consider freezing your sperm before your vasectomy. This is a method of preserving male fertility that would allow a biological child in the future with a simpler treatment

FAQs from users

By Sergio Rogel Cayetano MD (gynecologist).

A seminogram is usually requested three months after the vasectomy. Given that the period of production of the sperm is approximately 3 months, if azoospermia is proven after this period, it is possible to deduce that the testicle is functioning at full capacity after the surgery and that the section has been a success since no sperm reaches the exterior.

Which fertility treatment is best for patients who had a vasectomy?

By Rebeca Jiménez Alfaro MD, MSc (gynecologist).

Vasectomy is a permanent surgical contraceptive method that consists of blocking the vas deferens (channels that transport the semen) of the male reproductive system so that the passage of sperm from the testicles to the urethra is interrupted. This procedure is considered irreversible.

On some occasions, vasectomized men wish to have children again, for which they can resort to various treatments:

  • Vasovasostomy. Intervention to recanalise the vas deferens and allow sperm to pass back into the urethra. It is a complex procedure and the result will depend on the way the vasectomy was done, as well as the time that has passed since it was performed. Its success rate is much lower than the success rate with an in vitro fertilization treatment. It has the disadvantage that once pregnancy has been achieved, the patient must undergo another vasectomy if she does not wish to have any more offspring.
  • In vitro fertilization (IVF) with sperm obtained from testicular biopsy or epididymis aspiration
  • Sperm donation for artificial insemination (AI) or IVF depending on the characteristics of the woman.

How much is pregnancy likely after vasectomy?

By Zaira Salvador BSc, MSc (embryologist).

The likelihood of pregnancy in a couple whose man has had a vasectomy is virtually zero. There is a possibility that the tubes may recanalize on their own, but this occurs rarely and, moreover, with current surgical methods it is very rare.

It is important to remember that pregnancy can occur in the first few months after a vasectomy, so it is recommended that an additional method of contraception be used.

Can epididymitis be a complication of vasectomy?

By Marta Barranquero Gómez (embryologist).

Yes. Once a vasectomy is performed, a man may feel a sense of heaviness or discomfort in the genital area. In addition, he may have some testicular inflammation and pain, which could lead to epididymitis.

In these cases, it is essential to inform the specialist so that he can establish the best treatment for each particular case and some advice on how to alleviate the patient's symptoms.

Suggested for you

Vasectomy is not irreversible. If you want to become a father again after a while, you can evaluate the options we discussed in the following post: Is pregnancy possible with vasectomy?

We have discussed tubal ligation as a method of female sterilization. You can get more information about this in the following article: What is tubal ligation?

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Authors and contributors

 Cristina Mestre Ferrer
Cristina Mestre Ferrer
BSc, MSc
Embryologist
Bachelor's Degree in Biological Sciences, Genetics & Human Reproduction from the University of Valencia (UV). Master's Degree in Biotechnology of Human Assisted Reproduction from the UV and the Valencian Infertility Institute (IVI). Embryologist at IVI Barcelona. More information about Cristina Mestre Ferrer
 Marta Barranquero Gómez
Marta Barranquero Gómez
Embryologist
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Rebeca Jiménez Alfaro
Rebeca Jiménez Alfaro
MD, MSc
Gynecologist
Bachelor's Degree in Medicine from the University of Murcia, with specialty in Obstetrics and Gynecology, and Master's Degree in Human Reproduction by the King Juan Carlos University and the Valencian Infertility Institute (IVI). Currently, she is part of the medical team of the clinic Tahe Fertilidad. More information about Rebeca Jiménez Alfaro
License: 303009153
 Sergio Rogel Cayetano
Sergio Rogel Cayetano
MD
Gynecologist
Bachelor's Degree in Medicine from the Miguel Hernández University of Elche. Specialist in Obstetrics & Gynecology via M. I. R. at Hospital General de Alicante. He become an expert in Reproductive Medicine by working at different clinics of Alicante and Murcia, in Spain, until he joined the medical team of IVF Spain back in 2011. More information about Sergio Rogel Cayetano
License: 03-0309100
 Zaira Salvador
Zaira Salvador
BSc, MSc
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Romina Packan
Romina Packan
inviTRA Staff
Editor and translator for the English and German edition of inviTRA. More information about Romina Packan

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