Vasectomy

Definition

Vasectomy is a simple surgery that provides birth control for men. A vasectomy prevents you from getting your partner pregnant by cutting and sealing the tubes that carry sperm into your semen. The surgery is straightforward and has a low risk of problems. For most men, a vasectomy doesn't cause any noticeable side effects. Before getting a vasectomy, you need to be sure you don't want to father a child in the future. Surgery to reverse a vasectomy is complicated and doesn't always restore fertility.

Why it's done

  • Vasectomy is a good birth control choice for men who are certain they don't want to father a child.
  • Vasectomy is nearly 100 percent effective in protecting against pregnancy.
  • Vasectomy is a minor outpatient surgery with a low risk of complications or side effects.
  • The cost of a vasectomy is far less than the cost of female sterilization (tubal ligation) or the long-term cost of birth control medications for women.

Risks

Vasectomy is generally a very safe procedure. Serious side effects or complications are rare.
Vasectomy side effects right after surgery can include:

  • Swelling
  • Bruising of your scrotum
  • Bleeding or a blood clot (hematoma) inside the scrotum
  • Blood in your semen
  • Infection of the surgery site

Complications that may occur some time after surgery include:

  • Pregnancy, in the rare event that your vasectomy fails to block the flow of sperm or the tubes that carry sperm grow back together. A semen analysis about three months after your surgery will verify that there are no sperm present.
  • Fluid buildup in the testicle, which can cause a dull ache in the testicles that gets worse with ejaculation.
  • An immune system response to leaking sperm that causes inflammation around the testicle (granuloma).
  • Although a few researchers have suggested that vasectomy increases your risk of prostate or testicular cancer, studies have found no clear link between the two.

If you change your mind about having a child, it may be possible to reverse your vasectomy. However, there's no guarantee a vasectomy reversal will work — and the surgery is more complicated and risky than is the original vasectomy. Before you get a vasectomy, you should be certain you don't want to father a child in the future.

How you prepare

While some family medicine doctors do vasectomies, most are done by a urologist. Urologists are doctors with training in urinary and reproductive medicine.

Talking to your doctor

Deciding to get a vasectomy can be a tough decision, since you won't be able to father a child in the future. Before doing a vasectomy, your doctor will want to have an in-depth conversation with you to be sure a vasectomy is the right form of birth control for you. If you're in a relationship, it's a good idea to bring your partner to your initial doctor's appointment. Be prepared to discuss:

  • Whether there's any chance at all you might want children in the future
  • How your partner feels about the decision, if you're in a relationship
  • Other methods of birth control available to you
  • What a vasectomy surgery and recovery involves, and possible complications

Before surgery

Before your surgery, your doctor will give you instructions on how to prepare. You'll likely be asked to:

  • Stop taking aspirin one to two weeks before your surgery.
  • Stop taking other medications that can thin the blood three to four days before your surgery, such as warfarin (Coumadin), heparin and anti-inflammatory medications such as ibuprofen (Advil, Motrin, others). Acetaminophen (Tylenol,others) is OK.

What you can expect

A vasectomy is usually done at a doctor's office or surgery center under local anesthesia, which means you'll be awake and have medicine to numb the surgery area.

During surgery

To perform a vasectomy, your doctor will:

  • Examine your scrotum
  • Numb the surgery area
  • Make a small puncture in the upper part of your scrotum after the area is numb
  • Withdraw each of the tubes that carry semen (vas deferens) and tie them, seal them with heat (cauterize them) or close them with surgical clips

In some cases a small incision in the scrotum is used to do a vasectomy, but vasectomy is usually done with a "no-scalpel" technique. This involves making a tiny puncture in the scrotum and using special clamps to seal each vas deferens. This procedure is preferable because the hole in your scrotum is virtually invisible and will heal without stitches. It has less of a risk of bleeding or infection than other vasectomy techniques.

Vasectomy surgery usually takes about 20 to 30 minutes.

After surgery

Following a vasectomy, you'll have some bruising, swelling and pain. It usually gets better within a few days. Your doctor will give you instructions for taking care of yourself after your vasectomy, which may include:

  • Supporting your scrotum with a bandage and tightfitting underwear for at least 48 hours after your vasectomy.
  • Periodically using an ice pack to help with swelling and pain for one to three days after surgery.
  • Resting for 24 hours after surgery. You can probably do light activity after two or three days, but you'll need to avoid sports, lifting and heavy work for a week or so.
  • Not taking any aspirin or ibuprofen for three to seven days after surgery. These medications increase your risk of bleeding.
  • Avoiding sexual activity for a week. If you do ejaculate, you may notice blood in your semen for three or four days after surgery.
  • Contacting your doctor right away if you have signs of infection, such as pus or blood oozing from the surgery site, fever
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