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Vasectomy: 6 Things You Need to Know

Private: Michael J. Malone, MD
Contributor Michael J. Malone, MD

Vasectomy is 99 percent effective in preventing pregnancy and can be an appropriate birth control option for those who are not planning more children or those who have decided not to have them. If you or your partner have anxiety about the procedure, relax, says Michael J. Malone, MD, Department of Urology at Brigham and Women’s Hospital. A vasectomy is a short outpatient procedure with a brief recovery period. Read on to learn more about vasectomy.

What are common misunderstandings about vasectomy?

According to Dr. Malone, misunderstandings about vasectomy can heighten anxiety unnecessarily. A vasectomy is simply the disconnection of the vas deferens, the tubes that deliver sperm from the testes to the seminal fluid or semen during intercourse. A vasectomy does not involve the removal of the testes. Fears about erectile dysfunction are also unfounded. Following a vasectomy, the testes still produce sperm, but sperm die and are absorbed by the body. Sexual health is unchanged—testosterone levels remain the same and the ability to achieve an erection is not affected.

What happens during a vasectomy?

Vasectomy is an outpatient procedure performed with a local anesthetic. At Brigham and Women’s Hospital, we now offer a no-scalpel minimal invasive vasectomy which involves making one or two very small punctures in the scrotal skin to perform the procedure. This minimizes post-operative pain, swelling, risk of bleeding, and risk of infection. The procedure lasts about 20-25 minutes.

The first step in a vasectomy is to locate and expose the vas deferens. The surgeon will then remove a small section of the vas deferens through a small incision to interrupt the vas which then prevents transport of sperm during ejaculation. To prevent the two ends of the vas deferens from rejoining, the surgeon will seal the ends and stitch both ends closed. Your physician will close the skin with stitches which dissolve during the healing process. The entire procedure is repeated on the second testicle.

What is the recovery period like?

Patients may be sent home with a prescription for pain medication, though Tylenol may be all that is needed to relieve any discomfort. The most important part of recovery after vasectomy is taking it easy. Physical activity for the first one to two days should be limited to relaxing on the couch and watching television, says Dr. Malone.

For the first day of recovery, men will also need to keep an ice pack on the scrotum for 20 minutes of each hour until bedtime. The ice pack will minimize swelling and help keep the numbing medication that was used during the procedure within the scrotum, providing additional relief. The day after a vasectomy men can get up, walk around, remove the dressing and take a shower. Dr. Malone advises that patients that they avoid heavy lifting and lengthy walks on the first day of their recovery.

Men can expect to return to work within 24 to 48 hours of their procedure. Exercise routines which include intense activity, weightlifting running, or swimming, should be avoided for the first week after the procedure, says Dr. Malone. Men can resume sexual activity as soon as they feel comfortable but should they continue to practice birth control until with their partner until a sperm analysis confirms there is no sperm in their semen.

How soon does a vasectomy take effect?

It takes about two months for a vasectomy to become effective so men should continue to use birth control with their partner until a sperm analysis, performed two months after the procedure, confirms that there is no evidence of sperm in the semen. If the sperm analysis does detect sperm in the semen the sperm analysis will be repeated at monthly intervals until negative.

What are the risks associated with vasectomy?

Risks associated with vasectomy include bruising and swelling around the scrotum and recanalization or a reconnection of the ends of the vas deferens. The risk of recanalization is less than one tenth of one percent. If it does happen it will occur within the first few months of the vasectomy which is why it’s important to follow up with the sperm analysis afterwards.

What should be considered prior to vasectomy?

Though vasectomy is reversible, the procedure to reconnect the vas deferens is more involved than a vasectomy. If there is any chance you may want children in the future, Dr. Malone advises waiting until you’ve given the procedure more thought.

Private: Michael J. Malone, MD
Michael J. Malone, MD

Michael J. Malone, MD, is the Section Chief, Division of Urology, at Brigham and Women’s Faulkner Hospital.

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