If you have a vasectomy scheduled, you might be a little nervous or unsure of what to expect. After all, it’s surgery on a very sensitive area, and hearing people casually call it “the snip” could leave you feeling a bit apprehensive.
But rest assured that “most men find the process to be smooth and easy and are very happy with their decision to have a vasectomy,” says UNC Health urologist Steven Brousell, MD.
He shares what you should know before your vasectomy.
1. Vasectomies are effective and safe.
The list of reliable birth control options for men is short: condoms and vasectomies, Dr. Brousell says. Condoms are a good option but work only if you use them every single time, and some couples would rather not. Plus, they’re not perfect—condoms can break or slip off.
On the contrary, “vasectomies are extremely reliable and virtually 100 percent effective for men who follow the post-procedure testing protocol,” Dr. Brousell says.
Here’s how a vasectomy works: Sperm are made in the testicles for the purpose of fertilization of the egg during conception. The testicles and the urethra, the tube in the penis from which men ejaculate, are connected by a tube on each side called the vas deferens. Think of the vas deferens as the roadway for sperm to make it into semen; interrupting that roadway causes men to be sterile.
During a vasectomy, the urologist makes a tiny hole in the scrotum; from there, they isolate each of the vas deferens, take out a short segment, and seal the ends.
“When the tubes are interrupted, there’s no way to deliver sperm. However, there is no change to erectile function, sexual desire or even the volume of semen; it simply lacks sperm,” Dr. Brousell says.
The surgery is minimally invasive and complications are rare. Your doctor will ask you to shave your scrotum at home and bathe well before your procedure to reduce the risk of infection, which is very low—less than 1 percent, Dr. Brousell says.
2. A vasectomy is performed in mere minutes, but confirmation takes months.
The surgery takes about 15 minutes and is performed with local anesthetic in your urologist’s office. The only thing you’ll feel is a shot on each side of your scrotum, which delivers the anesthetic. Think of it like getting numbed at the dentist, Dr. Brousell says. You can drive yourself to your appointment and drive yourself home. Some men do take an oral sedative for anxiety, which can be provided by your physician by request. In this case, you would need a ride home.
For the surgery, you’ll lie down and be covered with a little drape, so you don’t see anything. Dr. Brousell and his vasectomy patients often talk during the procedure; some listen to music or scroll on their phones.
Despite the quick visit, Dr. Brousell reminds every patient that “it takes two to three months to have a vasectomy successfully.” That’s because there is still sperm living in the vas deferens above where it was sealed. You have to return for testing to make sure there’s no sperm in your ejaculate before you can rely on the vasectomy as birth control.
3. Recover from a vasectomy with ice and rest.
For the first two days after your vasectomy, you should take it very easy. Dr. Brousell tells his patients to recline on the couch, watch TV and ice their scrotum for 20 to 30 minutes at a time. Wear a jock strap or tight underwear for support.
“This is not the time to help with groceries or do yard work,” he says.
Over-the-counter drugs work well for any soreness, he says. “Between Tylenol, ibuprofen and lots of ice, guys are very comfortable. It really is a straightforward and easy thing to recover from.”
After two days, you can slowly increase your activity level. Avoid vigorous activity. Doing too much too soon can result in bruising.
After your vasectomy, you’re instructed not to ejaculate for a week and then to ejaculate at least 20 times over the next couple of months, Dr. Brousell says. That’s usually enough to clear any remaining sperm from the vas deferens. Your doctor will perform a semen analysis about two months after your procedure; Dr. Brousell does another one a month after that to be sure.
Once your doctor tells you your vasectomy was successful, you and your partner can discontinue other forms of contraception.
4. Vasectomies are permanent.
People sometimes believe that vasectomies can be reversed easily, which is not the case, Dr. Brousell says. It is possible to reverse them, but it doesn’t always work.
Do not pursue a vasectomy until you are certain you are done fathering children. Of course, sometimes life changes in ways you cannot expect, and even men who felt sure sometimes change their minds. In those situations, doctors can attempt a reversal or extract sperm from the testicles for in vitro fertilization.
“Regardless of a man’s age, I always counsel them extensively that a vasectomy is permanent,” Dr. Brousell says. “We can attempt to reverse it, but there’s no guarantee it will work.”
5. A vasectomy can improve your sex life.
For some couples, a vasectomy makes a fulfilling sex life easier to achieve. Many men are pleased to take on the responsibility for contraception so their partners can go off hormonal birth control, Dr. Brousell says. And vasectomies are less invasive and lower risk than tubal ligation, the surgery for female sterilization.
Without worrying about pregnancy, some couples find their sex lives to be more spontaneous and enjoyable. And there’s no impact on sexual function; 95 percent of ejaculate is made outside of the testicles, so you won’t notice a difference, Dr. Brousell says. Your testicles will still make sperm, which will be reabsorbed by the body.
“Patients tend to be very happy after, as do their partners,” Dr. Brousell says.
But a word of caution: If you’re not monogamous, you’ll want to continue to use condoms during sex to prevent sexually transmitted infections.
If you have questions about your reproductive health, ask your doctor or find one near you.