Urology

Frequently Asked Questions: Vasectomy & Vasectomy Reversal

Vasectomy has become a widely used form of male contraception, chosen by approximately 5–10% of US couples.

How is it done?

Although there are several techniques for performing vasectomy, the most common are variations on the “no-scalpel” technique. Each vas is grasped in such a way as to bring it to the surface of the skin. This may be done on both sides of the scrotum or both may vas may be brought to the same position so there is one incision. Your comfort is a high priority with us and we have developed several techniques to ensure that the vasectomy is neither scary nor painful.

Once the vas is fully dissected and isolated, it is divided. Many techniques may be used to ensure good separation of the vas. Based on the available studies, we feel that the best outcomes are achieved with a combination of 1) clipping the vas with permanent, small titanium clips 2) sealing the inside (“lumen”) of the vas and 3) interposition of tissue between the two ends of the vas.

Does it work?

Vasectomy works very well, with an unwanted pregnancy rate well below 1%. However, some points are important to remember.

  • The vas (where sperm are transported) is a very long tube. It requires time and ejaculations (at least 30) to clear the vas. The vasectomy does NOT work immediately. We CANNOT consider you sterile until you have two negative (no sperm seen) semen analyses. These are typically done 6 and 8 weeks after the procedure. If there are still sperm present, you may need to give additional samples.
  • Although vasectomy is reversible, the reversal is expensive and not completely reliable. It is a bad idea to have a vasectomy if there is any thought that you might want to have additional children.

What are the risks?

Risks include bleeding, swelling, discomfort, “recanalization” (i.e. the vas comes back together), infection, sperm granuloma (a swelling or lump where the vas was cut), persistent non-moving sperm in the semen analyses. To minimize issues after the procedure, it is best to take it very easy for a couple of days after the procedure and be relatively inactive (no sports or intense exercise) for a couple weeks. We have developed a written post-vasectomy instruction sheet to help patients remember what to do.