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Vasectomy

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Vasectomy:
Answers to Your Questions

What is vasectomy?
What is no-scalpel vasectomy?
How does vasectomy work?
Does vasectomy cause any medical problems?
Will it affect me emotionally?
Will it affect my masculinity?
How will it affect me sexually?
Will it protect me from sexually transmitted infections, like AIDS?
Can the operation be reversed?
Can I store semen in a sperm bank in case I change my mind?
About the operation
Will the operation hurt?
Are there any risks?
Does vasectomy ever fail?
How much will it cost? How can I pay for it?
After the operation
How long will it take me to get back to normal?
Will I have to take time off from work?
How soon after the operation can I have sex?
Will I still ejaculate?
What happens to the sperm?
Will I be sterile right away?
How can I decide?
Is vasectomy the right method for me?

What is vasectomy?

Vasectomy is a minor operation that is usually done at a doctor's office or at a clinic. You are awake during the surgery, which usually takes no more than 30 minutes. First, the scrotum is shaved and cleaned. The doctor injects a local anesthetic into the skin of your scrotum to numb it. Then the doctor makes one or two small cuts in the skin of the scrotum through which the tubes are gently lifted out. The doctor cuts the tubes, and may remove a small piece of each. The cut ends are tied or sealed with electric current. The openings in the scrotum are closed with small stitches. After a short rest (usually half an hour) you can go home.

No-scalpel vasectomy

This method of vasectomy, which was developed in China, does not use a scalpel. After the anesthetic is injected, the doctor pierces the skin of the scrotum with a sharp instrument, then gently stretches the opening so that the tubes can be reached and blocked. No stitches are needed to close the tiny wound. There is very little blood, and fewer complications than when the scalpel is used. This procedure accounts for nearly one-third of all vasectomies in the United States.

More information about no-scalpel vasectomy.


How does vasectomy work?

Sperm are made in a man's testes. During a man's sexual climax the sperm travel through two tubes (vasa deferentia), mix with semen, and come out of the penis. If the sperm enter a woman and one of the sperm joins an egg, the woman will become pregnant. During a vasectomy, these two tubes are cut and blocked so the sperm cannot mix with the semen. Without sperm in his semen, a man can no longer make his partner pregnant.

After a vasectomy, a man still has erections and climaxes. The amount of fluid in his ejaculations is not different, except there is no sperm. The fluid looks and smells the same. A man's hormones, beard, and voice do not change. His sex drive and ability to have sex do not change. The only change is that he cannot make a woman pregnant.

Does vasectomy cause any medical problems?

Most medical experts, including special panels convened by the National Institutes of Health and by the World Health Organization, have concluded that vasectomy is a safe procedure. A number of studies have examined the health effects of vasectomy. The body of research evidence continues to be reassuring and suggests that vasectomized men are no more likely than other men to develop heart disease, cancer, or other illnesses.

Will vasectomy affect me emotionally?

The decision to end your fertility is not a simple one. You may feel a little uncomfortable about ending the part of your life involved with creating a family. You may feel that you are getting older. These feelings usually pass in time, as you go on to the next stage of your life. On the other hand, you may feel relieved that the worry about pregnancy is over. You may feel freer and more spontaneous. You may be able to concentrate more on yourself, your children, your job, your partner, and your future.

Will vasectomy affect my masculinity?

No. Your body will continue to produce the hormones that make you a man. There will be no change in your beard, your voice, or any other of your male traits. The operation will not cause you to lose strength.

How will vasectomy affect me sexually?

Probably not at all. Your sexual drive will not change. Your erections and climaxes will be the same. Some men say that without the worry of accidental pregnancy and the bother of other family planning methods, they and their partners find sex more pleasurable and spontaneous. Once in a while a man has sexual problems after the operation. This is almost always emotional rather than because of physical changes.

Will vasectomy protect me against getting or passing on sexually transmitted infections, including AIDS?

No. Vasectomy will make you incapable of fathering a child. If you are at risk of disease because your partner has a sexually transmitted infection, or because you have many sex partners; or if you have a disease you can pass on, the best way to protect yourself and your partner is by using condoms.

Can vasectomy be reversed?

Even with improvements in surgical technique, you cannot count on the successful reversal of your vasectomy. The chance that the average man seeking reversal will be able to father a child is much smaller than many published success rates suggest. The reversal operation is more difficult and far more expensive than vasectomy. If you are seriously thinking about reversal now, vasectomy may not be the right step for you at this time.

Can I store semen in a sperm bank in case I change my mind?

You cannot be sure that semen stored in a sperm bank will be able to cause a pregnancy at an unknown time in the future. Sperm banking is not fertility insurance, and it is quite expensive. If you are thinking about sperm banks, vasectomy may not be right for you now.

About the operation

Will the operation hurt?

Before the operation, you may be given a mild sedative to relax you. When the doctor injects the local anesthetic into the skin of your scrotum, you will feel some discomfort. After the anesthetic takes effect, you should not feel any pain.

Are there any risks to the operation?

All surgery involves some risk, but the chance of serious problems is small with vasectomy. Some medical problems can occur. However, these problems don't happen often and usually disappear with simple treatment.
  • You may have an infection or swelling around the incision(s) or inside your scrotum.
  • You may have bleeding under the skin that might cause swelling or bruising.
  • If sperm leak from the vas into the tissue around it, you might feel a small lump, but this is not usually troublesome. Occasionally, this may need surgical treatment.
  • Does vasectomy ever fail?

    Yes, rarely. There is a very small chance (less than 1%) that a man's partner will become pregnant after he has had a vasectomy. A vasectomy can fail if the tubes were not completely sealed off during surgery. Sometimes, the cut ends of the vasa join together by themselves, or an opening develops that lets sperm pass through. A pregnancy may also happen if a couple do not use some other kind of family planning until a test of the semen shows that the man is sterile.

    How much will the operation cost?

    Costs will include doctor's fees, medication, counseling, clinic fees, and a follow-up checkup and sperm count. Costs also vary from doctor to doctor and in different parts of the country. The doctor or clinic should tell you in advance how much the entire procedure will cost.

    How can I pay for vasectomy?

    Many insurance companies pay for sterilization, but check with your own company to make sure. You might arrange payment through medical insurance, Medicaid, or a military medical plan. You might also look for a family planning clinic in your area. Clinics usually charge less than private doctors, and they sometimes offer fees based on income. For information about help with payment, contact your local board of social services or welfare office.

    After the operation

    How long will it take me to get back to normal?

    You will probably feel sore for a few days after the operation, and you should rest for at least one day. A mild painkiller should help. There may be swelling around the incision(s), and the scrotal skin may look bruised. To help avoid these problems, your doctor may suggest an athletic support, ice packs, and rest from hard work. Nearly all men recover completely in less than a week.

    Will I have to take time off from work or household duties?

    You should not do heavy physical labor for at least 48 hours after your vasectomy. If your job does not involve such labor, you can go back to work sooner. Many men have their vasectomies on Friday so that they can rest over the weekend and go back to work on the following Monday.

    How soon after the operation can I have sex?

    You can have sex as soon as you are comfortable. Remember to use some other form of reliable birth control after the vasectomy until the doctor tells you that you are sterile.

    Will I still ejaculate?

    Yes. The semen is produced by glands that are not affected by the vasectomy. They will continue to make the same amount of semen. The only difference is that it will not contain sperm.

    What will happen to the sperm?

    Your testes will continue to make sperm. When the sperm cells die, your body will absorb them. This is what happens to sperm cells that are not used--whether or not a man has had a vasectomy.

    Will I be sterile right after the vasectomy?

    No. Right after the operation there are always some active sperm left in the semen. It takes between 15 and 20 ejaculations to clear them. You and your partner should use some other form of family planning until the doctor tests your semen and tells you that it is free of sperm. If it isn't, the test will be repeated in a few weeks.

    How can I decide?

    Consider temporary methods of family planning like the condom. Consider with your partner the possibility of her using a method such as the pill, the IUD, or the diaphragm. One of these may meet your needs.

    Discuss the subject with your partner. You do not need your partner's consent, but it is a good idea for couples to make the decision together. You may want to consider tubal ligation even though vasectomy is simpler and less costly.

    Talk to a friend or relative who has had a vasectomy.

    Think about how you would feel if your partner had an unplanned pregnancy.

    Don't expect vasectomy to solve emotional, marital, or sexual problems. Vasectomy can free you from the fear of unwanted pregnancy. If you expect more than this, you may be sorry later on. Be absolutely sure you do not want to father a child under any circumstances. For example, what if:

    • Your current relationship ended and you had a new partner who wanted a child with you?
    • One or more of your children died?
    • Your family income improved a great deal?
    • You and your partner are lonely when your children grow up and leave home?
    Talk with a doctor, nurse, or family planning counselor.
    THINK THE DECISION OVER VERY CAREFULLY AND BE SURE.

    Is vasectomy the right method for me?

    There are a number of factors you should consider before deciding whether vasectomy is the right method for you. These questions can help you determine whether vasectomy might be an effective method for you.


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