What is a vasectomy and is it always reversible? Doctors explain.
Different methods of birth control have been a huge talking point after a draft Supreme Court opinion overturning Roe v. Wade was leaked in early May. And while much of the conversation has centered around women, there have been plenty of questions about vasectomies for men as well.
In fact, daily searches for vasectomies have jumped since the draft opinion was leaked, with a huge spike happening on May 4 — mere days after the leak happened. Doctors have seen an increase in vasectomies and vasectomy questions lately as well. "I am seeing a boom now in men who want vasectomies," Dr. David Kaufman, director of Central Park Urology, a division of Maiden Lane Medical, tells Yahoo Life. "It's really been incredibly popular."
Most people have a general idea of what a vasectomy entails — essentially, that it's considered a more permanent form of male birth control. But many aren't entirely sure of the details surrounding the procedure itself and the recovery. Here's what you need to know.
What is a vasectomy?
A vasectomy is a surgery that cuts the vas deferens, tubes that carry sperm from the testicles to the urethra, according to the U.S. National Library of Medicine. After a vasectomy, sperm cannot move out of the testicles, and, as a result, a person who has had a successful vasectomy cannot make a woman pregnant. While it can be reversed, a vasectomy is considered a permanent form of birth control, Dr. Danielle Velez, a urologist at Rutgers Robert Wood Johnson Medical School, tells Yahoo Life.
Why do people get a vasectomy?
In general, many people who get a vasectomy do so because it's relatively easy. "A vasectomy is a safe and easy method of birth control," Dr. Mohit Khera, professor of urology at Baylor College of Medicine, tells Yahoo Life. "A vasectomy is a simple office procedure that has an extremely high success rate."
Most people who choose to get a vasectomy "are done having children or know for sure that they don't want a family," Dr. Philip Werthman, urologist and director of the Center for Male Reproductive Medicine and Vasectomy Reversal in Los Angeles, tells Yahoo Life. Werthman stresses that a vasectomy is a "very effective form of permanent sterilization," adding, "It's not for someone who is not looking to have kids for a couple of years but wants to have children eventually."
How is a vasectomy performed?
A vasectomy is typically done in your doctor's office or a surgery center under local anesthesia, Kaufman explains — meaning, you're awake but won't feel pain.
The U.S. National Library of Medicine breaks it all down:
The scrotum is shaved and cleaned, and the surgeon will inject a shot of numbing medicine into the area.
The surgeon then makes a small cut in the upper part of the scrotum and ties off or clips and cuts apart the vas deferens.
The wound is closed with stitches or surgical glue.
There's also a vasectomy that doesn't involve a surgical cut called a no-scalpel vasectomy. This involves the surgeon's finding the vas deferens by feeling the scrotum, making a small hole in the skin of the scrotum and then tying and cutting part of the vas deferens, Werthman says. This form of the surgery "has been shown to decrease recovery time," he adds.
Compared with many other forms of surgery, a vasectomy is quick. "The preparation to sterilize the skin with alcohol takes about five minutes," Dr. Hector Pimentel, a urologist at Spectrum Health, tells Yahoo Life. "The procedure itself is about eight to 10 minutes. There is also a 10-minute recovery to discuss expectations after surgery."
Potential vasectomy side effects
Doctors stress that a vasectomy is a safe procedure. However, there is a risk of potential side effects. According to the Mayo Clinic, those include:
Bleeding or a blood clot inside the scrotum
Blood in your semen
Bruising of your scrotum
Infection of the surgery site
Mild pain or discomfort
There can also be delayed complications, including:
Chronic pain (this can happen for 1% to 2% of people who have surgery)
Fluid buildup in the testicle, which can cause a dull ache that gets worse with ejaculation
Inflammation caused by leaking sperm
Pregnancy (if the vasectomy fails)
An abnormal cyst that develops in the small, coiled tube located on the upper testicle that collects and transports sperm
A fluid-filled sac surrounding a testicle that causes swelling in the scrotum
What is recovery from a vasectomy like?
Recovery from a vasectomy is fairly quick, according to doctors. "I tell patients that they can expect to walk into my office and walk out of my office," Velez says. "They just might walk like a cowboy out of my office."
Patients "should not expect to need a narcotic afterward" but may want to use acetaminophen (Tylenol), she says. Velez recommends wearing boxer-briefs or briefs afterward, adding, "Boxers are not your friend after this procedure. You don't want the testicles swinging."
Velez also advises patients to hold a frozen pack of peas against their testicles for pain relief. "It molds to the shape of the scrotum," she explains. "Do 20 minutes on, 20 minutes off."
You also may need to take it easy for a little while afterward. "Typically, we ask patients not to engage in any strenuous exercise or physical or sexual activity for five days," Khera says. "By the fifth day, most patients are able to resume their full activity."
Werthman points out that many people are able to go back to work soon after, though. "If we do it on a Friday, they'll relax over the weekend and are back at work on Monday," he says.
A big element of vasectomy recovery is undergoing follow-up testing about two and a half months after the procedure to make sure ejaculate no longer contains sperm, Kaufman says. "The thing that makes us both look really bad is if you knock someone up afterward," he says, noting that patients need to ejaculate a set number of times over a certain time period — and have zero sperm count — in order to be cleared. "By three months, if they've been busy, they should be free to move about the cabin," he says.
Is a vasectomy always reversible?
People often talk about how vasectomies are reversible, and, while they can be, doctors say this isn't the best way to approach the procedure. "A reversal is a very expensive procedure," Kaufman says. "I tell people that insurance companies can't wait to pay for vasectomies because they'll never have to pay for another delivery. But it's not the same with reversals."
A reversal also isn't guaranteed to be successful. "A vasectomy is reversible, but the success rates decline the further out you are from the procedure," Khera notes. "In order to reverse a vasectomy, you simply have to find both ends of the vas deferens that have been clipped and reattach them together. The success rate for this procedure is roughly 95%." But, he says, if it's been "many years" since the procedure — namely, 20 or more — it may require attaching the vas deferens directly into a testicular structure called the epididymis. "The success rates for this procedure is roughly 65%," Khera says.
Semen can also be directly extracted from the testicles for IVF if a patient decides they want to try to have children after a vasectomy — it's just more complicated, Kaufman says. Still, he adds, "I do this all the time. It takes 30 seconds."
Why it's important for men to play a role in pregnancy prevention
Pregnancy prevention is often put on the woman, but doctors say it should be a responsibility shared by both partners. "Birth control and family planning is a bigger issue of personal responsibility," Werthman says. "For someone who is in a fairly monogamous relationship and knows they don't want to have kids or more kids, it's taking family planning into your own hands."
Pimentel agrees. "Vasectomy is much more effective than female surgical sterilization," he says. "It is also less expensive, less risky and more likely to be reversible than the female surgical option. So, for most couples it has a bigger upside than some of the other options."
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