Vasectomy

Conventional vasectomy, a surgical procedure that makes small incisions on the scrotum. The tubes (vas deferens) leading from each testicle are located, cut and sealed using heat or surgical clips. Stitches are made to seal the surgery site.

Minimally invasive vasectomy uses a procedure that makes one tiny puncture in the scrotum with a special instrument. The tubes are located and tied and no external stitches are needed.

A vasectomy is a simple surgical procedure that has the following benefits:

• 100 percent effective in preventing pregnancy
• Costs less than female sterilization or long-term female birth control medications
• Eliminates need for additional birth control such as condoms

Benefits of Minimally Invasive Vasectomy

Minimally invasive vasectomy is done under local anesthesia and takes approximately 30 minutes. There are fewer complications than with conventional vasectomy. Benefits include:

• No bleeding
• No stitches
• Rapid healing
• Little or no scarring

Before vasectomy surgery, your urologic surgeon may recommend:

• Eliminate blood-thinning medications several days before surgery
• Clean and shave the genital area thoroughly the day of surgery
• Bring tightfitting underwear or an athletic supporter to wear following surgery to minimize swelling

Your urologist will give your instructions for your recovery at home. These may include:

• Call immediately if you have a temperature higher than 100.4, or experience pain, swelling or drainage
• Apply ice packs to the scrotum for the first few days
• Wear tightfitting underwear for the first few days
• Limit activity for 48 hours after surgery. Avoid heavy lifting and sports for one week.
• Do not bathe or swim for 24 hours after surgery
• Resume sexual activity when comfortable
• Use another form of birth control until your urologist confirms sperm are no longer in your semen
• Continue to use condoms. Vasectomy does not protect against sexually transmitted diseases.

How common is vasectomy?

Hundreds of thousands of vasectomies are performed every year in the US—some estimates put the number of procedures at over 500,000. The vast majority of vasectomies are performed by urologists, who specialize in the surgical management of the male reproductive system. (Sharlip et al., 2012)

Is vasectomy really permanent?

Every man who undergoes a vasectomy should consider it a permanent method of birth control, or contraception. However, up to 6% of men who undergo vasectomy do wish to have further children. Options to achieve pregnancy after undergoing vasectomy include vasectomy reversal—in which the small ducts that are cut during vasectomy are re-connected. Since a man’s testicles do not stop producing sperm after a vasectomy, sperm can also be extracted from the testicle. Due to fact that these sperm cells are immature, surgically extracted sperm must be used in a process called in vitro fertilization. Sperm banking—or, freezing sperm—prior to vasectomy is another option.

What does the procedure involve?

The majority of vasectomies are performed in a clinic setting, under local anesthesia. If a man desires or if there are anatomic findings that may make the procedure more difficult, a man may receive anesthesia and undergo the procedure in the operating room. 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 in order to perform the procedure. This minimizes post-operative pain, swelling, risk of bleeding, and risk of infection. The procedures involve minimal or no pain and are performed in 20-25 minutes.

What do I need to do to prepare for a vasectomy?

Every man should have a counseling session with the surgeon during which an interview discussing the man’s medical history and a focused physical examination are performed. Your surgeon will discuss whether you will have to stop certain medications prior to the surgery (such as aspirin, ibuprofen, etc.) Your surgeon may also prescribe you an antibiotic to take at the time of the procedure. Many surgeons request that the man shave part of his scrotum the day prior to his surgery.

How does vasectomy compare to other methods of birth control?

A vasectomy is a minor surgical procedure used as a permanent form of male birth control or contraception to prevent pregnancy. During the procedure, a urologic surgeon cuts the vas deferens, the tubes that deliver sperm from the testes to the seminal fluid or semen during intercourse. 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. Urologists at Brigham and Women’s Faulkner Hospital and Brigham and Women's Hospital perform thousands of conventional and minimally invasive vasectomies each year. Rates of unwanted pregnancy after successful vasectomy are approximately 1/2000.

Brigham and Women’s Faulkner Hospital practices a multidisciplinary approach to patient care, routinely collaborating with colleagues in other medical specialties. If your urologist discovers an underlying illness, you will be referred to an appropriate BWFH/BWH physician for an evaluation.