More than 500,000 men undergo vasectomies every year in the U.S., making it the most common urological procedure. By severing the tubes (vas deferens) through which sperm travel from the testes to the penis, it is one of the best methods of birth control. If you’re considering it, here are seven things to know.
1. Vasectomy is typically done in a doctor’s office or clinic, using a local anesthetic rather than general anesthesia. It’s simple and safe, and can even be done without a scalpel (instead, a small hole is punctured with a special device). Look for a urologist who is board-certified.
2. It does not result in immediate sterility—you may still have viable sperm in your system for several weeks after. To avoid unintended pregnancy, use an alternative birth control method until a semen analysis confirms no detectable motile sperm.
3. Major side effects from the procedure are unusual. A little swelling and bruising at the incision area is to be expected. A pain reliever can help with any short-term pain or discomfort. But if you experience an increase in pain or swelling, or develop a fever—indications of possible infection—see your doctor. Some men develop pain in the scrotum, but rarely does it last more than a year.
4. Men need not worry that a vasectomy will increase their risk for diseases, including prostate cancer, heart disease, stroke, hypertension or testicular cancer, according to a guideline paper from the American Urological Association, published in the Journal of Urology in 2012. Though two studies done 20 years ago suggested an increased risk for prostate cancer, the link was weak and could have been due to chance, and subsequent research has failed to find a connection. There is no plausible biologic rationale for one anyway.
5. Men who have had a vasectomy do not report more sexual difficulties—such as a decrease in desire, difficulty maintaining an erection or problems with orgasm—than men who have not had one, according to a large Australian study published in the Journal of Sexual Medicine in 2010. In fact, vasectomized men were somewhat more likely to be very satisfied with their relationship, perhaps because the procedure decreases anxiety about unwanted pregnancy and conflict over the use of contraception.
6. Vasectomy does not protect against sexually transmitted infections (STIs). You can still transmit or acquire them when you have unprotected sex. If you or your partner has an STI or you’re not sure of your STI status or your partner’s, you should always use a condom.
7. Though a vasectomy should be considered a permanent form of contraception, it’s often possible to reverse it with a vasovasostomy or vasoepididymostomy if you decide you want to father a child. How successful the procedure is depends on several factors—in particular, the length of time since the vasectomy was done (the longer the interval, the more difficult the procedure is, possibly due to scarring that increases over time). A reversal may also be done to treat chronic vasectomy-related scrotal pain. Because the procedure is more complex than a vasectomy, it’s best done by a urologist who specializes in microsurgery, not a general urology surgeon. It can take anywhere from 3 to 12 months for sperm to reappear in semen. Sperm can also be surgically harvested during a reversal and used for in vitro fertilization.