5 Facts You Should Know Before Having a Vasectomy

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If you and your partner are looking for a permanent birth control method, you may be considering a vasectomy.

“A vasectomy is permanent male sterilization,” explains Puneet Masson, MD, Assistant Professor of Urology and Director of the Male Fertility Program at Penn Fertility Care. “That being said, life changes—it’s a very dynamic process.”

Before you have a vasectomy, here's what you should know:

Both you and your partner should decide if a vasectomy is the right choice

The decision to have a vasectomy is not one that should be taken lightly. You and your partner should take time to really think about whether it is the right choice for you.

A vasectomy may be right for you if:

  • You are certain that you desire no more or any children
  • Your partner should not get pregnant for the sake of her own health
  • You and/or your partner are carriers for genetic disorders that you do not want your children to have

On the other hand, a vasectomy may not be right for you if:

  • You and/or your partner are still unsure about whether you should have children
  • You are interested in temporary birth control

A vasectomy is generally safe and effective

A vasectomy can be done either under local anesthesia or conscious sedation (aka “twilight anesthesia”). If performed under local anesthesia, pain medicine will be administered directly to your scrotum to numb the area. You will be awake for the procedure. With conscious sedation, you will receive medications to sedate you and relieve any anxiety during the procedure in addition to receiving local anesthesia directly to your scrotum.

Regardless of the anesthesia, the procedure is the same. The physician will disconnect the vas deferens—the tubes that transport sperm from the testicles. After the surgery, sperm will not be able to leave the testicles.

Not Down For Long

You may be wondering what the vasectomy recovery period is like. After a vasectomy most men can:

  • Return to work in two to three days
  • Resume normal exercise in seven days
  • Start having sex again in seven days

Bruising and swelling should be gone within two weeks.

A vasectomy takes 20 minutes

Having a vasectomy will not affect your sexual functioning

A vasectomy should not decrease your sex drive, nor should it negatively impact your ability to have an erection or orgasm. Only five to 10 percent of the ejaculate comes from the testicle. The remainder comes from upstream structures such as your prostate and seminal vesicles. Thus, ejaculation will still look and feel the same. Just microscopically, there will be no sperm in the semen.

If you experience any changes in your sexual drive or functioning after the procedure, contact your physician.

Sterilization does not happen right away after a vasectomy

After the surgery, the sperm count in your ejaculate will begin to decrease gradually.

You will need to continue to use other birth control methods until your semen sample comes back completely sperm-free and you get the okay from your physician. This usually takes about two months or 20 ejaculations.

A vasectomy can be reversed, but there are other options

“Patients might desire children in the future. They may have a second marriage. Different sorts of things come up, and we have to respect that life is so dynamic,” says Dr. Masson.

There are a few options for achieving a pregnancy after vasectomy. “We can do a vasectomy reversal or a surgical sperm extraction,” explains Dr. Masson. “There’s a lot of counseling that goes on with this decision process as well.”

Whereas a vasectomy takes 20 minutes, a vasectomy reversal can take four to six hours. It's a much more complicated, delicate procedure. And there is no guarantee that it will lead to pregnancy.

If you and your partner decide that you would like to have children after you have had a vasectomy, there are other ways to obtain your sperm than a vasectomy reversal.

“We can do a surgical sperm extraction in combination with in vitro fertilization,” says Dr. Masson.

These procedures, known as testicular sperm extraction (TESE) and percutaneous epididymal sperm aspiration (PESA) have a high success rate of about 98 percent.

Both procedures involve extracting sperm through a small incision in either the testes (TESE) or epididymis (PESA), the Urology Care Foundation explains.

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