A vasectomy involves cutting the tube that carries sperm from each testis to the urethra. To accomplish this, a tiny opening is made on each side of the scrotum, through which the tubes are exposed and severed. Most patients need no sedative and only a local anesthetic during the procedure. There is a small risk of infection afterwards, which, if it occurs, can be treated with antibiotics. Vasectomy is the most effective long-term method of birth control available, with failure rates of less than two per thousand.
Tubal ligations have more than twice the failure rate and involve more risk.
In addition to the risk inherent in using general anesthesia, tubal ligation increases a woman's chance of having an ectopic pregnancy, a life-threatening condition that occurs when a fetus grows in a damaged fallopian tube rather than in the uterus. Vasectomy is not in any way a form of castration. Other components of semen production do not change, and ejaculation occurs as before. Hormone production remains unchanged and testosterone levels are unaffected. The operation has no effect on erection or sexual desire.