Vasectomy Procedure, Effects, Risks, Effectiveness, and More A vasectomy is considered a permanent method of birth control . A vasectomy prevents the release of sperm when a man ejaculates. During a vasectomy, the vas deferens from each testicle is clamped, cut, or otherwise sealed. This prevents sperm from mixing with the semen that is ejaculated from the penis . An egg cannot be fertilized when there are no sperm in the semen. The testicles continue to produce sperm, but the sperm are reabsorbed by the body. (This also happens to sperm that are not ejaculated after a while, regardless of whether you have had a vasectomy.) Because the tubes are blocked before the seminal vesicles and prostate , you still ejaculate about the same amount of fluid. It usually takes several months after a vasectomy for all remaining sperm to be ejaculated or reabsorbed. You must use another method of birth control until you have a semen sample tested and it shows a zero sperm count . Otherwise, you can still get your partner pregnant . What happens During a vasectomy: Your testicles and scrotum are cleaned with an antiseptic and possibly shaved.

You may be given an oral or intravenous (IV) medicine to reduce anxiety and make you sleepy. If you do take this medicine, you may not remember much about the procedure. Each vas deferens is located by touch. A local anesthetic is injected into the area. Your doctor makes one or two small openings in your scrotum. Through an opening, the two vas deferens tubes are cut. The two ends of the vas deferens are tied, stitched, or sealed. Electrocautery may be used to seal the ends with heat. Scar tissue from the surgery helps block the tubes. The vas deferens is then replaced inside the scrotum and the skin is closed with stitches that dissolve and do not have to be removed. The procedure takes about 20 to 30 minutes and can be done in an office or clinic. It may be done by a family medicine doctor , a urologist , or a general surgeon . No-scalpel vasectomy is a technique that uses a small clamp with pointed ends. Instead of using a scalpel to cut the skin, the clamp is poked through the skin of the scrotum and then opened.

The benefits of this procedure include less bleeding, a smaller hole in the skin, and fewer complications. No-scalpel vasectomy is as effective as traditional vasectomy. 1 In the Vasclip implant procedure, the vas deferens is locked closed with a device called a Vasclip. The vas deferens is not cut, sutured, or cauterized (sealed by burning), which possibly reduces the potential for pain and complications. Some studies show that clipping is not as effective as other methods of sealing off the vas deferens. 1 What To Expect After Surgery Your scrotum will be numb for 1 to 2 hours after a vasectomy. Apply cold packs to the area and lie on your back as much as possible for the rest of the day. Wearing snug underwear or a jockstrap will help ease discomfort and protect the area. You may have some swelling and minor pain in your scrotum for several days after the surgery. Unless your work is strenuous, you will be able to return to work in 1 or 2 days. Avoid heavy lifting for a week. You can resume sexual intercourse as soon as you are comfortable, usually in about a week. But you can still get your partner pregnant until your sperm count is zero.

You must use another method of birth control until you have a follow-up sperm count test 2 months after the vasectomy (or after 10 to 20 ejaculations over a shorter period of time). Once your sperm count is zero, no other birth control method is necessary. Most men go back to the doctor's office to have their sperm count checked. But there is also a home test available. A vasectomy will not interfere with your sex drive , ability to have erections, sensation of orgasm, or ability to ejaculate. You may have occasional mild aching in your testicles during sexual arousal for a few months after the surgery. Why It Is Done A vasectomy is a permanent method of birth control. Only consider this method when you are sure that you do not want to have a child in the future. How Well It Works Vasectomy is a very effective (99.85%) birth control method. Only 1 to 2 women out of 1,000 will have an unplanned pregnancy in the first year after their partners have had a vasectomy. 2 Risk of failure Pregnancy may occur after vasectomy because of: Failure to use another birth control method until the sperm count is confirmed to be zero.

It usually takes 10 to 20 ejaculations to completely clear sperm from the semen. Spontaneous reconnection of a vas deferens or an opening in one end that allows sperm to mix with the semen again. This is very rare. Risks The risk of complications after a vasectomy is very low. Complications may include: Bleeding under the skin, which may cause swelling or bruising. Infection at the site of the incision. In rare instances, an infection develops inside the scrotum. Sperm leaking from a vas deferens into the tissue around it and forming a small lump (sperm granuloma). This condition is usually not painful, and it can be treated with rest and pain medicine. Surgery may be needed to remove the granuloma. Inflammation of the tubes that move sperm from the testicles (congestive epididymitis ). In rare cases, the vas deferens growing back together (recanalization) so the man becomes fertile again. What To Think About Advantages Vasectomy is a permanent method of birth control. Once your semen does not contain sperm, you do not need to worry about using other birth control methods.

Vasectomy is a safer, cheaper procedure that causes fewer complications than tubal ligation in women. 1 Although vasectomy is expensive, it is a one-time cost and is often covered by medical insurance . The cost of other methods, such as birth control pills or condoms and spermicide , is likely to be greater over time. Disadvantages A vasectomy does not protect against sexually transmitted infections (STIs) , including infection with the human immunodeficiency virus (HIV) . Condoms are the most effective method for preventing STIs. To protect yourself and your partner from STIs, use a condom every time you have sex . Other considerations If you are considering a vasectomy, be absolutely certain that you will never want to father a child. A vasectomy is not usually recommended for men who are considering banking sperm in case they decide later to have children. Discuss other options with your partner and your health professional. Surgery to reconnect the vas deferens ( vasectomy reversal ) is available. But the reversal procedure is difficult. Sometimes a doctor can remove sperm from the testicle in men who have had a vasectomy or a reversal that didn't work. The sperm can then be used for in vitro fertilization .

Both vasectomy reversal and sperm retrieval can be expensive, may not be covered by insurance , and may not always work. Studies looking at whether having a vasectomy increases the risk of prostate cancer have had mixed results, but there may be a very small risk. This is something to think about as you think about the possible risks and benefits of having a vasectomy. Some doctors or health insurance plans may require a waiting period from the time you request a vasectomy and the time the procedure is done. This time allows you to be certain about your decision. Researchers are studying other male birth control methods, such as reversible vasectomy or hormonal methods. Reversible vasectomy involves plugging the vas deferens and then removing the plug when birth control is no longer wanted. Hormonal methods include pills or injections that the man would use to prevent sperm production. So far, no new method has been shown to be effective enough, with low side effects, to be marketed for men. Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery. References Citations Roncari D, Jou MY (2011). Female and male sterilization.

In RA Hatcher, et al., eds., Contraceptive Technology, 20th rev. ed., pp. 435-482. New York: Ardent Media. Trussell J, Guthrie KA (2011). Choosing a contraceptive: Efficacy, safety, and personal considerations. In RA Hatcher et al., eds., Contraceptive Technology, 20th ed., pp. 45-74. Atlanta: Ardent Media. Credits Vasectomy - In-Depth Report - NY Times Health The male reproductive tract performs three functions: It enables a man to produce offspring. It provides him with a supply of male hormones. It enables him to experience sexual pleasure. The Traveling Sperm. The sperm's journey through the male body -- from the testes (the testicles) to the final stage (the orgasm) -- is long and complex: Sperm are produced in the testes at a rate of 50,000 an hour within tiny ducts called seminiferous tubules. Sperm do not mature in the testes.

They must first pass into the epididymis , a C-shaped storage chamber adjoining the testes composed of a 20-foot coiled tube. The sperms' journey through the epididymis takes about 2 - 3 weeks. They are held here until sexual activity forces them to move on. When a man experiences sexual excitement, nerves stimulate the muscles in the epididymis to contract. This forces the sperm to pass into one of two rigid and wire-like muscular channels, called the vasa deferentia. (A single channel is called a vas deferens . It is the vas deferens that is cut during vasectomy.) Muscle contractions in the vas deferens from sexual activity propel the sperm along past the seminal vesicles, which are clusters of tissue that contribute fluid, called seminal fluid, to the sperm. The vas deferens also collects fluid from the nearby prostate gland . This mixture of various fluids and sperm is the semen. Each vas deferens then joins together to form the ejaculatory duct. This duct, which now contains the sperm-containing semen, passes down through the urethra . (The urethra is the same channel in the penis through which a man urinates.

During orgasm, however, the prostate closes off the bladder so urine cannot enter the urethra.) The semen is forced through the urethra during ejaculation , the final stage of orgasm when the sperm is literally thrown out of the penis. Click the icon to see an image of sperm. The decision to have a vasectomy should be made only after serious consideration. The surgery is intended to be permanent. The great majority of men who seek a vasectomy have been married for 10 years or more. Not all are good candidates, however. It is important that both the woman and the man completely agree that they no longer want to have children. They should also agree that permanent birth control is the right decision for them. Ideally, the couple should view the operation as a mutual commitment to an already successful marriage or relationship. Vasectomy generally is not a good idea if the couple's relationship is under great stress. It is not a cure for emotional or sexual problems between a man and woman. Single men, some of them younger, may also choose to have a vasectomy. Physicians may refuse to perform the procedure depending on how young person is, or ask these men to wait for a year or even more. In-Depth From A.D.A.M.

Treatment After deciding that permanent birth control is the best solution, a couple still has the option of either vasectomy for the male or tubal ligation (female sterilization) for the female. Female sterilization is performed three times as often as vasectomy, but vasectomy is a less complicated and less expensive procedure, and poses fewer risks for complications. Vasectomy is very safe and is nearly 100% effective for preventing pregnancy. It does not protect against sexually transmitted diseases (STDs). Condoms remain the best method of STD prevention for sexually active people. The decision to have a vasectomy should be carefully considered. A reversal procedure can be performed, but it is a major operation that does not guarantee restored fertility. In addition, these reversal procedures (vasovasostomy and vasoepididymostomy) are much more complicated surgeries than vasectomy. After-Effects Surveys indicate that the vast majority of men are satisfied with vasectomy and that this satisfaction persists. Most men who have vasectomies feel relieved that the worry about pregnancy is over, and most couples respond well to their new-found contraceptive freedom. Vasectomy does not affect a man's hormonal levels and does not impair sexual potency, desire, or satisfaction.

Some men may go through a brief period of self-consciousness, wondering whether others notice some difference in their masculinity. For most men, this tentativeness passes quickly. Some couples may experience difficulties, which manifest in sexual dysfunction such as erectile dysfunction, premature ejaculation, or painful intercourse. In such cases, the underlying cause is usually unresolved emotional issues, not the vasectomy itself. Who Should Have a Vasectomy Vasectomies may be right for: Men in relationships in which both partners agree they have all the children they want and both do not want to use or are unable to use other methods of contraception Men in relationships whose partners have health problems that make pregnancy unsafe Men in relationships in which one or both have genetic disorders that they do not want to transmit Vasectomies may not be right for: Men in relationships in which one partner is unsure about his or her desire to have children in the future.

Men whose current relationships are unstable, going through a stressful phase, or are marked by substantial conflict Men who are considering the operation just to please their partners Men who are counting on having children later by storing sperm or by surgical reversal of the vasectomy Young men, who still have many life changes ahead Men who are single (including those divorced or separated) at the time of vasectomy Men or couples whose only motive is freedom from distraction imposed by other contraceptive methods during sexual activity Sperm Banking Sperm banking can be used in conjunction with vasectomy or vasectomy reversal surgery. Sperm banking involves freezing (cryopreservation) and storage (cryobanking) of sperm. It is usually performed before a vasectomy, or during or after reversal surgery. If a man later desires to have children, the sperm can be used for assisted reproductive technologies, usually intracytoplasmic sperm injection used in combination with in vitro fertilization. Sperm banking is no guarantee for successful conception and pregnancy. Sperm can be frozen for many years, but even after 6 months not all sperm cells remain fertile after being unfrozen. In addition, sperm banking is typically not covered by health insurance plans and costs should be considered.

Although most men who have a vasectomy never use their banked sperm, it is understandable if some men are emotionally reassured by the idea that they have sperm preserved "just in case." Still, men who are considering vasectomy should not view sperm banking (or vasectomy reversal) as a guaranteed option if they later change their minds. It is best to undertake vasectomy as a permanent sterilization procedure. If future fathering of children seems a possibly desirable scenario, it is wise to reconsider whether vasectomy is the right decision to make. In-Depth From A.D.A.M. Vasectomy Surgery Vasectomy is a minor operation that takes about 15 - 30 minutes and is usually performed with local anesthesia in a doctor's office or a family planning clinic. Most insurance policies will cover vasectomies performed as a minor outpatient procedure, but will not cover vasectomies performed as major surgery in an operating room. If a Vasclip procedure is performed, there may be an additional cost for this device. Conventional Vasectomy A conventional vasectomy procedure is performed as follows: To prevent increased risk of bleeding, patients should avoid taking aspirin or NSAIDs (Advil, Aleve) for 10 days prior to the procedure.

Before the operation, the patient's scrotum is shaved and cleaned. A local anesthetic is injected into the skin of the scrotum over where the vasectomy will take place. An anesthetic cream may be applied before the injection to reduce its pain. The surgeon makes a tiny incision on one side of the scrotum and locates one vas deferens. The vas deferens is isolated, drawn through the incision, and clamped at two sites close to each other. The segment between the clamps (which should be more than 15 mm, or a little over 1/2 inch) is then removed. The surgeon then seals off (ligates) the tube with sutures and cauterizes it with an electric needle. Fascial interposition is an additional technique that may be used in combination with these methods to improve chance of permanent closure. With fascial interposition, the surgeon pulls the fibrous layer covering the vas (the fascia) over the cut end of the vas and sews it closed. This increases the barrier and further reduces residual sperm. Recent research suggests that cauterization, with or without fascial interposition, is the best method for sealing off the vas.

The surgeon may choose to close off either one end of the vas (called an open-ended procedure) or both ends (closed-ended technique). In the open-ended procedure, the vas section connected to the testis is left open, and the one leading to the prostate is sealed. In the closed-ended approach, both are sealed. Many surgeons prefer the open-ended version because it has lower complication and failure rates than the closed-ended method, and it results in fewer cases of chronic pain. After closing off the tube, the vas deferens is gently placed back into the scrotum. The procedure is then repeated on the other side. After a short rest, usually about half an hour, the patient can leave the doctor's office or clinic. Arrangements should be made ahead of time for someone else to drive the patient home. Slide Show:Vasectomy - series No-Scalpel Vasectomy A method of vasectomy called no-scalpel vasectomy (NSV) that does not require the use of a scalpel was developed in China in 1974. NSV is now used in a third of all vasectomies. The technique takes about 10 minutes and is performed in a doctor's office or a family planning clinic.

The no-scalpel vasectomy differs from a conventional vasectomy in the method of accessing the vasa deferentia: In NSV, the doctor feels for the vas deferens under the skin and holds them in place with a small ring clamp. Instead of making two incisions, the doctor uses a sharp hemostat, a special instrument that makes one tiny puncture and then is used to gently stretch the opening until the vas deferens can be pulled through it. (The surgeon must rotate his wrist to pull the vas out -- called a supination maneuver -- which may be difficult to perform.) The vas is then sealed off using the same methods (clips, sutures, cauterization using an electric needle, or some combination) as conventional vasectomy. As with standard vasectomy, the closures can be open- or closed-ended. There is very little bleeding with the no-scalpel vasectomy. No stitches are needed to close the tiny opening, which heals quickly and leaves no scar. When performed correctly, NSV works just as well as conventional vasectomy, takes less time, and causes less bleeding, infection, and pain. Current research indicates that NSV is the safest type of vasectomy procedure.

NSV is difficult to perform, however, and most surgeons must do about 15 - 20 procedures in order to be proficient. NSV is becoming a popular alternative to standard vasectomy, but it is important to select a doctor who is experienced with this procedure. A simpler method of NSV, called percutaneous vasectomy, is now also being used. Recent research suggests that it works as well as standard NSV and is easier to perform. Percutaneous vasectomy uses the same instruments as no-scalpel vasectomy, but with a different surgical technique. The hemostat is used to first puncture the skin (instead of spearing the vas and lifting it out). The ringed clamp is then passed through the incision and used to enclose the section of the vas that is then pulled out for closure. This avoids the need for the difficult wrist maneuver in NSV. Other Vasectomy Procedures Vasclip. The Vasclip is a recent alternative to conventional vasectomy. The procedure does not involve cutting the vas deferens. Instead, a very small rice-sized plastic clip is locked around the vas deferens to stop the flow of sperm.

Some studies have reported fewer post-surgical complications than with standard vasectomy, including infection and swelling. However, studies have also reported that the Vasclip is less effective than no-scalpel vasectomy for reducing sperm count. To date, there is insufficient evidence that the Vasclip is better than standard vasectomy. Some insurance companies consider this procedure to be investigational and will not pay for it. Recovery Vasectomy is a low-risk procedure, and complications, which occur in about 10% of patients, are usually easy to control. There are generally fewer complications with no-scalpel vasectomy. Pain or soreness typically lingers for a few days after the procedure, but this is normal and usually does not require a return visit to the doctor. No deaths resulting from vasectomy have ever been reported in the United States. Nearly all men recover completely in a few days. The following are some guidelines after the operation to help recovery: The local anesthetic wears off about 1 - 2 hours after the procedure, and most patients then experience a dull ache in the testicles and groin. The doctor may prescribe a painkiller for the first few days, continuing with mild over-the-counter pain relievers if discomfort persists.

Acetaminophen (Tylenol) with or without codeine is the primary choice for postoperative pain. Aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), or other non-steroidal anti-inflammatory drugs (NSAIDs) can cause bleeding and should be avoided. The patient should stay in bed on his back for at least one day and apply ice packs for 8 hours. The doctor may suggest that the patient wear an athletic supporter. Some oozing of blood onto the gauze pads is normal during the first 2 days after the operation. The patient should not perform any heavy physical labor for at least 2 days. Sports and heavy lifting may be resumed 2 - 3 weeks after surgery. Men can resume having sex about a week after surgery, but should use contraception until a semen analysis confirms that no sperm remain. During ejaculation, the patient may experience some discomfort in the groin and testicles at first due to the contraction of the vas deferens. This sensation diminishes as the tissues heal. Although rare, more serious complications may occur soon after surgery. They include: Bleeding .

Frequently, blood may seep under the skin, so that the scrotum and penis appear to be bruised. If there is no dangerous swelling, this painless problem usually disappears without treatment within 1 - 2 weeks. If the patient bleeds excessively in the days after the operation and requires more than two or three gauze changes per day, he should call his doctor. Hematoma . In a small percentage of cases, bleeding inside the scrotum can cause a painful swelling known as a hematoma. In these cases, the scrotum swells up shortly after vasectomy. The doctor should be called immediately. Infection . Infection can occur after vasectomy. The incision site may become infected, causing redness and swelling around the incision. Antibiotics, antimicrobial creams or ointments, or both, along with hot baths several times a day will usually clear the infection in a few days. Severe infections are extremely rare. Semen Analysis After the vasectomy procedure, there are always some active sperm left in the semen for several months, so the risk for pregnancy persists. The patient is considered sterile only when there are no live or moving (motile) sperm in his semen.

It takes, on average, around 3 months to clear the viable sperm from the reproductive system, but it may take some men as long as 6 months to become sterile. The doctor will perform a semen analysis at around 12 weeks after vasectomy to verify that no live sperm remain in the semen. It is essential that the patient and his partner continue to use other methods of birth control until his sperm count is zero. About 25% of men who have vasectomies never bother to return for follow-up sperm testing (semen analysis). Without a follow-up test, men do not know whether the vasectomy was successful. Until test results verify that there are no sperm in the semen, men are at risk of fathering unwanted pregnancies. Long-Term Complications Vasectomy Failure and Unexpected Pregnancy . Pregnancy rates after a vasectomy are very low, about 1 in 1,000. There are two main reasons for an unexpected pregnancy: Residual sperm were still alive when the partners had unprotected sex. This is the most common reason for an unexpected pregnancy after a vasectomy. Men should make sure they have follow-up sperm analysis testing.

They should also continue to use birth control until their doctor notifies them that the test results confirm sterility. Failure of the procedure and recanalization. Failure in some cases is due to a technical error, but most often it is due to recanalization -- when the cut ends of the vas spontaneously reconnect. Success rates are best when an experienced surgeon performs the vasectomy. Recanalization and Sperm Granulomas . The primary reason for vasectomy failure is recanalization-- when the cut ends of the vas deferens spontaneously reconnect. Recanalization in some cases may be due to sperm granulomas. These are tiny balls of debris that form from sperm, scar tissue, and white blood cells at the incision site. Cells lining the inside of the vas deferens grow through the scar tissue and form a new channel through which the sperm can now move. In general, surgeons can reduce the risk for recanalization by leaving a gap between the two cut ends. This natural vasectomy reversal can occur after any vasectomy surgical procedure, but it is uncommon. When recanalization does occur, sperm counts are almost always very low and pregnancies are still rare. Most cases of recanalization develop within several months after the operation.

In very rare cases, sperm have reappeared a year or even longer after vasectomy. Epididymitis . Epididymitis occurs when an inflammation at the site of the vasectomy causes swelling of the epididymis. This rare condition usually occurs within the first year and is treated with heat and anti-inflammatory medications. It usually clears up within a week. Anti-sperm Antibodies . Sperm continue to be produced after vasectomy but are disposed of in the body. In some men the immune system mistakes these sperm as foreign proteins (antigens) and produces anti-sperm antibodies that are designed to target and interfere with sperm's motility (ability to move). Infections in the genital tract, such as orchitis or sexually transmitted diseases, increase the risk for anti-sperm antibodies. The anti-sperm response itself appears to be a problem only if a man wishes to reverse the vasectomy. Chronic Pain . Some men develop testicular pain following vasectomy. If this pain lasts longer than 3 months, it is referred to as postvasectomy pain syndrome (PVPS). The causes of PVPS are unclear.

It may be due to obstruction and resulting contraction of the epididymal duct, or inflammation and formation of fibrous tissue after rupture in the duct, which can cause nerve damage. Sperm granuloma has also been discussed as a possible cause, although their role remains controversial. PNVS is first treated conservatively, with heat or cold therapy, rest, scrotal support, and nonsteroidal anti-inflammatory drugs (NSAIDs). Most patients are successfully treated with conservative therapies. If these methods do not work, other drug therapies, (including injections of local anesthetics or steroids), may be tried. Transcutaneous electrical nerve stimulation is another method that has been used with good results. If all options fail, surgical interventions, [including removal of the epididymis (epididymectomy), granuloma excision, or vasectomy reversal surgery], may be required. Cancer Concerns . Because testosterone levels remain higher for a longer period in men who had vasectomy, there have been concerns raised as to whether vasectomy can increase the risk of developing prostate cancer.

Men with a family history of prostate cancer can discuss the risks and benefits of vasectomy with their doctors, although the weight of evidence to date indicates there is no link between vasectomy and prostate cancer. There have also been some concerns that vasectomy could increase the risk of testicular cancer. Studies have not identified any significant associations between the two. In-Depth From A.D.A.M. Reversal Surgery (Vasovasostomy and Vasoepididymostomy) Although men should consider vasectomy a permanent decision, reversal procedures can restore fertility in some men who change their minds. The main reasons for requesting a vasectomy reversal are remarriage or the death of a child. Vasectomy reversal can also sometimes provide pain relief for some of the small number of men who suffer post-vasectomy pain, but these patients should first be treated with pain management therapies. For men who desire a vasectomy reversal for psychological reasons, counseling is a better option. Vasovasostomy Reversal Surgery Procedures There are two types of vasectomy reversal surgical procedures: Vasovasostomy . The severed ends of the vas deferens are sewn back together. Vasoepididymostomy .

The vas deferens is surgically reattached directly to the epididymis. This procedure is more difficult to perform and is used when vasovasostomy cannot be performed or does not work. These procedures help restore sperm flow so that sperm can be ejaculated out of the urethra. Both types of procedures are performed on an outpatient basis and the patient can return home the same day. It is not possible to know in advance which procedure will be performed. The surgeon will make the decision whether to use vasovasostomy or vasoepididymostomy based on a fluid sample taken at the start of the operation. The fluid is removed from the vas end closest to the testicle and examined for its appearance and the presence of sperm. If sperm are present or the fluid is clear, it indicates that there is no blockage in the epididymis, and a vasovasostomy can be performed. No sperm, or a creamy, thick appearance of fluid, is a sign of blockage, and the vasoepididymostomy surgical approach to bypass the blockage should be used. Other factors may also determine the surgeon's choice of reversal surgical procedure.

In some cases, a combination of the two surgeries may be used, with vasovasostomy performed on one side and vasoepididymostomy on the other side. Vasovasostomy . Vasovasostomy uses several different surgical approaches. Usually a microsurgical technique is used, in which a microscope helps magnify the surgical area. Vasovasostomy takes 2 - 3 hours to perform. The patient is given local anesthesia and a mild sedative. Vasoepididymostomy. Vasoepididymostomy is a more complex microsurgical technique. To appreciate the difficulty of this operation, one should realize that the epididymis is 1/300th of an inch wide with a wall thickness of 1/1000th of an inch. Microscopic techniques are critical for the success of this procedure and require a surgeon who specializes in them. Vasoepididymostomy takes up to 4 hours to perform. The patient is given either general anesthesia or an epidural block.

Recovery and Follow-Up Pain after reversal surgery is usually not severe and can be controlled with mild analgesics such as acetaminophen (Tylenol). A cold pack placed on the scrotum area can help relieve swelling. Your doctor may recommend that you wear a jockstrap for a few weeks to help provide compression and to keep the surgical incisions in place. Most patients can return to work and resume normal non-strenuous activities within a week, but patients may need to refrain from heavy lifting and other rigorous physical activities for up to 4 weeks following surgery. Patients should wait 2 - 4 weeks before having sex. The doctor will perform a semen analysis every 2 - 3 months after reversal surgery to check your sperm count. It generally takes around 2 months for sperm to reappear following vasovasostomy, and around 3 - 15 months following vasoepididymostomy. Either a stabilized sperm count, or pregnancy, indicates successful reversal surgery. If reversal surgery is not successful, a repeat surgery can be performed. However, the success rates for repeat reversals are lower than for an initial reversal.

Pregnancy Results after Reversal Surgery Vasectomy reversal restores sperm production in about 80 - 90% of men. On average, around 50% of couples achieve a pregnancy within 1 - 2 years after reversal surgery. Microsurgical techniques appear to help produce higher quality grade of sperm and better pregnancy rates than macrosurgical techniques. Several other factors determine the likelihood of a successful outcome. The experience of the surgeon is one critical factor. The time interval between the original vasectomy and the reversal procedure is another important factor. The closer the time between vasectomy and reversal, the better the chances for fertility. Sperm removed during vasovasostomy can be frozen and used for assisted reproductive technologies in case of unsuccessful reversal surgery. If reversal surgery is not successful, a doctor may also be able to retrieve sperm from the testes or epididymis using various sperm retrieval techniques such as testicular fine needle aspiration, microsurgical epididymal sperm aspiration, percutaneous epididymal sperm aspiration, or testicular sperm extraction.

Intracytoplasmic Sperm Injection (ICSI) The best assisted reproductive technology procedure for men who have had vasectomies or failed reversal surgery is intracytoplasmic sperm injection (ICSI). The procedure involves injecting a single sperm into an egg. The fertilized egg is then implanted in the woman using in vitro infertilization (IVF). Some men may consider pursuing ICSI in place of vasectomy reversal surgery. Even though the introduction of ICSI has helped improve pregnancy rates after vasectomy, reversal surgery is usually still a better choice for most men who want children. Reversal surgery costs less than ICSI and men have the potential to achieve long-lasting fertility. ICSI is performed a limited number of times, and the success rates are best if the women is younger than age 37. ICSI/IVF also increases the chance for multiple births, which can pose risks to the mother and babies. However, ICSI may be more effective than reversal surgeries in men whose vasectomies were performed at least 15 years earlier. In-Depth From A.D.A.M. Resources In-Depth From A.D.A.M. References Adams CE, Wald M. Risks and complications of vasectomy.

Urol Clin North Am . 2009 Aug;36(3):331-6. Cook LA, Pun A, van Vliet H, Gallo MF, Lopez LM. Scalpel versus no-scalpel incision for vasectomy. Cochrane Database Syst Rev . 2007 Apr 18;(2):CD004112. Cook LA, Van Vliet H, Lopez LM, Pun A, Gallo MF. Vasectomy occlusion techniques for male sterilization. Cochrane Database Syst Rev . 2007 Apr 18;(2):CD003991. Dassow P, Bennett JM. Vasectomy: an update. Am Fam Physician . 2006 Dec 15;74(12):2069-74. Nagler HM, Jung H. Factors predicting successful microsurgical vasectomy reversal. Urol Clin North Am. 2009 Aug;36(3):383-90. Peterson HB. Sterilization. Obstet Gynecol .

2008 Jan;111(1):189-203. Practice Committee of American Society for Reproductive Medicine. Vasectomy reversal. Fertil Steril . 2008 Nov;90(5 Suppl):S78-82. Sokal DC, Labrecque M. Effectiveness of vasectomy techniques. Urol Clin North Am . 2009 Aug;36(3):317-29. Tandon S, Sabanegh E Jr. Chronic pain after vasectomy: a diagnostic and treatment dilemma. BJU Int . 2008 Jul;102(2):166-9. Epub 2008 Jul 1. A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission ( URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M.

is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation ( A.D.A.M. Copyright The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited. Vasectomy: MedlinePlus Medical Encyclopedia URL of this page: //medlineplus.gov/ency/article/002995.htm Vasectomy A vasectomy is surgery to cut the vas deferens. These are the tubes that carry a sperm from testicles to the urethra. After a vasectomy, sperm cannot move out of the testes . A man who has had a successful vasectomy cannot make a woman pregnant. Watch this video about: Vasectomy Description Vasectomy is most often done in the surgeon's office using local anesthesia. You will be awake but not feel any pain.

After your scrotum is shaved and cleaned, the surgeon will inject a shot of numbing medicine into the area. The surgeon will make a small cut in the upper part of your scrotum . The vas deferens will then be tied off and cut apart. The wound will be closed with stitches or surgical glue. You may have a vasectomy without a surgical cut. This is called a no-scalpel vasectomy (NSV). For this procedure: The surgeon will find the vas deferens by feeling your scrotum. You will get numbing medicine. The surgeon will then make a tiny hole in the skin of your scrotum and then tie off and cut a part of the vas deferens. In a regular vasectomy, a small incision is made on each side of the scrotum. In a no-scalpel vasectomy, a sharp instrument is used to pierce the skin and make a single opening. A stitch or surgical glue is used to seal the openings in both forms of the procedure. Why the Procedure is Performed Vasectomy may be recommended for men who are sure they do not want to get a woman pregnant in the future. A vasectomy makes a man sterile (unable to get a woman pregnant).

A vasectomy is not recommended as a short-term form of birth control. The procedure to reverse a vasectomy is a much more complicated operation. Vasectomy may be a good choice for a man who: Is in a relationship, and both partners agree that they do not want children or additional children. They do not want to use, or cannot use, other forms of birth control. Is in a relationship and a pregnancy would be unsafe for the woman partner because of health problems. Is in a relationship, and one or both partners have genetic disorders that they do not want to pass on. Does not want to be bothered by having to use other forms of birth control during sexual activity. Vasectomy may not be a good choice for a man who: Is in a relationship with someone who has not decided on whether to have children in the future. Is in an unstable or stressful relationship. Is considering the operation just to please a partner. Wants to have children later by storing sperm or by reversing the vasectomy. Is young and may want to make a different decision in the future. Is single when deciding to have a vasectomy. This includes men who are divorced, widowed, or separated. Risks There is no serious risk to vasectomy.

Your semen will be tested in the months after the operation to make sure it does not contain sperm. As with any surgical procedure, infection, swelling, or prolonged pain can occur. Careful following of aftercare instructions reduces these risks significantly. Very rarely, the vas deferens can grow back together again. If this happens, sperm can mix with semen. This would make it possible for you to make a woman pregnant. Before the Procedure Two weeks before your vasectomy, tell your health care provider about of the medicines you take, including those bought without a prescription and vitamins, supplements, and herbs. You may need to limit or stop taking aspirin, ibuprofen (Advil, Motrin), and other medicines that affect blood clotting for 10 days before your surgery. On the day of your surgery, wear loose, comfortable clothes. Clean your scrotum area well. Take the medicines your provider told you take. Bring a scrotal support with you to the surgery. After the Procedure You should be able to return home as soon as you feel well. You can return to work the next day if you do not do heavy physical work. Most men return to work within 2 to 3 days.

You should be able to return to your normal physical activities in 3 to 7 days. It is normal to have some swelling and bruising of the scrotum after the procedure. It should go away within 2 weeks. You should wear a scrotal support for 3 to 4 days after the procedure. You can use an ice pack to reduce swelling. Pain medicine, such as acetaminophen (Tylenol), may help relieve discomfort. You can have sexual intercourse as soon as you feel ready, most often about a week after the surgery. You must use some form of birth control to prevent unwanted pregnancy until you know your semen is free of sperm. The vasectomy is considered successful only after your doctor has tested the semen to make sure no more sperm are in it. It is safe to stop using other forms of birth control at this point. Outlook (Prognosis) Vasectomy does not affect a man's ability to have an erection or orgasm, or to ejaculate semen. A vasectomy does NOT prevent the spread of sexually transmitted infections (STIs). A vasectomy does NOT increase your risk of prostate cancer or testicular disease. Your sperm count gradually decreases after a vasectomy.

After about 3 months, sperm are no longer present in the semen. You must continue to use birth control to prevent pregnancy until your semen sample is totally free of sperm. Most men are satisfied with vasectomy. Most couples enjoy not having to use birth control. Alternative Names Vasectomy | No Scalpel Vasectomy | Male Birth Control No needles, stitches or sutures used Quicker Recovery No-Needle No-Scalpel Vasectomy uses an advanced technique to anesthetize the scrotum more effectively. It requires no scalpel to enter through the skin. Instead, the physician avoids complex surgery by carefully isolating the vas deferens using the fingers of one hand. The vasa are then fixed just below the scrotal skin with an instrument designed to hold firmly without pinching. A single small opening in the skin is made with a pointed forceps. The vasa are then delivered through the skin, cut, and sealed in a conventional way. When the operation is complete, no sutures are needed to close the tiny opening. Answers to Common Questions How will a vasectomy affect me? Vasectomy is NOT castration. Vasectomy only interrupts the tubes that carry sperm from the testes to where they are added to the semen.

Your penis and testes are not altered. All hormonal and sexual functions are completely unaffected, so your voice, body hair, and interest in sex remain the same. Your body still produces semen, and erections and ejaculations occur normally. The only difference is that your semen will no longer contain sperm. As before, the body naturally absorbs unused sperm. Can I discontinue other birth control methods right away? No! Sperm can remain in the vas deferens and seminal vesicles above the operative site for weeks or even months after vasectomy, You will not be considered sterile until two post-surgical semen tests have shown that no sperm remain. Until then, you must continue to use other birth control to prevent pregnancy. Are there potential complications? Yes. All contraceptive methods carry some risk as well as benefits. Vasectomy is a very low risk procedure, but complications are possible Though rare, bleeding (hematoma) and infections are the most common complications of vasectomy. No-scalpel vasectomy, the procedure performed by Central Arizona Urologists, reduces their likelihood because the blood vessels responsible for bleeding are less likely to be affected and because the opening in the scrotum is so small. Another potential risk is failure.

Vasectomy is not guaranteed to be 100% effective. Even when the operation is performed perfectly, it is possible in rare cases for sperm to find its way across the void between the two blocked ends of the vas deferens. This situation, called recanalization, is highly unusual but does occur. This is another reason why samples must be taken from 6 to 10 weeks post-vasectomy to verify that your semen contains no sperm. Recanalization usually occurs in the first 2-3 months after vasectomy, but has been known in extremely rare cases to occur even years later. Sperm granuloma, a hard, sometimes painful lump about the size of a pea may form as a result of sperm leaking from the cut vas deferens. The lump is not dangerous and is almost always resolved by the body in time. Scrotal support and mild pain relievers are usually all that are needed for symptoms, though I may suggest other treatment. Congestion, a sense of pressure caused by sperm in the testes, epididymis, and lower vas deferens, and may cause discomfort some 2 to 12 weeks after vasectomy.

Like granuloma, congestion usually resolves itself in time Is vasectomy painful? No. You may feel mild discomfort when the local anesthetic is given. After it takes effect, you should feel no pain, though some men feel a slight “tugging” sensation as the vasa are manipulated. After surgery, you may be a little sore for a few days. Generally, two or three day’s rest is recovery enough before men return to work and most normal, no-strenuous physical activity. Sex can usually be resumed 7 days after the procedure. Does vasectomy pose long-term health risks? No. Many studies have looked at the long-term health effects of vasectomy. The evidence is reassuring, suggesting that no significant risks exist. Men who have vasectomy are no more likely than other men to develop cancer, heart disease, or other health problems. In 1993, a panel assembled by the National Institutes of Health, the Association for Voluntary Surgical Contraception, and the National Cancer Institute reaffirmed the conclusion of most medical experts that vasectomy is a safe and effective means of permanent birth control.

The panel advised that physicians continue to offer vasectomy and that all men, vasectomized or not, receive the same regular screening for prostate cancer and other illnesses. Can vasectomy be reversed? In many cases, the cut ends of the vas deferens can be surgically reattached. However, this operation, a vasovasostomy, is expensive and, for a variety of reasons, does not guarantee a return to fertility. Vasectomy should therefore be considered a permanent procedure. Before you choose to have a vasectomy, make sure that you and your partner do no want any more children. If you’re thinking about a reversal now, perhaps you should take more time to decide whether vasectomy is right for you. If you are ready for a vasectomy, or for more information, then call 602-242-1556 for an appointment with a physician at either of Central Arizona Urologists offices in Phoenix, Arizona. Click on the links below for more information and then print them out for your reference. Vasectomy - Surgery Procedures & Risks - NY Times Health Information Back to Top Description » Vasectomy is usually done in the surgeon's office using local anesthesia.

You will be awake but not feel any pain. After your scrotum is shaved and cleaned, your surgeon will give you a shot of numbing medicine into the area. Your surgeon will then make a small surgical cut in the upper part of your scrotum, and tie off and cut apart the vas deferens. Your surgeon will use stitches or a skin glue to close the wound. You may have a vasectomy without a surgical cut. This is called a no-scalpel vasectomy (NSV). Your surgeon will find the vas deferens by feeling your scrotum and then give you numbing medication. The surgeon will then make a tiny hole in the skin of your scrotum and seal off the vas deferens. The surgeon will usually pull your vas deferens through the tiny hole in order to tie off and cut it apart. You will not need stitches. Back to Top Risks There is no serious risk to vasectomy. Your semen will be tested in the months after the operation to make sure it does not contain sperm. As with any surgical procedure, infection, swelling, or prolonged pain can occur. Careful following of aftercare instructions reduces these risks significantly. Very rarely, the vas deferens can grow back together again.

If this happens, sperm can mix with semen. This would make it possible for you to make a woman pregnant. Kavoussi PK, Costabile RA. Surgery of thescrotum and seminal vesicles. In: Wein AJ, ed. Campbell-Walsh Urology . 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 37. More Information on This Topic 5 Things to Know Review Date: 4/16/2012 Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc. A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission ( URAC's accreditation program is an independent audit to verify that A.D.A.M.

follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation ( A.D.A.M. Copyright The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited. ASRM Patient Fact Sheet: Fertility Options After Vasectomy Fertility Options After Vasectomy Download a PDF of this fact sheet here Vasectomy is currently one of the most common methods of sterilization in the United States.

After your vasectomy, if you change your mind about having children, there are two procedures that can help you have a child with your partner. The two options are: a vasectomy reversal or sperm aspiration prior to in vitro fertilization (IVF). Your doctor can help you choose which procedure is better for you and your partner based on: How long it has been since your vasectomy Your age The number of children you want The cost How quickly you want to conceive a child, either naturally or through IVF What are the first steps I should take? The first thing to do is see a urologist. A urologist is a doctor who specializes in medical care of a man’s reproductive organs. Your urologist will take your medical history and do a physical examination to make sure you have no other health issues that would affect your fertility. Your partner should also see her doctor to make sure she has no fertility issues. What happens in a vasectomy reversal procedure? There are two types of vasectomy reversal procedures. The procedure used depends on the area of the male reproductive tract that was blocked during your original vasectomy procedure.

A vasovasostomy (vas-o-vay-ZOS-tuh-me) reconnects the two ends of the vas deferens. The vas deferens is a tube that transports sperm out of the testicle. You have two vasa deferentia, one each on both the right and left side of the scrotum. Each of the vasa deferentia was cut during your vasectomy to prevent sperm from mixing with semen. A vasoepididymostomy (vas-o-ep-ih-did-ih-MOStuh-me) reconnects the epididymis to the vas deferens. The epididymis is a coiled segment of the sperm ducts where sperm mature. This surgery is used when a vasovasostomy is not possible due to blockages caused by the vasectomy. Your doctor will decide which procedure is better for you during the operation. Both types of vasectomy reversal may let you and your partner have a baby naturally through sexual intercourse. How is sperm aspirated prior to an IVF cycle? During this procedure, your doctor aspirates (gently suctions) sperm from your testicles.

This procedure is usually performed under local anesthesia (with the use of numbing medication) in the office. It can also be done under general anesthesia (when you are put to sleep). A tiny needle is used to remove sperm directly from each vas deferens close to the testicle, or even directly from each testicle. Most men have some minor pain complaints after this procedure is completed. The sperm is then used to fertilize your partner’s eggs in a laboratory by using IVF. The sperm can either be aspirated the day of the IVF procedure or it can be removed in advance and frozen for a future IVF procedure. Because the quantity of sperm is small, its use for artificial insemination is not recommended. When this method is used along with IVF, it is highly successful, especially if your partner is under 35 years old. There are several other advantages to this method. It may mean that it will take less time for your partner to get pregnant and you won’t have to use birth control after a successful pregnancy. It is also a less invasive procedure for the male partner. There are some disadvantages as well. It is more expensive.

If more than a single embryo is transferred, your partner may have more than one child at the same time. It is also a more invasive procedure for the female partner, and the procedure may have to be repeated if you want to have more children. Revised 2011 Vasectomy. Male steralisation and vasectomy info | Patient 726 Vasectomy is an effective and permanent form of contraception. The operation is quicker, easier and more effective than female sterilisation. There is a very small failure rate. Sterilisation is only for people who have decided they do not want children, or further children in the future. It is considered a permanent method of contraception, as reversal is a complicated operation which is not always successful. In addition, reversal is not usually available on the NHS. What is vasectomy? Vasectomy is a small operation to cut the vas deferens. This is the tube that takes sperm from the testicles (testes) to the penis. Sperm are made in the testes. Once the vas deferens is cut, sperm can no longer get into the semen that comes out (is ejaculated) during sex. How reliable is vasectomy?

Vasectomy is very reliable - but not quite 100%. Even after a successful operation about 1 in 2,000 men who have had a vasectomy will become fertile again at some point in the future. This is because, rarely, the two ends of the cut vas deferens re-unite over time. In a few cases, operations are not successful and tests show sperm are still present in semen after the operation. This occurs in less than 1 in 100 operations. How is a vasectomy done? Vasectomy is usually done under a local anaesthetic. This means you are awake but have an injection into the skin so that you do not feel pain. Local anaesthetic is injected into a small area of skin on either side of the scrotum above the testicles (testes). A small cut is then made to these numbed areas of skin. Occasionally vasectomy is done under a general anaesthetic . A tiny cut or puncture hole is made in the skin on each side of the scrotum. The vas deferens can be seen quite easily under the cut skin. It can be cut with a surgical knife (scalpel) or using diathermy.

Diathermy is electrical current that cuts and seals the ends of the tubes. It stops bleeding at the same time. Sometimes a small piece of the vas deferens is removed. The hole is so small you may not need any stitches. If you do, dissolvable stitches are used, or a special surgical tape. The operation takes about 15 minutes. There is usually some discomfort and bruising for a few days afterwards. This normally goes away quickly. The discomfort can be helped by wearing tight-fitting underpants day and night for a week or so after the operation. It is also best not to do heavy lifting or strenuous exercise for four weeks or so after the operation. Are there any risks to the operation? Most men have no problems after a vasectomy. Problems are uncommon but include the following: As with any operation or cut to the skin, there is a small risk of a wound infection. The bruising around the operation site is sometimes quite marked. However, it will go in a week or so. Rarely, sperm may leak into the scrotum and form a swelling which may need treatment. A small number of men have a dull ache in the scrotum for a few weeks or months after the operation.

This usually settles within three months. A small number of men develop a pain which does not settle over time. This can be mild or severe. It may be in the scrotum, the penis, the testicles (testes) or the lower tummy. If you have a general anaesthetic, as with any operation, there is a small risk associated with the anaesthetic. How do I know it has been successful? Some sperm survive in the upstream part of the vas deferens for several weeks after vasectomy. These can get into the semen for a while after the operation. About twelve weeks after the operation you will need to produce a semen test. This is looked at under the microscope to check for sperm. If there are no sperm in this sample, you will be given the all clear. If not, you will need another test a month later. You will be told when the test shows the operation has been successful. Until this time you should continue using another method of contraception . What are the advantages of vasectomy? It is permanent and you don't have to think of contraception again. It is easier to do and more effective than female sterilisation . What are the disadvantages of vasectomy?

It may take a few months before the semen is free from sperm. As it is permanent, some people regret having a vasectomy, especially if their circumstances change. Vasectomy does not protect you from sexually transmitted infections. Will it affect my sex drive? No. The sex hormones made by the testicles (testes) - for example, testosterone - continue to be passed into the bloodstream as before. Also, vasectomy does not reduce the amount of semen when you come (ejaculate) during sex. Sperm only contributes a tiny amount to semen. Semen is made in the seminal vesicles and prostate higher upstream. Sex may even be more enjoyable, as the worry or inconvenience of other forms of contraception is removed. What happens to the sperm? Sperm are still made as before in the testicles (testes). The sperm cannot get past the blocked vas deferens and are absorbed by the body. Read more blog posts Some other points about vasectomy Do not consider having the operation unless you and your partner are sure you do not want children, or further children. Consider all sorts of situations including a tragedy in the family or a break-up of your relationship.

Only have a vasectomy if you are sure you would not want more children even in those situations. It is wise not to make the decision at times of crisis or change, such as after a new baby or termination of pregnancy. It is best not to make the decision if there are any major problems in your relationship with your partner. Remember there are reversible forms of long-term contraception which are very effective. Consider these as a couple before making your decision. Long-acting contraception choices include coils , implants and injections . These are all for women. Doctors normally like to be sure that both partners are happy with the decision before doing a vasectomy. However, it is not a legal requirement to get your partner's permission. Some common questions about vasectomy Is vasectomy done on the NHS? Yes most men have a vasectomy done on the NHS. However, waiting lists may vary throughout the country. Some men prefer to have it done at a private clinic or hospital. Does the operation hurt? No more than any other minor operation that uses local anaesthetic. The injection of local anaesthetic may sting a bit for a few seconds. It is put in just a small area of skin. After this, the operation is usually painless.

After the operation, when the local anaesthetic wears off, the top part of the scrotum is normally mildly sore for a few days. What if I change my mind? Vasectomy is considered permanent. There is an operation to re-unite the two cut ends of the vas deferens. It is a difficult operation and not always successful. It is also not available on the NHS, so you would have to pay for this yourself. How soon after the operation can I have sex? You can resume sex as soon as it is comfortable to do so. However, remember you will have to use other methods of contraception until your semen specimen has been confirmed as clear of sperm. Some sperm will survive upstream from the cut vas deferens for a few weeks. I have heard that there is an increase in the risk of prostate cancer after vasectomy. Is this true? A few studies have shown that there does seem to be an association between vasectomy and a small increased risk of prostate cancer. Guidelines in the UK from the Faculty of Sexual and Reproductive Healthcare (FSRH) state that there is no evidence that the vasectomy causes prostate cancer. They consider that it is likely there is another factor which links vasectomy and prostate cancer.

Further reading & references Male and female sterilisation ; Faculty of Sexual and Reproductive Healthcare (FSRH) Clinical Guidance (September 2014) Dohle GR, Diemer T, Kopa Z, et al ; European Association of Urology guidelines on vasectomy. Eur Urol. 2012 Jan;61(1):159-63. doi: 10.1016/j.eururo.2011.10.001. Epub 2011 Oct 19. Siddiqui MM, Wilson KM, Epstein MM, et al ; Vasectomy and risk of aggressive prostate cancer: a 24-year follow-up study. J Clin Oncol. 2014 Sep 20;32(27):3033-8. Trussell J ; Contraceptive failure in the United States, Contraception, 2011 Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy.

Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions . Original Author: Vasectomy and vasectomy reversal | Andrology Australia Is vasectomy right for me? Vasectomy may be right for you if: you and your partner are sure you have completed your family you want to take responsibility for family planning you want an effective, permanent method of contraception that does not need ongoing treatment. Vasectomy may not be right for you if you are: relatively young and do not have any children not in a relationship, or you have recently separated or divorced having relationship or marriage problems. What are the risks of vasectomy operations? Vasectomy is safe but carries a small risk (less than one in 20) of infection or bleeding. A small proportion of men have long-term pain or discomfort in the scrotum and some have pain with ejaculation; it can’t be predicted before the vasectomy which men will have ongoing pain. Some medicines can help with pain or, in very rare cases, other surgery is needed. There is no evidence that vasectomy increases the risk of other health problems.

A recent study suggested that there may be a link between vasectomy and a small increased risk of prostate cancer but several other studies have shown no link with prostate cancer and further research is needed. Why is it important to think about sperm storage? Even though only a small fraction of men who undergo vasectomy want another child, some men store sperm before a vasectomy “just in case”. This may prevent the need for a vasectomy reversal in the future; however, when using stored sperm, the female partner will still need some form of assisted reproductive technology (ART) to fall pregnant. There are also costs involved with sperm storage. Vasectomy reversal What is a vasectomy reversal? About three percent of men who have had a vasectomy will think about having more children, for reasons such as a new relationship, either by having a vasectomy reversal or by using assisted reproductive technology (ART). Vasectomy reversal involves re-joining the cut ends of the vas deferens usually by microsurgery (using an operating microscope). The operation is much more complex than the original vasectomy and is usually done under general anaesthetic by a specialist and can take several hours. How successful is a vasectomy reversal?

In 60-90% of vasectomy reversals, sperm return to the ejaculate. The chance is lower if: there has been a long time between the vasectomy and the reversal; after 10-15 years, the chances fall significantly a large amount of vas deferens was removed originally, or it was cut near the epididymis other blockages have developed in the epididymis. Even after technically successful surgery, pregnancy is not guaranteed. After vasectomy reversal, only about 40-70% of couples achieve a pregnancy over the next 2-3 years of regular sex. The chance of pregnancy is lower when the woman is older or has other fertility issues. Sperm problems may contribute if there is a lower sperm count, poorer sperm function if the epididymis has been damaged, or because of sperm antibodies which may develop. What are sperm antibodies? Sperm antibodies happen when the immune system reacts to the man’s own sperm as if it were foreign tissue. About four in five men develop sperm antibodies after vasectomy. How is vasectomy reversal affected by sperm antibodies?

In most men sperm antibodies do not cause any problems and will not affect the chance of a pregnancy, so testing for sperm antibodies is not needed before a vasectomy reversal. However, in a few men, sperm antibodies can interfere with the ability of sperm to swim, and to attach to and penetrate (get into) the egg. This can stop fertilisation happening, even if the vas deferens is successfully re-joined. When is ART used after vasectomy? Men who have had a vasectomy reversal but their partner has been unable to become pregnant can seek ART. Some couples decide not to have a vasectomy reversal and go straight to ART depending on the couple’s individual circumstances. Sometimes the choice is easy but often it needs in-depth discussion with a specialist to decide what is best. Factors that affect this choice include: the time since vasectomy and the type of original surgery the age and fertility of the female partner the couple’s desire to have only one or many children the availability and cost of surgical and ART services. How is ART used after vasectomy? Sperm can be collected from the epididymis or testis using a fine needle under local anaesthetic.

These sperm can then be injected one by one into eggs collected from the female partner in an ART process called intracytoplasmic sperm injection (ICSI). The success of treatment depends mainly on the age and health of the female partner. For women in their 30s, pregnancy rates around 40% per cycle are typical. Last modified: April 29, 2015 Andrology Australia is funded by the Australian Government Department of Health and administered by Monash University (ABN 12 377 614 012). Please note that the Andrology Australia website does not host any form of advertisement. Andrology Australia, School of Public Health & Preventive Medicine, Monash University Postal Address: PO Box 315, Prahran, VIC 3181 Street Address: 549 St Kilda Road, Melbourne, VIC 3004 Phone: 1300 303 878

Question: If you had your vas deferens cut, what operation would you have had?
Answer: Vasectomy