Thinking about a vasectomy? Here are the most common questions..

Thinking about a vasectomy? The number of men and couples who have performed a web search for vasectomy has nearly doubled since the recent leak of the Supreme Court documents and concerns regarding care for unintended pregnancies. A vasectomy is a very highly effective form of birth control for men.

Here are the most common questions I get from men considering a vasectomy.    

1.     What is the recovery like? Is it going to be uncomfortable?

Vasectomy is a minor, office-procedure that is performed over 500,000 times every year in the United States. Typically, most men get the procedure completed under just local numbing medication which is injected at several locations through a single skin puncture just prior to starting the procedure. A small scrotal incision (smaller than the tip of your pinkie finger) is sufficient to complete the vasectomy. Generally, you may feel slight pressure and tugging sensation, but you should not feel any sharp or intense pain, like getting dental work completed. Immediately after the procedure men may have slight soreness in the scrotum which typically lasts about 48-72 hrs. Ice pack, scrotal support, and non-narcotic pain medications can help with any discomfort in the first few days after the procedure. Most men are fully recovered within 1 week of their vasectomy and back to their normal activities including sex.  

2.     Will sex feel the same after the procedure?

After vasectomy, sexual function and satisfaction for you and your partner should not change. Since a vasectomy simply blocks the addition of sperm to the ejaculate, there is no impact on erotic sensation or the ability to achieve sexual pleasure and orgasm. In fact, some studies have shown that men after vasectomy generally are more sexually active, primarily because this removed anxiety associated with unwanted pregnancy and using cumbersome, less effective forms of contraception such as condoms.   

3.     Will the amount of my ejaculate go down?

Almost 98% of the ejaculate volume is produced from the prostate and accessory glands. Sperm contribute less than 2% of the total volume of the ejaculate. Therefore, you should not notice a change in the ejaculate volume after vasectomy.

4.     Will my testosterone levels go down?

Testosterone, a critical hormone for normal body processes, is made by the testicles that is largely distributed throughout the body through the blood vessels. A vasectomy will only create a block of the tube that adds sperm to the ejaculate. The testicles will continue to make the same amount of testosterone before and after vasectomy.   

5.     Will sperm build up in my body?

Healthy men make nearly 1,500 sperm is made every second. That is a lot of sperm. Even in hyper-sexual guys that ejaculate multiple times a day, that still means there is excess sperm that your body will resorb. Hence, the resorption of sperm is a normal process even in men without a vasectomy. After a vasectomy, the sperm that are produced by the testicle are blocked from joining the ejaculate. In a similar manner as before the vasectomy, you will continue to resorb the sperm that is made after the procedure.  

6.     Will I be at a higher risk of cancer?

Some historic medical studies have suggested an association with vasectomy and development of prostate cancer later in life. However, newer, stronger studies have shown that this is not true. Getting a vasectomy, will not put you at higher risk of developing cancer.

7.     I’ve heard that sometimes a vasectomy doesn’t work

Vasectomy is 99.9% effective in preventing unwanted pregnancy. This is much more effective than any other form of available contraception. It is also as effective every single time compared to contraception methods like condoms, where the effectiveness decreases if used incorrectly (or it breaks). It is also less costly and less dangerous compared to hormone contraception for females and tubal ligation for females. Vasectomy is not 100% effective, (vasectomy can lead to unintended pregnancy in 1/2000 couples) but is sure close.    

8.     What if I change my mind and want to have additional children?

I counsel men that vasectomy should be considered a permanent form of sterilization. However, things can change. You can have additional children after vasectomy, but it can be costly and is not guaranteed. There are two ways that this can be done. First, you can undergo a vasectomy reversal. This is a technically challenging procedure that can take 4-5x the amount of time to complete compared to the initial vasectomy. The success rate is high, but it’s important to search for a provider that has specialized training in microscopic surgery. The second method bypasses the blockage and obtains sperm directly from the source. A testicular sperm aspiration can be safely performed in the office under numbing medicine to obtain sperm directly from the testicle. This sperm may need be used with artificial reproductive technologies to have a baby.  

Contact us if you are interested in learning more about vasectomy.

-Dr. Patel