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Vasectomy

Download Pre/Post Vasectomy Instructions.

Vasectomy is considered a permanent form of contraception (sterilization). However, vasectomy reversal is possible and successful. Many changes may happen in life, and you are encouraged to remember that life changes; such as, the death of a spouse or children, divorce, and/or improvement in financial status, might change your views towards fathering children.

Vasectomy is a straight-forward procedure which may be performed in the office to cut, tie, and/or burn the tube (vas deferens) that carries the sperm from your testicle to the ejaculate on both sides. The procedure takes 20-30 minutes to perform under local anesthesia. After the procedure, you will need to wait 6-8 weeks and ejaculate 15-20 times to remove the stored sperm from your system before you can be cleared as “sterile.” You will need to utilize other forms of contraception until 2 consecutive semen samples show no sperm.

The following complications may happen, even when the vasectomy is performed correctly.

SCROTAL PAIN – the most commonly reported complication of vasectomy in the first 5 years after the procedure; however only adversely affects the quality of life in only 2.2% of men. This discomfort may be related to blocking the vas tube and the flow of sperm. There may be a feeling of “congestion” and swelling; which usually improves with ibuprofen. Post-vasectomy pain syndrome is persistent scrotal pain which usually occurs 10-15 years after surgery. It is a rare late complication and often improves with vasectomy reversal.

BLEEDING – bleeding into the scrotum following the procedure is uncommon, but may cause bruising and scrotal discoloration. Rarely, it is necessary to perform a second surgery to remove accumulated blood.

INFECTION – every time a skin incision is made, there is potential for germs to enter the body and cause an infection. Shaving the scrotum at home in the morning of the procedure will help decrease your chance of infection.

SPERM GRANULOMA – leakage of sperm from the cut end of the vas deferens after surgery that causes a round scar (feels like a small pea in your scrotum) in 1 in 100 cases. This is not harmful but can sometimes cause discomfort.

RECANNULATION – about 1 out of 300 vasectomies will have the tube (s) re-connect and lead to unplanned pregnancy. This may occur months or years after the procedure.

If you are scheduled for this procedure, please refer to the Pre-operative and Post-operative Instructions.

Vasectomy Booklet

Download the Vasectomy Booklet [ PDF ].

LIVING WITH A VASECTOMY

A vasectomy will not affect your manliness in any way because it has no effect on the male hormones produced by the testes. Nor will it alter your sexual functioning. You will have the ability to have an erection and an orgasm, and the amount of semen ejaculated will not decrease noticeably. Sexual relations will have the same sensations and excitability as before. If you had a good relationship before your vasectomy, it will be the same afterwards. Your mutual enjoyment may actually improve because you will no longer be afraid of unwanted pregnancy, and sex may be more spontaneous because birth control is no longer necessary.

WHAT HAPPENS DURING A VASECTOMY?

After you undress, the area around the incision will be washed and you will be draped. A local anesthetic will be injected into the scrotum. The anesthetic will prevent you from feeling pain. One small puncture site in the scrotum in usually made. The vas deferens, which lies just below the skin, is then cut and a section of the tube is removed, the two ends are cauterized or tied, shut and sutured closed . You may feel a sensation of pulling while the tube is being lifted and cut. The incision will be closed with the dissolving stitches.

AFTER SURGERY

After the operation, you will probably rest on the table for a few minutes. When you first get up, you might fell a bit wobbly, but you won’t experience pain; the anesthetic is still working and probably won’t wear off for an hour or two. A pain medication can be prescribed if you need one, but the discomfort is usually not severe. Any discomfort will be the greatest during the first 24 hours. You will need to have someone take you home following the surgery.

WHEN YOU GET HOME

Once you're home, there are several things you can do to aid your recovery and to help prevent complications. Try to stay off your feet as much as possible for the next 2 days. This will reduce the chances of swelling. Apply an ice pack to the scrotum when you get home for 12-24 hours after the surgery. Avoid heavy lifting or vigorous exercise for 7 days afterward. If your job is not a strenuous one, you can usually return to work on the third day after surgery. Sexual activity can be resumed in about two weeks. It is usually a good idea not to bathe or shower for at least 48 hours to protect your incision. You will probably find it more comfortable if you wear a pair of cotton, jockey type under shorts that provide you with some support. Wear an athletic supporter over this until discomfort resolves.

HEALING AFTER SURGERY

For a period of time after surgery, you may have a dark discoloration around the genital area, and there may be a small amount of bloody discharge from the incision. These are considered normal and may be accompanied by slight pain and a little swelling.

POSSIBLE COMPLICATIONS

As with all surgeries, even a minor operation like a vasectomy, carries with it the possibility of complications. Those that may occur soon after your vasectomy are the following:

Internal bleeding in the scrotum may cause increasing pain, great swelling, or an enlarging mass. If you have these symptoms, which usually occur within 2 days of surgery, call the doctor.
Infection in the incision. Be sure to call if you have yellowish drainage from your incision site.
Sperm granuloma, which occurs in 3-5% of all vasectomies, is a painful lump at the site where the vas deferens is tied off, and is caused by a leakage of sperm.
Congestion, caused by sperm left in the epididymis, may cause some pain about 3-12 weeks after surgery. The congestion usually disappears without the need for treatment.
"Post-vasectomy pain syndrome," is scrotal discomfort which may occur 10-15 years after the vasectomy. It is thought to be caused by prolonged blockage. Reversing the vasectomy may improve pain in 50% of patients.
Sperm antibodies in the blood are a normal response of the body to proteins formed from absorbed sperm. As of this time, these antibodies have not been found to be harmful.
Spontaneous formation of a new vas deferens through the scar tissue left by the vasectomy very rarely occurs. This can usually be detected within the first few months after surgery by a semen test. Until this test is done, you cannot be certain that you are sterile.

You may be aware of some publications that have suggested an increased incidence of prostate cancer with vasectomy. Re-evaluation of these specific publications and further research has not substantiated this claim. You should have appropriate examinations of your prostate as recommend by your personal physician.

BEFORE YOUR VASECTOMY

In the morning before your vasectomy, shave your scrotal area concentrating towards the base of the penis.
Bring or wear a scrotal supporter or briefs, not boxers. You may have a light meal before your procedure and may take any medications with sips of water.
Do not take aspirin/aspirin containing products/ ibuprofen /Naprosyn, etc. for at least 10 days before the procedure.
If you should have any questions concerning the procedure or preparation for it, please feel free to call.

AFTER YOUR VASECTOMY

Apply an ice pack directly on top of the supporter (on/off 10 minutes) when you get home (a bag of frozen vegetables works well). Use this for the next 12-24 hours.
If you were sent home with scrotal dressing, you may remove this the morning after surgery. Wear a scrotal supporter or firm fitting underwear for 2 weeks.
You may shower 48 hours after surgery. Do not soap or scrub the area. Just let the water run over your scrotal area. Do not take a bath or swim for 3 days.
Beginning on the third day after your vasectomy you should start taking hot tub baths daily for 20-30 minutes. You should do this for the next 10-14 days or until you no longer feel any discomfort.
You may notice a small amount of discharge or bleeding from your incision(s). Do not worry about this unless you develop excessive bleeding, fever, redness, swelling, foul smelling discharge or pus.
You may resume sexual intercourse and exercise when it is comfortable for you.
You must continue to use birth control until you have been told that there are no sperm in your ejaculate in 2 successive semen collections. Generally, it takes approximately 20 ejaculations to clear the sperm from your ejaculatory system, or 12 weeks.
You can make an appointment at the Center for Sexual Health office for your collection following your doctors instructions regarding time:
Dr. Steinbecker patients -12 and 16 weeks
Drs. Adkins, Bigg, Lovinggood and Naughton - 6 and 8 weeks
You do not need to be seen by your physician at that time. You can call 2-3 days after leaving specimen for results.
If you have questions, please feel free to call the office:
Center for Sexual Health - 314-315-9965
St. John’s Office - 314-315-9914

A CHANGE OF HEART

Sometimes an unforeseen event in your life may cause you to seek to have a reversal of your vasectomy. Although vasectomy must be considered irreversible, there is a surgical procedure called a vasovasostomy or vasoepididymostomy that may be extremely successful to restore your fertility. During a vasovasostomy, the cut vas deferens is reconnected to reestablish the flow of sperm. During a vasoepididymostomy, the vas deferens is reconnected to the epididymis (delicate tubules behind the testicle). This is a microsurgical procedure, and should be performed by a urologist with sub-specialty fellowship training in microsurgery. The success rate of vasectomy reversal is dependent upon the years since you have had your vasectomy. A vasectomy reversal may or may not be reimbursable by insurance. For more information on vasectomy reversal and success rates, call Dr. Cathy Naughton at the Center for Sexual Health at 314-315-9965.