Few birth control options for monogamous couples are as effective or convenient as vasectomy. Yet, when it comes to having an operation "down there," many men are naturally concerned. What if the surgeon slips? What if it hurts? What is the complication rate?
"The reality is, vasectomy is one of the most common procedures done for sterilization in the United States," says Amarnath Rambhatla, M.D., a urologist at Henry Ford Health. "It's quick, safe and it doesn't require an operating room."
What You Need To Know About Vasectomies
With advanced minimally invasive approaches, some of which don't even require a scalpel, men are becoming increasingly comfortable with the idea of vasectomy.
We asked Dr. Rambhatla to address men's most pressing — and embarrassing — questions about the procedure:
Q: How does a vasectomy work?
A: Your body produces sperm in the testicles. Mature sperm move through tubes called the vas deferens and combine with secretions from the prostate and seminal vesicles to form semen (male reproductive fluid). During a vasectomy, the surgeon cuts and closes off the vas deferens preventing sperm from coming out.
Q: What is the doctor actually doing down there?
A: Most doctors today use a minimally invasive approach to vasectomy, making a small opening in the scrotum to access the vas deferens. We pull up the vas deferens through one or two tiny incisions, then cut it to make sure that sperm cannot pass through the tubes.
Q: Does getting a vasectomy hurt?
A: We use local anesthesia to numb the area, so it doesn't hurt. The local anesthesia lasts for a few hours after the procedure. We ask patients to use ice for 24 to 48 hours and wear supportive underwear for a few days to help with swelling. Most post-vasectomy discomfort resolves within a few days.
Q: Does getting a vasectomy affect sexual performance or ejaculate volume?
A: No. Men will still be able to get and maintain an erection and they'll still produce testosterone and sperm. We're just making it so the sperm can't get out. Since the sperm component of a man's ejaculate only comprises about 2 to 5 percent of its volume, most men won't notice any difference in their ejaculate.
Q: What happens to the trapped sperm?
A: The testicles still make sperm after the procedure. That sperm stays in the vas deferens or epididymis until it dies off and gets reabsorbed by your body.
Q: Can you get a partner pregnant after having a vasectomy?
A: Yes. Vasectomies are not 100 percent effective. The failure rate hovers around 1 in 2,000. After a vasectomy, there are still sperm on the other side of the cut vas deferens. We recommend men resume sexual activity using a form of birth control until a post-vasectomy semen analysis shows there's no sperm. Most studies show up to 80 percent of men have cleared out all of the sperm after three months, but some men require six months or more before a semen analysis shows no sperm in their ejaculate.
Q: How long is the recovery?
A: Pain or swelling after surgery should be mild and lasts only a few days. You can use an ice pack on your scrotum or take anti-inflammatory medication to reduce pain and swelling. Since the scrotum heals quickly, most men can have sex as soon as a week after their procedure.
Q: What if you decide you want to have children after you've had a vasectomy?
A: Experienced doctors can reverse a vasectomy. Up to 5 percent of men who undergo vasectomies seek a reversal at some point. Leading-edge centers have experienced urologists on staff who are specially trained in vasectomy and vasectomy reversals.
A Successful Vasectomy
Vasectomy is a great option for men who don’t want to have children or for couples whose families are complete. While vasectomy is a simple office procedure that typically takes only 20 to 30 minutes, doctors recommend taking it easy for a few days after the procedure.
Since vasectomy is a surgical procedure, there is a small (up to 2 percent) chance of pain, bleeding and hematoma formation. There's also a complication called post-vasectomy pain syndrome that affects 1 to 2 percent of men. "Very rarely do we have to do another procedure for someone who has this persistent pain," says Dr. Rambhatla.
Dr. Amarnath Rambhatla is a urologist who specializing in men's sexual health. He sees patients at Henry Ford Hospital in Detroit, Henry Ford West Bloomfield Hospital and Henry Ford Medical Center - Fairlane in Dearborn.