Vasectomy is a form of birth control for men. This minimally invasive surgery prevents sperm from entering the scrotum and then being released during ejaculation.
According to the Centers for Disease Control and Prevention (opens in new tab) (CDC), a vasectomy is a minor surgical procedure to cut or seal the vas deferens—the tube that connects the testicles to the penis. Because sperm are produced in the testicles, they can no longer be transferred to semen and therefore cannot cause pregnancy.
An estimated 500,000 men have a vasectomy each year in the United States, according to the Cleveland Clinic (opens in new tab). Many men consider having a vasectomy when they are sure they don’t want any more children or no children at all.
Dr. Hussain Alnajjar (opens in new tab), consultant urological surgeon at University College London Hospital in the United Kingdom and honorary associate professor at University College London, said vasectomy is the most reliable method for male sterilization. “It should also be considered irreversible,” he told Live Science in an email. “The vasectomy procedure, often referred to as a vasectomy reversal, is possible but may not always be successful.”
How does a vasectomy work?
A vasectomy is a minimally invasive surgery performed by a urologist – a specialist who focuses on everything related to the urinary and reproductive systems.
The procedure does not affect a man’s ability to have sex or achieve orgasms and does not visibly change the sperm, said Dr. Paurush Babbar. (opens in new tab)a urologist at The Urology Group in Cincinnati, Ohio and a member of the American Urological Association.
Babbar completed both his undergraduate studies and medical school at Wake Forest University in Winston-Salem, North Carolina, in 2013. He went on to the Cleveland Clinic in Cleveland, Ohio, for his urology residency, which he completed in 2019. Babbar is a member of the American Urological Association and board certified by the American Board of Urology.
There are two common types of vasectomy: conventional and scalpelless. During a conventional vasectomy, small incisions are made in the scrotum—the sac of skin that protects the testicles—in order to reach the vas deferens. In a scalpel-free vasectomy, no incisions are made during the procedure—instead, the doctor makes a small puncture or incision to reach the vessel.
A 2014 review was found in the Cochrane Database of Systematic Reviews (opens in new tab) no difference in effectiveness between the two approaches. However, scalpel-free vasectomies may result in less bleeding, infection, and pain, as well as a shorter operating time compared to the conventional technique.
In both types of surgery, the patient is put under local anesthesia. In a conventional vasectomy, a doctor then cuts the vas deferens, Babbar told Live Science in an email. The procedure takes about 30 minutes. Once the incision is made in the scrotum, the doctor removes a small piece of the scrotal tube. Limbs are sewn, cut and sealed with cautery – a practice of burning a body part to remove or close it. The patient also receives two or three stitches near the incision, Babbar said.
In a scalpelless vasectomy, the urologist feels the vas deferens and then holds it in place with a clamp. A tiny hole is then made in the scrotum so the tube can be removed and cut or tied. The vas deferens is then repositioned.
While the testicles continue to produce sperm, they are simply reabsorbed back into the body, in exactly the same way they would if the man wasn’t having sex, Adam Watkins said. (opens in new tab)associate professor in reproductive and developmental physiology at the University of Nottingham in the UK
It usually takes a few months before the patient is completely sterilized, Babbar said. “A doctor will confirm infertility with a sperm sample two to three months after a vasectomy,” he said.
Does vasectomy work?
Vasectomy is a highly effective method of birth control, according to the Mayo Clinic, (opens in new tab) with a success rate of over 99%. However, there is always a small chance that pregnancy will occur, according to the CDC.
Despite its effectiveness, a vasectomy does not work immediately, and men should use other forms of contraception until the sperm analysis after the vasectomy, Alnajjar said. That’s usually 12 weeks after the procedure or when 20 ejaculations have tested negative for sperm, he said.
A vasectomy carries little risk of short- and long-term complications, according to a 2021 review published in The World Journal of Men’s Health (opens in new tab). Most patients experience swelling, bruising and some discomfort for about two weeks after the procedure. These symptoms tend to go away on their own. However, there is a small risk that some patients will develop a scrotal infection, hematoma (bleeding under the skin that looks like a bruise) and spermatic granuloma (a lump in the scrotum caused by sperm leaking from the vas deferens into the tissue).
Can a vasectomy be reversed?
Although a vasectomy is considered a permanent procedure, it can be reversed, Watkins told Live Science in an email. However, it’s harder to undo a vasectomy than it is to have the original surgery, he said.
“A vasectomy is a fairly routine and quick procedure. Although it can be a reversal procedure, there is no guarantee that it will restore a man’s fertility,” Watkins said. “Therefore, a vasectomy should only be performed if the person is absolutely certain that they do not want to have any, or any, children.”
Alnajjar said the vasectomy reversal is performed by reattaching the previously cut ends of the spermatic vessels using tiny sutures.
The chance of success for a vasectomy reversal is directly related to the time between the vasectomy and its reversal and the woman’s age, Alnajjar said. According to the Mayo Clinic (opens in new tab)pregnancy success rates vary from about 30% to 90%, with the lowest rates for men who had a vasectomy 10 years ago.
Additionally, a vasectomy reversal procedure takes longer (about 2 to 3 hours) and is more expensive than a vasectomy, Babbar said.
This article is for informational purposes only and is not intended to offer medical advice.