Because a vasectomy involves a sensitive part of the body, there are many questions and even misconceptions about the procedure. Men want to know how it feels, how it affects their sex life and if a vasectomy is truly permanent. A vasectomy is a minimally invasive surgery that prevents sperm from flowing into the semen – think of it as a male form of birth control. For men who are confident they do not want children in the future, a vasectomy is a safe and highly effective contraceptive option. To share the facts and to ease any potential anxiety, Peter Dietrich, MD, a Froedtert & MCW urologist, debunks some of the common myths around vasectomies.
Is a Vasectomy Painful?
MYTH: A vasectomy is painful.
FACT: Pain is minimal and well-controlled with medications.
A vasectomy is a quick outpatient procedure that is done under local anesthesia. It takes 10-15 minutes and does not require incisions or stitches. It involves two tiny puncture wounds, one on each side of the scrotum. The punctures measure about 1-3 mm. For comparison, 1 mm is the size of a sharp pencil point, and 3mm is about the size of a sesame seed. This is called a no-scalpel vasectomy. It is the most popular technique, and it is the one performed by urologists with the Froedtert & MCW health network. The punctures are how the urologist accesses each vas deferens, the two tubes responsible for carrying sperm from the testicles to the penis.
“We remove a small section of the vas deferens, then seal the tubes by applying heat,” Dr. Dietrich said. “Then, we position a small layer of tissue to tent over the area, which creates a physical barrier.”
During the vasectomy, a brief stinging or burning sensation is usually the most noticeable discomfort. Dr. Dietrich compares the moment of the puncture wounds to what you feel at the dentist when your gums are poked. For men who are particularly anxious, a single dose of anti anxiety medication is offered.
“The Froedtert & MCW urology team does more than 1,000 vasectomies a year, so we are very skilled,” Dr. Dietrich said. “We prioritize making the experience for our patients as painless as possible, and we are very attentive to how guys are feeling at all times.”
Recovery from a no-scalpel vasectomy is quick.
Restrictions after a vasectomy are:
- No lifting more than 15 lbs. for 5 days
- No ejaculating for 5 days
- No exercise for 5 days
“We recommend over-the-counter anti-inflammatories and ice to relieve soreness for the first few days,” Dr. Dietrich said. “I tell guys they will typically feel back to normal and will be moving around in one week.”
Vasectomy and Sexual Performance
MYTH: A vasectomy decreases sexual performance.
FACT: A vasectomy has no impact on sexual performance; it is purely contraceptive.
A vasectomy does not affect erections, orgasms, testosterone production, sex drive or sensation during sex; it is purely a contraceptive. A vasectomy changes one thing; it blocks sperm from joining the semen. The body continues to produce sperm in the testicles, as usual, but it can no longer travel through the vas deferens, so the body reabsorbs it. Reabsorbing the sperm is harmless and is what happens to sperm that is not ejaculated. The nerves responsible for sexual sensation, the blood flow supporting erections and the glands that produce semen and hormones are all separate from the vas deferens.
“The analogy I give to my patients is that we are simply plumbers turning off the sperm pipe in a much bigger water system,” Dr. Dietrich said. “When we turn off the sperm pipe, the semen simply doesn’t have sperm in it.” Sperm contributes only a small fraction of the total semen volume, so men should not notice a change in ejaculation volume, how ejaculating feels or how it looks.
Reversing a Vasectomy
MYTH: A vasectomy is easily reversable.
FACT: A vasectomy reversal is complex and not always successful.
A vasectomy should be considered a permanent contraceptive option. Reconnecting the vas deferens to the testicles so that sperm can flow into the ejaculate is a much more extensive procedure than the initial vasectomy. A vasectomy reversal also involves a longer recovery and does not guarantee a return to fertility. The success rate for vasectomy reversals can vary and many factors will affect whether or not a pregnancy can be achieved after a vasectomy reversal.
“We understand circumstances can change, and we do reversal procedures on about 5% of men,” Dr. Dietrich said. “Still, we strongly encourage men to be as certain as possible about family planning. If there is any uncertainty, consider alternatives to a vasectomy.”
Vasectomy reversals are not typically covered by health insurance.
A Note About Sterility After a Vasectomy
Men are not considered sterile until three months after their vasectomy because the sperm that was already present needs to be cleared out. Patients are asked to ejaculate 20-30 times in the 3-month timeframe after their procedure. Then, patients will provide a sample for post-procedure semen analysis. If sperm is still present, the analysis may be repeated with a new sample after more ejaculations.
The Froedtert & MCW urology team offers virtual consultations for vasectomy patients. With a virtual consultation, men do not need an exam until the day of the procedure.
Learn more information about what to expect before, during and after the procedure visit.
About the Vasecectomy Procedure
