Vasectomy: How it Works

Sperm passes from the testes to the penis in tubes called the vas deferens.  A vasectomy is a surgery that cuts or blocks these tubes. This surgery makes a man unable to make a woman pregnant.

A vasectomy is normally done as permanent birth control. This option is for men who are fairly sure they will not want to father a child in the future. However, there is a surgery to reverse a vasectomy (called vasectomy reversal), and this surgery is normally successful in restoring the vas deferens function.

A vasectomy is in most cases a simple and fairly risk-free procedure. However, If you are planning to have a vasectomy, your doctor will review a list of possible complications with you, which may include:

• Infection, swelling, bruising, or bleeding.
• Chronic pain in and around the testes.
• Sperm granuloma (lumps due to immune system response to sperm leaking from the reproductive organs).
• The ability to still make a woman pregnant.

Factors that may increase the risk of complications include:

• Smoking.
• Local infections.
• Bleeding disorders.
• Prior surgery in that area.

Prior to the procedure, your doctor may perform a physical exam, review your medical history and medications, and also discuss the effects of this procedure with you.

Make sure that you talk to your doctor about any medications you may be taking. You may be asked to stop taking some medicines up to one week before the procedure. These include:

• Aspirin or other anti-inflammatory drugs.
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin).

For the day of the procedure, make sure that you:

• Arrange for a ride to and from the procedure.
• Wear comfortable clothing.
• Take any medicine as ordered by your doctor. A mild sedative before the procedure may be recommended.
• Shower before leaving home.
• Note: you may be asked to clip your scrotal hair prior to the surgery.

As the incision for this procedure is small, only local anesthesia will be necessary in order to numb the area of the surgery. You may also be given medication to help you relax.

Conventional Approach.  One small cut will be made in the skin on each side of the scrotum. The vas deferens will be pulled through the openings. The tubes will then be cut. A small piece of the tubes may also be removed. The ends of the tube will be sealed off with stitches, clips, or an electrical pulse. The vas deferens will then be placed back into the scrotum. The incision will be closed with stitches.  (Note the graphic illustrating this methodology.)

No-scalpel Vasectomy.  The doctor will locate the vas deferens under the scrotal skin. A clamp will be attached to hold it in place. A special tool will be used to punch a small hole in the skin. The hole will be stretched open to pull the vas deferens through. The tubes will then be cut and sealed as above. The holes will heal without stitches.

Vas Clip Vasectomy.  The vas deferens will be exposed in either of the two manners above. Special clips will be placed around each  vas deferens and cinched in place. The clips will block the flow of sperm beyond the position of the clip.

Conventional vasectomies take about 30 minutes. No-scalpel procedures take about 20 minutes.

Anesthesia prevents pain during the procedure. You can expect some soreness for a few days. Take pain medicines as directed by your doctor.