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Vasectomy: Risks, Failure Rates, and Other Must-Knows

Perhaps you’ve had enough children to make your family complete or you’ve decided parenthood isn’t for you. Either way, now you may want to find a birth control method you won’t have to worry about. One permanent birth control option for men is a vasectomy. During this procedure, your surgeon will cut a tube called the vas deferens to stop sperm from getting into the semen and reaching a woman’s body.

Vasectomy is more reliable at preventing pregnancy than any other birth control method. It’s also easier and cheaper than its female equivalent, which is called tubal ligation. Tubal ligation is a surgery done to tie off a woman’s fallopian tubes, preventing an egg from meeting sperm cells.

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Still, no surgery is 100 percent foolproof. In a very small number of cases, vasectomies can fail.

Before you have a vasectomy, talk to your doctor about the pros and cons. Together you can determine whether this is the best birth control method for you.

How Does a Vasectomy Prevent Pregnancy?

Your sperm are produced and housed in your testicles. The testicles reside inside a pouch called the scrotum. The sperm travel down a tube called the vas deferens. The sperm mix with fluid from the prostate gland to form semen. During ejaculation, semen travel through the urethra and out of the penis into the woman’s body. During a vasectomy, your doctor cuts the vas deferens so sperm can’t get into the semen.

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How Is a Vasectomy Performed?

A vasectomy can be done at a urologist’s office, an outpatient surgery center, or a hospital. You’ll usually be awake during the procedure. If you prefer, you may able to receive general anesthesia and sleep through the process. Either way, you’ll receive numbing medicine in your scrotum so that you won’t feel any pain.

In a conventional vasectomy, the doctor makes one or two small cuts in the scrotum to reach the vas deferens. Then, the doctor cuts the vas deferens and ties off the ends. The cuts in the scrotum may be closed with stitches.

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Today, vasectomies are often done without a knife. No-scalpel vasectomies reduce the risks for side effects like bleeding and pain. During the procedure, the doctor feels for the vas deferens through the skin of the scrotum and holds it in place. Then, the doctor makes a tiny hole on the side of the scrotum and pulls the vas deferens out through it. The tube is cut or tied, and then put back into the scrotum. No stitches are needed. The hole seals itself.

Vasectomies are very effective. Only about 2 out of every 1,000 women get pregnant in the first year after their partner had the procedure done.

What Happens Next?

About two months after the procedure is done, you’ll meet with your doctor to determine whether sperm is still present in your semen. This is called a semen analysis. You may need to keep having checkups until you’ve reached the three months mark or 20 ejaculations, whichever comes first. During this time, use a backup birth control method such as a condom or diaphragm to prevent pregnancy.

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Vasectomies are very effective at preventing pregnancy, but they don’t work right away. Some sperm can remain in the vas deferens in the weeks and months after the surgery. You’ll need to wait for them to clear out before having unprotected sex.

Why a Vasectomy Might Fail

A vasectomy can fail if the doctor misses the vas deferens during the procedure. In rare cases, the tube can regrow. If this does occur, the vas deferens is usually much smaller than it was before.

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Sometimes, sperm can make their way from one cut end of the vas deferens to the other. This is most common in the first three months after the procedure. That’s why your doctor will tell you to avoid having unprotected sex until you get confirmation that your semen is free of sperm.

If your doctor finds sperm in repeat tests of your semen, you may need to have a second procedure. Less than 1 percent of vasectomies need to be repeated.

Other Potential Risks

Just like any surgery, a vasectomy carries some degree of risk. Some common risks associated with this procedure are:

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  • bleeding, which is less likely if you have a no-scalpel vasectomy
  • swelling of the scrotum
  • bruising
  • pain
  • an infection
  • a lump that forms when sperm leaks from the cut vas deferens, which is called a sperm granuloma
  • pressure in the testes

A small number of men get a condition called post-vasectomy pain syndrome. Their pain doesn’t decrease after the procedure. It’s not clear what causes this pain. Sometimes, even reversing the procedure doesn’t make the discomfort go away.

Can Impotence (Erectile Dysfunction) Occur After Vasectomy?

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A vasectomy won’t affect your ability to have and enjoy sex. You’ll still ejaculate. The only difference is your semen will no longer contain sperm.

Who Should Get a Vasectomy?

A vasectomy is a good choice for men who know for sure that they don’t want to have more children. Although a vasectomy can sometimes be reversed if you change your mind, you’ll need to have another procedure. A vasectomy reversal is a more complicated procedure and isn’t always successful.

Men with an infection in the area around their scrotum should wait to have a vasectomy. Vasectomy also isn’t a good option for men with a bleeding disorder, undescended testicles, or a tumor in the testicles.

If you’re very sensitive or nervous about having surgery in the delicate area of your scrotum, talk with your doctor. Together you can discuss your options and whether this procedure is right for you.

Before having any surgery, you want to weigh the benefits of having the procedure against any risks. Have an open conversation with your doctor, and ask a lot of questions.

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