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A vasectomy is a minor surgical procedure that blocks sperm from mixing with semen. This prevents someone with a penis from getting someone pregnant.

It’s a common method of contraception that about 500,000 men in the United States choose every year. You may still wonder if a vasectomy hurts since it requires incisions in the scrotum.

Like any type of surgery, there is the likelihood of some pain and discomfort. However, vasectomy pain is usually minor, temporary, and easily treated.

A vasectomy is a relatively quick and simple procedure that’s performed by a urologist. It may be done in a urologist’s office, or at a hospital or surgery center.

Because the goal of a vasectomy is to be sterile, it’s a procedure that requires careful consideration — not just about the nature of the surgery and recovery, but what it means for the future.

It’s also important to remember that a vasectomy should have no long-term impact on sexual function.

Procedure

A vasectomy is usually performed with local anesthesia, but it may be done under full sedation. If you’re especially nervous about this procedure — or if another surgery is being done at the same time — then full sedation may be appropriate.

Prior to the surgery, your scrotal area will be prepped by shaving and cleaning it with an antiseptic wash. You may be asked to shave that area around the scrotum — but not the scrotum itself — the night before your procedure.

If you’re having local anesthesia, you’ll receive a shot in the scrotum, which numbs the area and prevents pain. The injection will hurt a little, but soon you won’t feel any pain. You may be able to sense tension or movement during the surgery, but no pain.

During a conventional vasectomy, the doctor will make two small incisions in the scrotum to access the vas deferens.

After the incisions are made, the urologist will cut the ends of each of two vas deferens and tie them off or place tissue where the cuts were made. This blocks sperm from flowing up through the vas deferens.

Another method, called cautery, may be used instead of dividing the vas deferens. The surgeon will burn the inside of the vas deferens with a special tool to promote scar tissue formation.

Dissolvable stitches may be used to close the incisions. In some cases, no stitches are used and the scrotum is allowed to heal on its own. The entire procedure takes about 20 minutes, and after a brief recovery period, you can go home the same day.

Once the anesthesia wears off, you can expect some pain in your scrotum. You may notice some slight swelling and bruising. These reactions should last only a few days. After that, your scrotum should look as it did before your vasectomy.

To help treat the pain, wear snug (but not too tight) underwear to restrict your testicles from moving too much.

An ice pack may also help. Many people opt for something more flexible that will fit around the scrotum, such as a bag of frozen peas. Over-the-counter pain relievers may also help during those first few days.

You should avoid heavy physical exertion for about a week. You may be able to have sexual intercourse after a few days, but if you experience pain or discomfort, wait a week or until you are symptom-free.

Be sure to listen to instructions from your doctor about aftercare, and ask questions if you need clarity.

Follow-up

Pregnancies after vasectomies are rare — only about 1 to 2 women out of 1,000 get pregnant within a year after a partner’s vasectomy. But it’s important to follow up your procedure by having a semen sample checked for sperm.

This is usually done about 8 weeks or 20 ejaculations after the vasectomy. During that time, you’ll want to use an alternative form of contraception.

You’ll need to follow up with your doctor after a vasectomy makes sure that the procedure was successful. Other than that, there’s not normally a need to keep following up.

The pain you feel in the hours and days right after a vasectomy should gradually fade, but if you notice the pain getting worse, notify your doctor. The same is true if you notice swelling that doesn’t subside.

Bleeding complications are rare, but if you notice bleeding from the incision, call your doctor. If you see pus coming from that area or experience a fever over 100°F (37.78°C), don’t hesitate to call your doctor, as these may be signs of an infection.

In 1 to 2 percent of vasectomies, a rare condition called post-vasectomy pain syndrome (PVPS) occurs.

PVPS is defined as scrotal pain that is constant or intermittent over a period of at least 3 months. In many cases, the pain flares up during or after sexual activity, or after vigorous physical activity.

You may also experience pain, which may be sharp or throbbing, without any activity triggering it. Sometimes, PVPS appears soon after a vasectomy, but it may also develop months or even years later.

The causes of PVPS aren’t yet well understood, but they may include:

  • nerve damage
  • pressure within the scrotum
  • scar tissue affecting the vas deferens
  • epididymitis, which is an inflammation of the epididymis

Treatment

One way to treat PVPS is with a vasectomy reversal, which restores the ability to have children.

One 2017 study suggests that vasectomy reversal is the most “logical” solution to PVPS, assuming that scar tissue or other obstruction in the vas deferens is the cause of pain. While uncommon, surgery to free an entrapped nerve may also be an option.

In recent years, an alternative to traditional vasectomies has become popular. It’s known as a no-scalpel vasectomy.

This involves a small poke in the scrotum to open it up just enough to pull the vas deferens through. A cut is made of the vas deferens, which are then allowed to retreat back through the hole.

The recovery time is shorter for a scalpel-free vasectomy, and the risk of bleeding problems and complications is lower compared to a conventional vasectomy.

The scalpel-free approach is newer, and recommended by the American Urological Association. Many newer urologists will have training in this technique.

Though a vasectomy is a procedure performed on an especially sensitive part of the body, it’s not an operation that causes a lot of pain or lingering discomfort.

If you’re planning to have a vasectomy, just have some ice or a frozen bag of peas available when you get home, and relax for a few days. If you notice any complications or lingering pain, you should notify your doctor immediately.