What Is a Vasectomy?

It's a birth control procedure that could be reversible.

To prevent pregnancy, a person might consider several birth control methods, from hormonal birth control or diaphragms to spermicides or condoms. There are also procedures that healthcare providers can perform as permanent contraception—one such procedure being a vasectomy.

A vasectomy is a minor surgery used as a permanent form of male birth control. "The procedure blocks sperm from reaching the semen, which is the fluid that's ejaculated from the penis," S. Adam Ramin, MD, urologic surgeon and medical director of Urology Cancer Specialists in Los Angeles, told Health. "The testes still make sperm, but it can't reach the semen."

In other words, semen still exists, but it doesn't contain any sperm. The unused sperm eventually die and are absorbed by the body, and the process repeats itself.

Here's what else you need to know if you or your partner is considering a vasectomy.

What Happens During a Vasectomy?

A vasectomy is a relatively quick procedure done under local anesthesia, meaning a person would be awake during the vasectomy.

After anesthesia administration, a surgeon may decide to do a procedure with a surgical cut in the upper part of a person's scrotum or complete the surgery without a significant cut, known as a no-scalpel vasectomy (NSV).

For regular vasectomies, the surgeon will make incisions on either side of the scrotum and tie off the vas deferens (the tube that carries sperm) or clip it and cut it apart. Sometimes there is tissue also placed over the cut sites to prevent failure of the vasectomy.

For NSVs, the surgeon will make a tiny hole in the skin of the scrotum to tie off and cut part of the vas deferens. In both cases, the procedure is completed by sealing openings made in the scrotum with a stitch or surgical glue.

How Painful Is the Procedure?

A vasectomy shouldn't be painful for most individuals because the area will be sufficiently numbed, although they might feel slight pressure or tugging. (Of note, during the procedure, an individual might also experience nausea or lightheadedness.)

There might also be some discomfort following the procedure. "After a vasectomy, most men feel a bit of soreness or aching, but it is usually minor and resolves after a few days of ice and rest," explained Dr. Ramin.

Like with all medical procedures, it's important to remember that everyone responds to pain differently—what is painful to one person may not be to another.

What Are the Potential Side Effects?

After the procedure, the most common side effect of a vasectomy is aching, said Dr. Ramin. Other side effects might be hematoma (a blood clot in the scrotum), bleeding, infection, trauma, and a condition called post-vasectomy pain syndrome.

Post-vasectomy pain syndrome causes pain in the testicles that lasts longer than three months following the procedure. However, it's extremely rare, only affecting a tiny minority (1-2%) of patients.

Also, the procedure does not interfere with a man's sex drive, facial hair, voice, or anything else influenced by testosterone: Research has shown that a vasectomy doesn't reduce testosterone levels.

"You can expect erections, climaxes, and the amount of ejaculate to remain the same as before the surgery," added Dr. Ramin.

How Much Does a Vasectomy Usually Cost?

A vasectomy is more appealing than female sterilization options, such as tubal ligation, because it's a much simpler medical procedure, has fewer complications, and is much less expensive.

The procedure is usually covered by insurance, said Bruce Sloane, MD, from Philadelphia Urology Associates, told Health, but "at my practice where there is no insurance or where insurance doesn't cover, we charge $650."

Dr. Ramin added that most insurance companies set the cost at $400 to $600, and healthcare providers who don't accept insurance for vasectomy charge between $500 to $1500.

How Effective Is a Vasectomy As Birth Control?

Unlike temporary birth control measures—such as the pill—a vasectomy is a permanent solution to avoiding pregnancy. "It's more effective in preventing pregnancy than any other birth control method except abstinence," said Dr. Ramin.

However, it's important to check, post-procedure and after recovery, that a vasectomy has been successful—as in, no more pregnancies will happen. This requires semen samples, which are examined in the lab, to make sure no or very little motile sperm are present.

This is also important because a vasectomy isn't effective right away, and a few couples will still get pregnant in the first year after a vasectomy. The advice is to use another form of birth control until the remaining sperm are cleared out of the system, which is estimated to take 15 to 20 ejaculations—or around three months in terms of time.

Some individuals may still have sperm in their semen. In those cases, they'll need to use another birth control method and wait for a healthcare provider to give them an all-clear to not use additional birth control.

How Can a Vasectomy Be Reversed?

A vasectomy is reversible but much more complicated and takes longer to complete than the initial procedure.

It requires a microsurgical approach, which is when a healthcare provider (typically a urologist) uses a microscope to magnify the ends of the vas deferens to make smaller stitches for a water-tight connection. This helps lessen any scarring that might occur and increases success rates.

Additionally, a different kind of reversal procedure may be necessary when there is an epididymis blockage. If this has happened, the provider will move the upper part of the vas deferens to a spot that goes by the blockage.

However, it can be harder for fertility to return and for pregnancy to happen the longer you wait between the initial vasectomy procedure and the reversal. On top of that, it can take between three and 15 months for sperm reappearance, depending on if there has been a blockage in the vas deferens.

The cost of the reversal may also be an issue. Insurance plans may not cover a vasectomy reversal, so check with an insurance company first and understand the costs involved.

If you have any doubt about having a vasectomy in the first place, it's best to hold off—and you shouldn't consider having a vasectomy if you plan to have it reversed later.

A Quick Review

A vasectomy is a brief surgical procedure used as a form of birth control that may be covered by insurance, at least in part. It's also important to note that vasectomies are not effective right away, so it may be necessary to use birth control until the success of the vasectomy is clear.

Additionally, it might be possible to have a vasectomy reversed. However, you may be unable to pay for the procedure using insurance, and success rates are high but not guaranteed.

But if you're unsure if you want to have a vasectomy or know you would want to have it reversed later, it's best not to have the procedure.

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