Vasectomy & Reversal Procedures

What is a Vasectomy?

A vasectomy is a surgical procedure that permanently prevents a man from being able to impregnate a woman.

Sperm are produced in the testicles. From each testicle, sperm typically travel through a tube called the vas deferens, where they mix with seminal fluid from the seminal vesicles and prostate fluid from the prostate gland. The combination of sperm, seminal fluid, and prostate fluid forms semen. During ejaculation, this semen is expelled through the penis and out of the body. A vasectomy involves cutting the vas deferens on both sides to prevent sperm from being included in the semen.

How is a Vasectomy Done?

A vasectomy is typically performed in a doctor’s office and takes about 30 minutes. You will be awake during the procedure. A local anesthetic will be applied to numb the scrotum (the sac that holds the testicles).

Types of Vasectomy Procedures

Traditional Vasectomy

In a traditional vasectomy, the doctor makes a small incision on one side of the scrotum and pulls out a portion of the vas deferens. You may feel some tugging or pulling during the procedure. A small section of the vas deferens is removed, and the remaining ends are sealed, either by stitching, cauterization (sealing with heat), or another method. The procedure is then repeated on the other side. Afterward, the incisions are closed with dissolvable stitches that typically dissolve within 3 to 10 days.

No-Scalpel Vasectomy

The no-scalpel vasectomy involves a small puncture in the scrotum instead of an incision. This puncture is so small that it doesn’t require stitches, and the procedure follows the same steps as a traditional vasectomy. This method generally carries a lower risk of bleeding and infection.

No-Needle, No-Scalpel Vasectomy

In this modified technique, a pressurized jet injector administers a thin spray of local anesthetic directly into the tissue. This is followed by a needle for extended numbing, offering an alternative to traditional anesthesia methods.

How Effective is a Vasectomy in Preventing Pregnancy?

A vasectomy is one of the safest and most effective forms of birth control. Fewer than 1 in 1,000 couples experience an unintended pregnancy in the first year after the procedure—approximately 15 out of 10,000. This level of effectiveness is higher than nearly all other forms of birth control, except for complete abstinence.

Are There Alternatives to a Vasectomy?

The use of condoms, barrier devices, oral contraceptives (birth control pills), and tubal ligation (female sterilization) are all options for temporary or permanent birth control. 

Are There Any Reasons Why I Should Not Have a Vasectomy?

Do not have a vasectomy unless you are certain that you do not want to have children in the future. Your doctor will likely discuss this with you beforehand. Other reasons may include a genital infection or a bleeding disorder. 

Some vasectomies can be reversed, but the surgery is expensive and must be performed in a hospital. Even though most men can ejaculate sperm after the reversal surgery, the sperm are often unable to fertilize an egg. The chance of a successful pregnancy decreases the longer you wait to reverse a vasectomy. 

What Are the Risks of a Vasectomy?

A vasectomy is generally a safe and low-risk procedure, but it can have potential side effects or complications. These common, short-term side effects include: 

• Mild pain or discomfort in the scrotum for a few days

• Swelling or bruising

• Minor bleeding or oozing from the incision site

• Infection at the incision site (usually treatable with antibiotics)

Most side effects are mild and resolve within a week or two. Serious complications are rare, and vasectomy remains one of the safest permanent birth control options available.

How Can I Prepare for the Operation?

Before the Day of Your Procedure:

• Shave the upper and central areas of your scrotum, including near the base of the penis, using a fresh razor (avoid clippers).

• Do not apply lotion or powder to the area.

On the Day of the Operation:

• Wear or bring supportive underwear (jockstrap, athletic supporter, tight underwear, or compression shorts). Some vasectomy underwear with built-in ice packs are available on Amazon.com.

• Make sure your genital area is clean.

• Optional: Bring music and headphones to help you relax during the procedure.

What Should I Expect After a Vasectomy?

Immediately After the Procedure:

• Rest at home for a few hours.

• Lie on your back with your legs elevated and place a rolled-up washcloth under your scrotum for support.

• Apply an ice pack wrapped in a towel to your scrotum to reduce swelling. Keep the ice outside your underwear and never place it directly on the skin.

• Wear snug, supportive underwear (jockstrap, athletic supporter, or compression shorts) to minimize discomfort.

First 24 Hours:

• Keep the area dry—avoid bathing or showering.

• Continue resting, icing, and wearing supportive underwear as needed.

First Week:

• Avoid sex or ejaculation for at least 7 days.

• Avoid heavy lifting and strenuous activities to reduce the risk of complications.

• Continue wearing supportive underwear to ease any aching or swelling.

Ongoing Recovery:

• Bruising and swelling are common and usually fade within two weeks.
• Most men feel back to normal within 1–2 weeks.
• Continue using another form of birth control until your doctor confirms your semen is clear of sperm—this typically takes several weeks and one or more follow-up tests.

What is a Vasectomy Reversal?

A vasectomy reversal is a procedure for men who have previously undergone a vasectomy and now wish to have a child. This surgical intervention reconnects the vas deferens, creating a pathway for sperm to reenter the semen. Typically, the cut ends of the vas deferens are reattached, and, in some cases, they may be joined to the epididymis. The success of the reversal is highest when performed sooner rather than later after the vasectomy. It is important to inquire early in the planning process whether a reversal procedure is covered by health insurance, as most health plans do not.​

Types of Vasectomy Reversal Procedures 

• Vasovasostomy reconnects the ends of the vas deferens, allowing sperm to flow naturally. When performed using microsurgery, vasovasostomy has a success rate of approximately 95%.

• Vasoepididymostomy, a more complex procedure, is performed when a blockage affects another portion of the vas deferens or testicular tissue. This procedure bypasses the blockage by joining the upper end of the vas to the epididymis. Vasoepididymostomy has a success rate of approximately 70%.

After Treatment

The recovery process is typically swift and manageable. Post-operative pain is usually controlled with oral medication and rarely lasts beyond a few days to a week.  Most men can resume normal activities and light work within a week, while strenuous activities and sexual activity are generally safe after 2 to 3 weeks.

Achieving pregnancy after vasectomy reversal may take 4 months to a year. Testing sperm count is the primary method to assess surgical success, with periodic semen analysis recommended until sperm count stabilizes or pregnancy occurs. Sperm may appear in semen within a few months after vasovasostomy, while vasoepididymostomy may take between 3 to 15 months.