Vasectomy is a safe procedure, but it does involve a recovery period.
A vasectomy may be the safest and most reliable permanent birth control option for men and couples who want to prevent pregnancy. This form of male sterilization requires only a quick surgical procedure, but it may involve side effects during a recovery period, including bruising and pain.
Vasectomy Procedure: What to Expect
Next to abstinence, vasectomy is the most effective form of birth control, with a failure rate of 1 in 10,000. It is much less likely to result in a pregnancy than condoms, the pill, or other common birth control methods.
The procedure is simple: “Vasectomy is basically a surgical sterilization technique where the vas deferens — which is essentially the highway for sperm to travel from the testicle to the urethra — is cut near the testicle itself,” says Mehran Movassaghi, MD, a urologist at Providence Saint John’s Health Center in Santa Monica, California. A man has two vasa deferentia, one in each testicle.
The conventional method requires one large incision or two smaller incisions, but there is also a newer, minimally invasive no-scalpel procedure. A vasectomy can be done under general or local anesthesia. “As far as the technique, it has a lot to do with surgeon preference and what they're used to performing,” says Dr. Movassaghi, unless there’s something in a man’s anatomy that requires a specific method.
Any type of vasectomy is an outpatient procedure. It typically takes under 30 minutes, and you’ll be able to go home the same day. Recovery time should be minimal. “I tell patients to take a couple of days off, so a lot of guys do it on a Friday so they can get back to work on Monday or Tuesday,” says Movassaghi.
Vasectomy Short-Term Side Effects
The most common vasectomy side effects are relatively minor.
Swelling, bruising, and pain: For a few days after surgery, you may experience some swelling, bruising, and pain around the scrotum. You can take acetaminophen (Tylenol) or place an ice pack over your scrotum to reduce pain and swelling.
Oozing: Your scrotum may ooze a small amount of fluid after the surgery. You will probably be asked to place a dressing over the incision to absorb any liquid. The dressing should be unnecessary after a day or so.
Sperm granuloma: Up to 40 percent of men develop a sperm granuloma after a vasectomy, which is a small lump filled with leaking sperm that develops where the vas deferens was cut. Although it can be painful, in most cases, a granuloma is not dangerous; any discomfort can be managed with over-the-counter pain medicine until the lump goes away.
Possible Complications of Vasectomy
“I tell patients that complications of vasectomies are usually related to either infection or bleeding,” says Movassaghi.
Infection: You will probably be given antibiotics after the procedure to minimize the risk of developing an infection. These infections are quite rare, but they do require treatment from a clinician if they occur. Common signs include fever, increasing pain in the scrotum, and issues with urination.
Scrotal hematoma: In rare cases, men may accumulate blood within the scrotum after a vasectomy, which is known as scrotal hematoma. “The likelihood of a post-vasectomy hematoma is less than one percent,” Movassaghi says. Symptoms include swelling, pain, and scrotum bruising more than 72 hours after the procedure.
Most scrotal hematomas get better without medical treatment. But if you have significant pain, extreme swelling, bleeding, or a fever three or more days after your procedure, call your healthcare provider right away.
Epididymitis: After a vasectomy, sperm can still flow from the epididymis — a coiled tube at the back of the testicle — into the vas deferens. If the sperm becomes backed up, it can result in inflammation, called epididymitis, for up to 12 weeks. This can result in pain and swelling. The likelihood of epididymitis or other prolonged forms of pain after vasectomy, known as post-vasectomy pain syndrome, are 3 percent or less. As with other complications, most cases of epididymitis will get better on their own.
Common Concerns About Vasectomy Side Effects
There are many misconceptions about vasectomy side effects and complications that may keep men from getting them, or from understanding how the procedure works. Here’s the truth about vasectomy.
Does a Vasectomy Reduce Testosterone Production?
No. A vasectomy will not change your hormones, and as such, it doesn’t alter your testosterone levels.
Will Your Sperm Look or Feel Different?
No. You’ll still ejaculate semen after a vasectomy, but it won’t have any sperm in it. But that doesn’t change the appearance of your sperm, Movasagghi says.
Do Vasectomies Cause Erectile Dysfunction (ED)?
No. It’s a common myth that getting a vasectomy can lead to ED. But a meta-analysis found that vasectomy does not negatively affect sexual function. In fact, the procedure may even improve sexual performance, as men can feel safer and more confident in their sexual lives after surgery.
Do Vasectomies Make Sex Painful?
No. You will want to wait a week or two after surgery to have sex and ejaculate, but after this recovery period, sex isn’t going to be painful, says Movasagghi.
Is a Vasectomy Effective Right Away?
No. Movasagghi says that men will need to use another form of contraception for three months after the procedure to avoid impregnating a woman. “The reason why we say three months is it takes about 30 ejaculatory episodes in order for those swimmers [sperm] to find their way out,” he says, “and the average life cycle for sperm is 72 days.” Your doctor will perform a semen analysis two to three months after the procedure to make sure you’re sterile. Until then, you should continue using a birth control method.
Can a Vasectomy Cause Prostate Cancer?
Probably not. A few studies have found that vasectomies lead to a slightly elevated risk of prostate cancer (although not fatal prostate cancer). But those study correlations may be questionable: “The reason why some of the study participants that had a vasectomy had a higher risk of prostate cancer was because they were getting screened earlier,” says Movasagghi. “The fact that they were getting screened puts them at increased risk for actually having the disease, not because doing the procedure made that happen.” The American Urological Association states that there is no strong evidence that vasectomy is tied to a higher risk of prostate cancer.
Do Vasectomies Have Any Serious Long-Term Risks?
Almost certainly not. Decades of evidence suggest that the vasectomy is not at all dangerous for long-term health. The procedure appears to have no influence on the risk of testicular cancer, heart disease, or any other serious long-term problems.
The Takeaway
The vasectomy is probably the safest and the most effective form of birth control besides abstinence. There may be some minimal short-term side effects, such as pain or bruising, but they usually go away after a few days, and the procedure is not associated with any long-term health problems.
