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A vasectomy is an operation that renders a male sterile.

Vasectomy essentials

Key things to know about male sterilization

-- A vasectomy is a permanent form of birth control. It is not a quick solution for young men in their 20s who want to have sex without the fear of an unwanted pregnancy, said Upstate urologist Timothy Byler, MD. 

A reversal in the future might be possible, but that operation is expensive, may not be covered by health insurers, and may not work.

(Hear the full interview about vasectomies with Timothy Byler, MD.)

-- The procedure has no physical effect on sexual drive or performance.

-- A vasectomy does not protect against sexually transmitted diseases.

-- A man can choose a vasectomy on his own, but for most men it’s a joint decision with their partner.

-- The first appointment with a urologist typically includes a physical exam and discussion about anesthesia preferences. 

A “local” anesthesia will numb the area where the doctor works, and the patient will remain conscious during the procedure. More sedating options mean the patient will be unconscious — and will require a driver after the procedure.

-- Most vasectomies are done in the urologist’s office and take about an hour. Byler schedules procedures on Fridays, so patients have the weekend to rest and decide if they’re ready to return to work.

-- The surgeon makes one or two tiny incisions in the scrotum to access and divide each of the vas deferens, tubes about the size of spaghetti strands that transport the sperm from the testicle. 

The ends of each vas deferens are cauterized and closed with tiny, permanent clips. The incisions are closed with sutures that are absorbed, and scars are usually not visible a couple of months after the procedure. 

Some men are able to feel tiny bumps in the scrotum, which are the clips that remain.

-- Recovery includes about a week on “light duty,” starting with two days lying flat on a bed or sofa with acetaminophen and/or ice packs as needed. Some men experience temporary bruising or minor pain. 

It’s important not to ejaculate for the first week to allow the tissues to heal properly, Byler said.

-- A lingering testicular pain may persist for 1% to 2% percent of men, and it is notoriously difficult to treat.

-- The failure rate — called spontaneous recanalization — is about 1 in 2,000 men. This risk is minimized by following doctor’s orders during recovery.

-- A vasectomy does not take effect immediately. Doctors advise using another form of birth control until subsequent semen analysis shows no sperm in the ejaculate.

-- When’s the best time of year for a vasectomy? Byler said some men plan for March Madness, so they have plenty of good basketball to watch during recovery.

 

To schedule a consultation with an Upstate urologist, call 315-464-1500. 

This story appears in the 2024 Upstate Health magazine, Issue 1

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