How Does a Vasectomy Work?

A vasectomy is a form of permanent contraception that prevents people with a penis from having children. The common outpatient procedure blocks the supply of sperm to the semen, which means sperm can't exit the body through ejaculation, says Natan Bar-Chama, M.D., director of the Center of Male Reproductive Health at RMA of New York. Vasectomies are nearly 100% effective and have minimal side effects.

Here, we'll fill you in on everything you need to know about vasectomies as a male sterilization method, including how they work, if vasectomies are reversible, the average cost, and what to consider before getting one.

What Is a Vasectomy?

A vasectomy is an effective form of contraception for those with a penis. About 500,000 people in the United States get the procedure every year.

"The purpose of a vasectomy is to create a blockage that prevents the sperm from exiting the body," says Dr. Bar-Chama. Essentially, the tubes that carry sperm to the penis are closed off, so when someone ejaculates, the semen no longer contains sperm. Because sperm is necessary for conception, vasectomies greatly minimize the chances of pregnancy—in fact, they can be almost 100% effective when done properly, says Dr. Bar-Chama.

A vasectomy comes with a very minimal risk of complications. But it's important to understand that the procedure has a few limitations. You can still get and spread STIs, for example, and it can take a few months for the vasectomy to be fully effective.

What to Consider Before Getting a Vasectomy

If you're thinking about getting a vasectomy, there are a few things you'll want to know before signing up. Below, we've listed some considerations to discuss with your partner and your physician before getting a vasectomy.

• Vasectomies should be considered permanent. A person should only get a vasectomy if they are 100% sure they never want to have another child (with anyone) for the rest of their life. While a vasectomy reversal is possible in some cases, it doesn't guarantee a return to fertility, and the procedure is very expensive.
  
• It takes time to be effective. It can take up to three months (or around 20 ejaculations) for sperm to stop exiting the body after a vasectomy. Dr. Bar-Chama recommends following up with your doctor to have a sperm count test performed before engaging in unprotected sex after a vasectomy. In the meantime, use a condom or another form of birth control.
  
• You'll experience minor discomfort. You can expect a small amount of discomfort after your vasectomy. This should be easily relieved with over-the-counter pain medication, ice packs, and rest. It's best to avoid doing any hard work or exercise for about a week after your vasectomy, says Dr. Bar-Chama.

Vasectomy Procedure: How Does It Work?

Urologists often conduct vasectomies, though they may also be done in a hospital or surgery center. The procedure usually takes about 10 to 30 minutes. Today, there are two common ways to perform a vasectomy. Both are considered minimally invasive and result in only mild discomfort.

• Conventional vasectomy. In this type of vasectomy procedure, two tiny cuts are made to the skin of the scrotum. The vas deferens (the tubes that carry sperm) are cut and may be partially removed. Then, the tubes are tied or cauterized (a process that involves using an electrical current to close a wound).
• No-scalpel vasectomy. This procedure involves making a tiny puncture hole rather than a cut. This allows the doctor to reach the vas deferens in order to tie off or cauterize them. This method doesn't require need stitches, and it comes with a lower risk of complications.

After getting a vasectomy, you'll still ejaculate semen. But after a few weeks, it will no longer contain that sperm that's necessary to create a pregnancy. Sperm cells will instead be absorbed by your body. Vasectomies don't impact your sexual performance, orgasms, or libido.

Vasectomy Side Effects

After a vasectomy, it's normal to experience some swelling, bruising, and mild pain; this should improve within a few days. Most people can return to normal activities in less than a week.

About 1% to 2% of patients experience persistent discomfort following the procedure, called post-vasectomy pain syndrome (PVPS), that might be treated with medications, therapies, or follow-up surgeries. Other possible complications include sperm granulomas (lumps or inflammation due to sperm leakage), infection, and bleeding under the skin (hematoma). Complications are very rare, but you should call your doctor for severe pain or other worrying symptoms.

What's the Success Rate of a Vasectomy?

According to Penn Medicine, vasectomies are considered a very effective method of birth control due to their long-term success rate of over 99%. The failure rate of vasectomy is 1 in 10,000 cases—less than any other method of contraception besides abstinence. That said, it's important to wait until after you've had a follow-up appointment with your physician before assuming you can't get your partner pregnant. It can take several weeks for sperm to fully exit the body.

How Much Does a Vasectomy Cost?

According to Dr. Bar-Chama and Planned Parenthood, you should be able to get a vasectomy for under $1,000. The price can vary, of course, based on factors like the practice you choose, the type of vasectomy you get, and whether you have any sort of health insurance.

Many insurance plans will partially or fully cover the vasectomy cost, so get in touch with your plan administrator prior to your procedure. If you don't have coverage, consider looking into Medicaid and other government-sponsored programs, which help with cost reduction.