Vasectomy is a form of birth control for men that is becoming more popular over time. It is the most common non-diagnostic operation that urologists in the U.S perform. Approximately half a million men undergo vasectomies every year in this country. That is about 5% of all married men of reproductive age.
It is a permanent form of birth control that involves a minor surgical procedure to seal the vas deferens so that sperm does not reach the semen. A vasectomy is over 99% effective in the long run. Per Penn Medicine, only 1-2 women per 1,000 get pregnant within a year after their partner has a vasectomy. Further, the procedure has a number of great benefits for both men and women.
Why vasectomy is a better choice for men
A vasectomy is a reliable form of birth control that helps prevent unplanned pregnancy. Read on to learn about the benefits it provides, specifically for men. Benefits for women are covered later in the article.
A vasectomy is one of the most effective forms of birth control. According to the Urological Association guidelines  the risk of pregnancy after vasectomy is approximately 1 in 2,000 for men who have a sperm count of zero in a post-vasectomy semen analysis. This is equivalent to the contraceptive effectiveness of tubal ligation.
This 20-30 minute procedure is almost always done in a doctor’s office rather than in an operating room. If the patient is anxious, oral or intravenous sedation can be administered. Then, the scrotum is cleaned with an antiseptic (sometimes shaving is required). After the vas deferens are located, a local anesthetic is injected to numb the area.
The doctor then makes one or two small openings in the scrotum through which the two vas deferens tubes are cut. Both ends of the severed vas deferens are then tied, stitched, or otherwise sealed. Sometimes electrocautery is used to seal the ends with heat. Scar tissue as a result of the surgery will block the tubes. The vas deferens are then returned to the scrotum and the skin openings are closed with resorbable sutures.
Unlike tubal ligation, a vasectomy does not require going under general anesthesia.
While a vasectomy is a reliable form of birth control to prevent unplanned pregnancy. However, it can be reversed should a couple desire to have children after the procedure. Modern approaches utilize microsurgical techniques, robotic-assisted surgery, and video microsurgery.
Between 6-10% of men choose to reverse their vasectomy. And, reversals tend to be successful , ranging from a 30-90% success rate depending on the type of procedure and other factors .
Lower health risks
Vasectomy patients have lower surgical risks than women who undergo tubal ligations. One reason is that a vasectomy avoids risks associated with general anesthesia.
A vasectomy is also a less invasive procedure, lowering the risk of bleeding and infection. Lastly, vital organs are not exposed, unlike in a tubal ligation.
A vasectomy is one of the most cost-effective forms of contraception. The average cost of the procedure is far less expensive than the sterilization methods for women, such as tubal ligation. This shouldn’t be a surprise because the procedure is performed in a doctor’s office instead of an operating room. Further, general anesthesia is not required.
A vasectomy is a permanent choice of birth control. This means it is just a one-time expense. While other contraceptives like condoms or pills may have a cheaper initial cost, the total cost accrues with each purchase.
Years of using oral contraceptives and condoms become more expensive over time . For couples who no longer want to have children, a vasectomy is the most cost-effective option.
Often covered by insurance
Not only are vasectomies a one-time cost, but this cost is usually covered fully or in part by health insurance (after any co-pay or deductible).
Does not affect sexual pleasure
Although many studies on the correlation between sexual pleasure and vasectomies are poorly defined, men reported  that they did not experience negative effects on sexual function. Approximately, 98-99% of men were satisfied with the results of their vasectomies. Evidence also shows that a man’s orgasm does not change after a vasectomy.
Related content: How to Delay Age-Related Erectile Dysfunction
Men may experience minor symptoms  after a vasectomy including bruising, swelling, and pain after the procedure. However, those symptoms typically only last for a few days.
According to the American Urological Association, only 1-2% of men experience chronic scrotal pain. After getting a vasectomy, a patient needs to rest for 24 hours and abstain from sexual activity for a week. This recovery time is much shorter than tubal ligation, which may take from one to two weeks.
No-scalpel vasectomies available
To speed up recovery time, a no-scalpel vasectomy procedure has been developed. First introduced to the United States in 1984, it relies on specialized surgical instruments, not scalpels, to expose the vas deferens. This option is less invasive and has fewer risks associated with it including less bleeding, infection, and pain.
Why vasectomy is a better choice for women
While vasectomies are performed on males, they provide a number of benefits to female partners as well. Although tubal ligation is still a more popular form of permanent birth control , read about some of the benefits a vasectomy offers specifically to women.
Stop hormonal birth control
While each woman reacts differently to oral contraceptives, the pill typically results in exaggerated mood changes. If her partner undergoes a vasectomy, a woman can avoid taking hormonal pills and can effectively regulate her mood better. A vasectomy also removes the constant worry of trying to remember a daily pill.
Avoid tubal ligation
As mentioned, tubal ligation is a much more invasive procedure than a vasectomy. There are greater risks, a longer recovery time, and a higher cost associated with tubal ligation.
A vasectomy prevents a woman from having to undergo this invasive procedure, going to the operating room, and being put under general anesthesia. Because of these risks, a vasectomy is actually safer than tubal ligation.
Prevent risks of female sterilization
Female sterilization is associated with an increased risk of ectopic pregnancy in which the baby develops outside the womb. Vasectomy avoids exposing women to the increased risk of this serious pregnancy complication.
The bottom line when it comes to vasectomy
A vasectomy has many benefits for both men and women. The decision to undergo this procedure is a very personal one and, of course, should be discussed between the couple. Consult a doctor if you are considering this procedure or if you have any further questions.
- The American Urologic Association. Vasectomy Guidelines (2015) https://www.auanet.org/guidelines/vasectomy-guideline – accessed 11/17/20.
- The Cleveland Clinic. Vasectomy (Male Sterilization). https://my.clevelandclinic.org/health/treatments/4423-vasectomy-sterilization# – accessed 11/17/20.
- Penn Medicine. 7 Things You Didn’t Know About Vasectomies. March 2019. https://www.pennmedicine.org/updates/blogs/health-and-wellness/2019/march/7-things-about-vasectomies – accessed 11/17/20.
- Procedure description adapted from Cigna. Vasectomy Surgical Overview – accessed 11/17/20 https://www.cigna.com/individuals-families/health-wellness/hw/medical-topics/vasectomy-hw7265 – accessed 11/17/20.
- American Society of Reproductive Medicine. Vasectomy Reversal: Contemporary Techniques. https://www.fertstert.org/article/S0015-0282(19)30009-3/fulltext#secsectitle0030 – accessed 11/17/20.
- Mayo Clinic. Vasectomy reversal. https://www.mayoclinic.org/tests-procedures/vasectomy-reversal/about/pac-20384537 – accessed 11/17/20.
- Mayo Clinic. Vasectomy. https://www.mayoclinic.org/tests-procedures/vasectomy/about/pac-20384580 – accessed 11/17/20.
- Medscape. No Scalpel Vasectomy (updated Jan 19, 2016) https://emedicine.medscape.com/article/148512-overview – accessed 11/17/20.
- Medical News Today. Is Pregnancy After Tubal Ligation Possible? https://www.medicalnewstoday.com/articles/323044#is-pregnancy-after-tubal-ligation-possible – accessed11/17/20.
Published on 2/5/17. Reviewed and updated 3/25/19, 11/17/20.
Parviz K. Kavoussi, MD
Dr. Parviz Kavoussi holds academic positions as Adjunct Assistant Professor at the University of Texas at Austin and in the Department of Urology at the University of Texas Health Sciences Center at San Antonio, where he teaches residents training in urology; helps guide best clinical practices in male fertility in his position on the American Society of Andrology Public Affairs and Policy Committee; and is an expert peer reviewer for multiple scientific medical journals. Dr. Kavoussi runs the Austin Center for Vasectomy & Vasectomy Reversal and is the leading and only specialty fellowship trained Vasectomy Urologist in Austin, TX.