What is a vasectomy? What to know about the birth control method that is 99.99% effective in preventing pregnancies

• A vasectomy is a surgical procedure and a permanent form of birth control.
• During the one-time procedure, the tubes carrying sperm are cut, so sperm cannot leave the body.
• While vasectomies can be reversed, doing so may not always lead to a successful pregnancy.

Vasectomies are the second-most common form of permanent contraception in the US, next to tubal ligation.

They're also the most effective form of male birth control available with a failure rate of less than .01%.

So if you're certain you don't want kids, or you're done having children, a vasectomy is a relatively quick and easy procedure worth considering.

What is a vasectomy?

A vasectomy is a surgical procedure that severs the tubes carrying sperm from the testicles to the penis, says Eric Springer, MD, a urologist at The Ohio State University Wexner Medical Center.

The procedure does not impact testosterone production or sex drive. And the testicles will continue to produce sperm. However, with the vas deferens (aka tubes) severed, sperm can't be ejaculated. Instead, sperm cells eventually die and, like other dead cells, are absorbed by the body.

Important: While you can reverse a vasectomy, it is costly and does not always lead to a successful pregnancy. Therefore, a good candidate for a vasectomy is someone who is sure they are done having children and wants to prevent future pregnancies, Pineda says.

There are two types of vasectomies:

1. Incision method. This involves a doctor making one or two small cuts into the skin of the scrotum under local anesthesia. They then remove a tiny part of each vas deferens and then close them off by tying them, blocking with surgical clips, or closing with an electrical current. The doctor then stitches up the cut.
2. No incision method. With this method, the doctor makes one small hole to reach both vas deferens tubes under local anesthesia but does not cut the skin of the scrotum with a scalpel. A tool is used to stretch the skin open so the doctor can reach the vas deferens and close it off. Because no cuts are made, this method does not require stitches.

Both methods aim to prevent sperm from traveling to the penis, Springer says, but the no incision method heals faster, has minimal scarring, and comes with a lower risk of infection.

What's the cost? Most insurance carriers cover vasectomies, though the exact cost will vary depending on your plan's co-pays, deductibles, and out-of-pocket costs, says Springer. Without insurance, a vasectomy can cost anywhere from $1,000 to $3,000.

Vasectomy procedure: What to expect before, during, and after

Vasectomies are typically done in a urologist's office under local anesthesia, Springer says. The procedure takes about 10 to 30 minutes and typically includes the following steps:

1. The doctor will numb the area by injecting a local anesthetic into the skin of your scrotum with a small needle.
2. For the incision method, the doctor will make a small cut in the upper part of your scrotum. With the no incision method, the doctor will make a small puncture in the scrotum, not an incision.
3. Next, the doctor will locate the tube that carries sperm from your testicles. This is called the vas deferens.
4. The doctor will then withdraw part of the vas deferens through the incision or puncture, cut the tube and then seal it either by applying heat (cauterizing), blocking off with surgical clips, or tying it.
5. The final step involves closing the incision area either with stitches or glue. In some cases, the wound may be left to close on its own.

The procedure is mostly painless except for the numbing medication which may feel uncomfortable, Springer says. After the numbing medication is in place, you should not feel anything sharp, only some tugging or pressure.

However, to reduce any potential pain or complications, Elmer B. Pineda, MD, a urologist with Pomona Valley Hospital Medical Center recommends:

• Not taking aspirin, ibuprofen, or any blood thinners a week before your procedure as these medications can increase the risk of bleeding.
• Washing the scrotum and groin thoroughly before the procedure to reduce the risk of infection.
• Shaving the front part of the scrotum and the base of the penis on the day of the procedure.
• Bringing supportive undergarments to wear after the procedure, like tight compression shorts.

Recovery time can vary from a couple days to a full week, Springer says.

A week after the procedure is when it is considered safe to have sex and ejaculate again, Springer says. However, you are not infertile until a semen analysis is performed two to three months after the procedure.

Therefore, Springer suggests using other forms of birth control until your doctor has confirmed the vasectomy was successful.

Benefits of vasectomies

Compared to other forms of birth control, a vasectomy has a few stand out benefits like being:

• 99.99% effective at preventing pregnancy. In fact, the risk of pregnancy after vasectomy is approximately 1 in 2,000, compared to 1 in 100 for an IUD and 9 in 100 for birth control pills.
• A one-time procedure that offers permanent contraception, Springer says.
• Less invasive than other permanent contraception procedures, like female tubal ligation, which involves operating on the fallopian tubes to prevent sperm from reaching an egg.
  
  

In short, a "vasectomy is the safest, simplest, and least expensive form of permanent contraception," Springer says.

Vasectomy side effects and risks

The most common side effects of a vasectomy are related to recovery and should resolve within a few days. These include:

• Pain and discomfort
• Mild swelling
• Bruising of the scrotum
• Blood in semen
• Sperm granuloma, which is a hard, sometimes painful lump about the size of a pea. This is often the result of sperm leaking out of the cut in the vas deferens. The body usually absorbs this and sperm granuloma is typically not dangerous.

Infection occurs in less than 1% of those who undergo a no-incision vasectomy and less than 2% of those who undergo a scalpel vasectomy. Chronic scrotal pain is another rare side effect that occurs in about 1% to 2% of cases.

Insider's takeaway

Vasectomies are a low-risk, fast, and relatively painless procedure. They're also one of the most effective forms of birth control available.

Not to mention, vasectomies are permanent, so once you've passed the semen analysis test, you don't have to worry about birth control ever again.

That said, you can reverse a vasectomy. However, these procedures can be expensive and don't ensure a successful pregnancy. Therefore, weigh your choice carefully when considering a vasectomy.