Vasectomy: What You Should Know

Written by Matt McMillen, Lori M. King, PhD
Medically Reviewed by Jabeen Begum, MD on January 08, 2025
10 min read

A vasectomy is a simple, generally permanent procedure to prevent pregnancy. It's the most effective form of birth control other than abstinence. 

During the brief procedure, your surgeon will cut and seal your vas deferens, the tubes that carry your sperm from your testicles to your penis. This blocks sperm from getting to your semen when you ejaculate. With no sperm leaving your body, you can’t fertilize your partner's egg. You can still have an orgasm and ejaculate. A vasectomy only prevents pregnancy. It won’t protect you or your partner from sexually transmitted infections (STIs).

How common are vasectomies?

Every year, about 500,000 people in the U.S. choose to get a vasectomy.

Vasectomy vs. tubal ligation

Vasectomy and tubal ligation are both surgical procedures for permanent birth control. Tubal ligation is a birth control procedure where the fallopian tubes are cut and tied off. This prevents eggs from passing through the fallopian tubes so that sperm can’t reach and fertilize them.

The difference is that vasectomy is a much simpler procedure. Most vasectomies are done on an outpatient basis using local anesthesia, offering a relatively easy and fast recovery, low complication risk, and much lower cost. Tubal ligation is an inpatient procedure that needs general anesthesia. Being more complicated, tubal ligation is much more expensive, involves a longer recovery, and carries a higher risk of complications.

You should have a conversation with your doctor before you have a vasectomy. Here are some things you should know before your procedure:

It's permanent. Although there's a procedure to reverse a vasectomy and you could try sperm retrieval with in vitro fertilization, these don't always work and can be expensive. So, you should be sure that you don’t want children (or more children if you’re already a parent) before you schedule your procedure.

It doesn't make you sterile immediately. It usually takes about two to four months for your semen to be free of sperm. You'll need to use another form of contraception or avoid sex until you have a post-vasectomy semen analysis if you want to ensure you and your partner don't get pregnant.

It isn't always 100% effective. No form of birth control is foolproof, including vasectomy.

Avoid ejaculation for about a weekafter a vasectomy. This is necessary for proper healing.

During your consultation, your doctor will also likely ask if you:

  • Have a history of heavy bleeding or a bleeding disorder
  • Regularly take medicines that increase your bleeding risk, such as aspirin
  • Take any over-the-counter medicines, vitamins, herbs, or other supplements
  • Are allergic or sensitive to local anesthetics, such as benzocaine, lidocaine, or procaine (Novocaine)
  • Have any infected pimples or other skin problems on your scrotum
  • Have had injuries or previous surgeries on your genitals, scrotum, or groin, such as a hernia repair
  • Have had a recent urinary tract infection (UTI), genital infection, or a history of such infections
  • If you smoke (because smoking can keep you from recovering well after surgery)

You'll be asked to sign a consent form to show that you understand the risks of a vasectomy. Make sure you understand all the risks and are comfortable with your decision before you sign. Ask your doctor if you don't understand something or need more information. You can change your mind at any time before your surgery if you're uncomfortable.

Who does a vasectomy?

Most vasectomies are done by a urologist. A urologist is a doctor who specializes in diagnosing and treating diseases of the urinary system (such as your reproductive organs, kidneys, bladder, and urethra).

Before your vasectomy procedure

As blood thinners may increase your risk of bleeding, your doctor will tell you not to take any blood thinners for seven days before your surgery. Examples of blood thinners include:

  • Aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil and Motrin) or naproxen (Aleve)
  • Clopidogrel (Plavix)
  • Oral anticoagulants, such as dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa and Lixiana)
  • Ticlopidine (Ticlid)
  • Warfarin (Coumadin)

Your doctor may ask you to shave all the hair from your scrotum the night before or the morning of your procedure. Or, they may shave and wash your scrotum right before the procedure.

Take any medications your surgeon prescribed to prepare you for your vasectomy. Bring a supportive jockstrap and compression shorts to wear after the surgery. You can usually eat before your procedure, but make it a light or liquid meal.

What does a vasectomy do?

Each of your testicles has a tube called a vas deferens that carries the sperm from your testicles to your penis. During a vasectomy, your vas deferens tubes are tied, cut, clipped, or sealed to keep your sperm from getting into your semen. Since your semen has no sperm in it, you can't fertilize an egg from your partner. This prevents pregnancy.

Conventional vasectomy

For this type, your doctor will make one or two cuts in your scrotum to reach both of your vas deferens. Your doctor will take out a small piece of each tube and leave a short gap between the two ends. Then, your doctor will close each end by sealing it with heat (cauterizing), clipping it, or tying it. You may need dissolvable stitches to help your cuts heal or they may heal without them. Your doctor will decide at the end of your procedure.

No-scalpel vasectomy

During this type, your doctor will feel for each vas deferens under the skin on your scrotum and clamp it in place. They’ll make a tiny hole in your skin, stretch it open, and lift each vas deferens out. Then, they’ll cut them and seal or tie them closed and put them back into place.

It's similar to tubal ligation in women and people assigned female at birth (AFAB) in that it's a one-time procedure that gives you permanent birth control. However, a vasectomy offers many advantages over tubal ligation, such as: 

  • It's more effective (when successful, it's over 99.99% effective at preventing pregnancy).
  • It's a much simpler procedure because your testicles and vas deferens are on the outside of your body. You won't need general anesthesia and your recovery will be relatively easy.
  • It can be done on an outpatient basis.
  • It has less risk for complications.
  • It's much less expensive.

The rate of unintended pregnancy after the procedure is only about 0.1% per year. Vasectomy is much more effective than other methods of birth control used by men and people assigned male at birth (AMAB), such as condoms and withdrawal. For instance, the rate of unintended pregnancy is about 15%-20% per year for condoms and 25%-30% per year for withdrawal.

However, it’s not immediately effective. Some sperm will remain in your semen, usually for about two to three months after the procedure. While you can have sex within a few days, you should use another form of birth control until you have a semen analysis that shows no sperm. This is usually scheduled about three months after your vasectomy. The timeline varies, though, so your semen could contain sperm for longer.

Vasectomy failure rate

The failure rate for vasectomy is less than 1% or about 1 in 10,000 procedures. It means that in very rare cases, sperm can still cross the separated ends of your vas deferens, which could lead to pregnancy.

Vasectomies are generally very safe, but they do come with some risks, just as all surgeries do. You may not have any side effects at all. If you do, they're likely to be short and mild, including:

  • Bleeding or bruising in your scrotum
  • Mild pain or discomfort
  • Blood in your semen
  • Infection at the incision site
  • Swelling

Many people who consider a vasectomy worry about how the surgery will affect their sex life and reproductive and general health. But it generally doesn't have much impact beyond preventing pregnancy. For instance:

  • It's not severely painful. You may have some discomfort during or after the procedure, but pain is rare.
  • It won't lower your testosterone levels.
  • It won't reduce your sex drive or ability to get an erection or climax.
  • It won't affect how much semen you produce or the quality of your semen.
  • It won't raise your risk of prostate or testicular cancer.
  • It won't raise your risk of heart disease.

Most people return to work less than a week after the procedure. However, if you have a physically demanding job, your doctor may recommend a full week off. 

Regardless, you should take it easy for two to three days before you get back to your regular daily activities. You should wait even longer before starting strenuous activities, such as sports and heavy lifting. If you're not sure, go through your routine with your doctor and ask for advice about when you can expect to return to your favorite activities. Most people say they're fully recovered about eight to nine days after the procedure.

Vasectomy aftercare

Your doctor will probably ask you to keep a bandage on your scrotum and wear tightfitting, supportive underwear for a couple of days after your procedure. You can use an ice pack or unopened bag of frozen vegetables for about 5-10 minutes on and off to help relieve swelling. Also, watch out for signs of infection. Call your doctor if you have any of the following:

  • Blood coming out of the surgery site
  • A fever over 100.4 F
  • Redness
  • Pain and swelling that gets worse rather than better

How long after a vasectomy can I shower?

Generally, you can take a shower the day after your surgery. But you shouldn't take a bath or go swimming for about two weeks. Don't rub yourself dry. Pat your scrotum dry with your towel to keep from tearing your stitches or damaging your skin.

When can I have sex again after a vasectomy?

Your doctor will probably say to wait about a week to have sex again. Be sure to use another form of birth control until you get your semen tested to make sure there isn't any sperm in it. You'll usually have this test about two to three months after the procedure.

Your doctor will test your semen three months or so after surgery (or after you've ejaculated 20 times) to see if you have sperm in your semen. About 1% of people will still have sperm in their semen and may need to wait a bit longer for their semen to be clear.

Don't assume that your vasectomy worked until you get tested. Make sure that you use alternative birth control methods until your semen analysis shows that it's clear.

You may need to have a second vasectomy if your semen still has sperm in it after a few months.

Complications of surgery aren't common and if you do have them, they're generally not serious. Some possible complications include:

  • A dull ache caused by fluid buildup in your testicle. This becomes more painful during ejaculation.
  • Sperm granuloma, which is a hard lump due to inflammation caused by leaking sperm.
  • Spermatocele, which is a cyst in the tube that collects sperm.
  • Hydrocele, which is a sac of fluid around a testicle that causes swelling in your scrotum.

Vasectomy scar

If you have a conventional vasectomy, you may have a small scar where the incision was made. This scar is usually hard to see. No-scalpel vasectomies leave minimal or no scarring.

Post-vasectomy pain syndrome

About 1%-2% of men who have a vasectomy have pain that doesn't go away. This is called post-vasectomy pain syndrome, and it can cause a dull ache in your testicles. It may start right after your procedure or it may start months, even years later. The pain may be ongoing or you may feel it from time to time. It’s not clear what causes it. 

Your doctor may suggest you do pelvic floor exercises (Kegels) to help ease your symptoms. They may also suggest you try taking pain medicine, like nonsteroidal anti-inflammatory drugs (NSAIDs), gabapentin, or antidepressants. Complementary strategies, such as acupuncture or biofeedback, may also help. If these don't work, surgery, such as a vasectomy reversal, may relieve your pain. Surgery relieves the pain in 90% of people, but this will likely make you fertile again.

The cost of a vasectomy varies depending on several different factors, including what kind of insurance you have, what your insurance covers, and where you live. Many health insurance plans cover the procedure, as does Medicaid (if you’re eligible). Your policy may cover the entire cost, including follow-up. Talk to your doctor about the cost of the procedure and your insurance provider about what they cover. Price estimates range from about $1,000 to $3,000.

Is a vasectomy reversible?

Yes, a vasectomy can be reversed in many cases, but the procedure is complex and may not be successful. The chance of a successful reversal depends on how long it's been since your vasectomy.

Vasectomy reversal success rate

Vasectomy reversal is successful about 60%-95% of the time. But success rates drop after about 15 years.

Vasectomy reversal cost

Insurance typically does not cover this, so you'll probably have to pay out of pocket. Estimates range from around $6,000 to $16,000, depending on what kind of reversal procedure you opt for.

A vasectomy is one of the most effective means of birth control. It’s a safe and quick procedure and only rarely has complications. While it can be reversed in some cases, it's not guaranteed to return your fertility. Before you get a vasectomy, make sure you don't want to be a parent. 

Does a vasectomy protect against STIs?

 No. You’ll still want to use an external condom for the best protection against HIV and other STDs.

Does a vasectomy make prostate cancer more likely?

The research on this is mixed. The American Cancer Society says that some studies suggest a slightly higher risk of prostate cancer after a vasectomy, but other studies haven’t found such a link.

The most current findings show that a vasectomy does not increase prostate cancer risk and should not be a reason to avoid the procedure. (Find out more on what causes prostate cancer.)