About a million men get a vasectomy each year. It is safe, simple, and inexpensive and compares favorably with your current form of birth control for effectiveness. While vasectomy reversal can be done, it is often not covered by insurance, involves more surgery and recovery, and is not always successful. You should consider your vasectomy as a permanent birth control solution. Before getting your vasectomy you should be sure that you would not want more children if you should get divorced or lose a child. Sperm banking is possible but is expensive and most men choose not to do so.

We do the vast majority of vasectomies here in our office under local anesthesia. If you have certain medical conditions, previous scrotal surgery, or unfavorable anatomy, the vasectomy can be done under general anesthesia as an outpatient. The procedure takes 10-20 minutes to perform. A local anesthetic is used, sometimes supplemented with relaxing oral medication (i.e. Valium® and Vicodin®). If no relaxing oral medications are used, you can drive yourself to and from the office for this procedure.

The preoperative consultation with your doctor at Willamette Urology will consist of an interview, medical history review, and physical examination. The operation will be described completely to the your satisfaction. If both you and the physician are in agreement, the vasectomy will be scheduled at when it is mutually convenient.

Vasectomy is considered a very safe alternative to other forms of birth control, including birth control pills, tubal sterilization, and the IUD. The short-term risks typically associated are those seen with any kind of surgery; bleeding, infection, and pain. Significant bleeding resulting in a need for further surgery is extremely rare and is minimized by avoiding medications that might make you bleed for a week before surgery such as aspirin, ibuprofen, Advil®, Motrin® and certain other anti-inflammatories. Be sure to tell us what medications you are taking at the time of your preoperative visit to help ensure good care. The risk of infection is typically less than the risk of antibiotics, so that the use of antibiotics at the time of the vasectomy procedure is not routine. Some patients can get infection at the vasectomy site. This may cause drainage of yellowish fluid, pain, redness and heat around the area of incision. This usually responds to local hygiene and oral antibiotics. The pain associated with vasectomy is usually mild and usually controllable with an over the counter pain pill such as Tylenol although prescription pain pills are offered to you. Most men take one or none of these pain pills, and if so, usually just the night of surgery for the dull, toothache-like pain that they perceive. Discomfort is different for each man.

In the long term, 40% of men can have sperm antibody production, which lasts for up to 6 months. The person having the vasectomy will feel no different. Roughly one time out of a thousand, the vas ends that have been severed and cauterized will grow back together again which may result in additional pregnancy. This pregnancy rate is far lower than other reported birth control such as condoms, birth control pills, and even tubal sterilization in women which routinely requires general anesthesia. It was once feared that there was an increased risk of prostate cancer, heart disease, and vascular disease but further research has convincingly shown that these risks are not increased by vasectomy.

No. The sex hormones made by the testes (testosterone etc) continue to be passed into the bloodstream as before. Also, vasectomy does not reduce the amount of semen when you ejaculate ('come') during sex. Sperm only contributes a tiny amount to semen. Semen is made in the seminal vesicles and prostate higher 'upstream'. Ask your doctor when you can resume sexual activity. Remember that you must use another form of birth control until your doctor says you are completely sterile. Remember that sterility is not impotence. The hormones that affect masculinity are still made in the testicles. They still flow throughout the body in the blood stream.

Many men (and their partners) report that sex may even be more enjoyable as the worry or inconvenience of other forms of contraception are removed.

Depending upon the area of the country, vasectomy charges or costs vary. In general, most insurance companies will cover a very large portion of this cost, leaving a relatively small co-pay or deductible for the patient. You will be responsible for checking with your insurance coverage and what co-pay will be due at the time of your procedure or if self pay, please call the Billing department (503 561-7112) for private pay prices. We do not typically charge for the routine postoperative semen analyses after vasectomy so we encourage you to bring your samples to our office for examination six weeks after the procedure.

We ask that you do not shave the area unless it is your habit to do so as this increases the risk of infection. We will do any shaving that is required at the time of the procedure. Make sure you have the next 48 hours to relax and rest. A mild sedative can be requested, and if so, be sure you do not drive yourself to or from the procedure.

In a vasectomy, an incision is made in the man's scrotum. The spermatic cord is pulled out (B) and incised to expose the vas deferens, which is then severed (C). The ends may be cauterized or tied off (D). After the procedure is repeated on the opposite cord, the scrotal incision is closed (E). (Illustration by GGS Inc.)

While we typically do the procedure through one opening, occasionally your anatomy requires an incision on both sides to perform the vasectomy properly. We typically also perform a “no-scalpel” procedure and close the incision with a dissolving single stitch and a biological glue.

The vasectomy will take about 10- 20 minutes to perform. A local anesthetic is injected into the scrotal skin adjacent to the vas deferens. This results in almost immediate anesthesia. A small incision is made in the scrotum, the vas deferens is exposed, and a small portion is removed. The severed ends are then either tied with suture or cauterized. The skin incisions are usually closed with one suture, which dissolves in seven to ten days. The patients can take showers the following morning. The patient is advised to be very sedentary for 48 hours after the procedure to reduce the incidence of complications. Ice packs can be applied to the scrotum periodically for the first 24 to 36 hours to ease swelling. After 48 hours, the patient may begin physical activity, including intercourse, as comfort allows.

You will receive a packet of information that also includes your post procedure instruction. These instructions will answer questions regarding activity level, pain control and possible reactions to the vasectomy. A staff member will review these instructions with you one more time reinforcing the importance of following them.

Once you are home you can do several things to assist in your recovery. The most important advice is to follow the instructions that have been provided to you on your instruction sheet.

For about a week your scrotum may look bruised and slightly swollen. You may also have a small amount of bloody discharge from the incision site.

Scrotal pain, referred to as post-vasectomy pain syndrome, occurs in a small percentage of patients. Apparently the vas deferens is blocked and sperm builds up in the epididymis causing it to swell. This increased pressure in the epididymis causes pain but it is a rare occurrence. Usually, hot baths, analgesic medication and time resolve it, but occasionally more invasive treatment is needed.

To make sure that you are sterile you will have a postoperative semen exam. Your semen is less than 1% sperm. The rest is seminal fluid from the prostate and other glands. The change in the amount of fluid is too little to notice. After a vasectomy your sperm is absorbed in the body. We will provide specimen cups with specific instructions on when to collect and transport the semen sample to our lab. If you have not heard from Willamette Urology within a two-week period of taking semen specimens to the lab please call us right away. Once we have notified you that there are no longer sperm in the ejaculate, it is safe to resume unprotected intercourse. Some of us require you to have two negative semen analyses before resuming unprotected intercourse. We will make that clear to you at the time of the procedure. In addition, the semen sample can sit unrefrigerated for several hours before being examined for efficacy of the vasectomy, so it can be produced comfortably at home and brought to our office. Be sure your name is on the label when you drop it off.