Common and important vasectomy questions answered:
There are several choices available for contraception. Each couple should choose the method that best suits their needs. Your doctor can also help you choose the best option for you.
Temporary and reversible methods of birth control include condoms, spermicides, a diaphragm, an IUD, the pill, the patch, and the Depo shot. Permanent methods include female sterilization by tubal ligation and male sterilization by vasectomy. These procedures cannot be performed in a way that makes them easier to reverse. This means only those who have decided not to have more (or any) children should choose permanent sterilization.
Sperm banking — freezing sperm for later use — is available through regional fertility laboratories. While it offers the possibility of future pregnancy, the process of storing and retrieving your sperm (and the assisted fertility procedures of artificial insemination or in vitro fertilization) can be complicated and costly, with no guaranteed results.
Vasectomy is a safe, simple, and minimally invasive procedure that is more than 99% effective. If you are deciding whether to get a vasectomy, it may be helpful to answer these questions: can you imagine a situation in which you would regret not having biological children? Would you consider adoption? You should also consider the risks and consequences of having an unintended pregnancy while using a reversible method of contraception.
With a microscopic surgery performed by a skilled and experienced surgeon, in most cases the vas can be reconnected.
A small percentage of men with vasectomy have undergone surgery to attempt to restore their fertility. The procedure, called a vasovasostomy, can be performed by an experienced microsurgery specialist using a microscope in the operating room. Often general anesthetic is necessary to prevent motion during the surgery, which lasts 1.5 to 3 hours.
Within a few weeks or months, about 50% to 70% of men will achieve sperm counts high enough to expect a pregnancy, while as many as 50% will not achieve pregnancy. For intervals greater than 10 years since vasectomy, success rates are about 30%. Of course, the age and fertility of the female partner also affects success. If pregnancy occurs, there is no special concern about abnormalities related to the sperm produced after vasectomy.
For those who fail after the vasovasostomy, it may still be possible to retrieve sperm from the semen or by extraction from the testicles. The doctor can then microscopically implant a sperm into an egg in vitro. If an embryo forms, it is then transplanted into the woman’s uterus. This highly specialized form of in vitro fertilization is called intracytoplasmic sperm implantation, or ICSI, and requires specialized laboratory facilities. It is generally more expensive and less successful than vasectomy reversal.
Over several years, it would cost more to use the pill, an IUD, even condoms, than the one-time cost of a vasectomy.
A vasectomy is currently the only form of male permanent method of birth control. It is also safer and less invasive than a tubal ligation.
Vasectomy is the most effective of all the methods of birth control. It also ranks among the safest and most effective of surgeries. But nothing is perfect, and no surgery is 100% safe or effective.
The failure rate for this method of vasectomy is about 0.3%. That is to say, 3 out of 1000 men would remain fertile, even several months after the vasectomy. Failure can occur due to reconnection of the cut ends during healing, formation of a new channel through which sperm can travel, failure to identify and cut the vas, or duplication of the vas on one side.
At DrSnip, if your semen test is positive, we would repeat the vasectomy procedure at no cost to you.
During vasectomy, the vas deferens from each side is cut high in the scrotum. The sperm stored “downstream” in the channel leading to the prostate may still be ejaculated and cause pregnancy. The pathway needs to be emptied, which takes a variable amount of time, and will be complete in some men as early as 6 weeks, with at least 15 ejaculations, while other men require 6 months or more to clear.
Yes. The amount of semen you ejaculate after vasectomy is only decreased by about 5%. Without a microscope, you could not detect the absence of sperm cells in the fluid.
Your testes will continue to produce sperm cells that will go through their life cycle as before. Although testes produce millions of microscopic sperm cells each day, the actual volume of sperm stays quite small and stable. Old sperm cells continue to be reabsorbed naturally within your body, as are all other old cells throughout the rest of the body. Sperm antibodies help in the removal process, but these are not harmful.
If you have a negative semen check once, there is an exceedingly small chance (about 1 in 2000) that you will experience a late failure, with spontaneous reappearance of sperm in the semen. You are welcome to retest if you would like reassurance of sterility.
Unfortunately, one cannot simply “undo” sterilization.
If your life plan changes unexpectedly, the options for having children after a vasectomy include adoption, attempted vasectomy reversal, or pregnancy by artificial insemination using either frozen stored sperm, fresh donor sperm, or sperm surgically withdrawn from the testes. All forms of assisted fertility involve a considerable commitment of resources and are not generally covered by health insurance.
Yes. If you do not want vasectomy and are having it because you are told you should, you may feel resentment.
If you are unsure whether you are going to want more children, you should not have a vasectomy.
If you are having problems with impotence, sexual fears, or are in an unhappy marriage, it is not likely that vasectomy will help any of these problems.
If your sexual fulfillment or your partner’s satisfaction depend upon you being able to cause pregnancy, then sterilization would probably create a sexual problem.
If your ability to conceive children factors significantly into your or your partner’s sexual fulfillment, sterilization may cause intimacy issues
We understand you might not be “looking forward” to this procedure. We want to make your vasectomy experience simple, convenient, and comfortable. Vasectomy is what we do. We’ve performed tens of thousands of vasectomies using a proven and minimally invasive technique. Beyond the procedure, we are available to you. From your first communication through your aftercare, we’re here to help every step of the way.
However you like! You can register online or give us a call. We have appointments available almost every week. If you are using your insurance benefits, please allow us a week to check your benefits coverage for you. If you are paying privately, we might be able to see you within a week of receiving your completed registration forms.
Just one. We can perform your consultation and procedure in a single visit. During your consultation, we will discuss your procedure, your other birth control options, and your reasons for considering a vasectomy. We will answer any questions you and your partner may have. After your consultation, if you are ready to proceed, the doctor will perform the procedure.
Please note the following prior to your appointment:
- Avoid all aspirin and aspirin-containing products (such as Bufferin, Excedrin, Alka Seltzer) for five days before vasectomy. Stop ibuprofen and other anti-inflammatories two days before vasectomy. Use Tylenol at any time.
- Lather and wash the scrotum and groin area the evening before or the day of your vasectomy.
- The day before, shave or trim away the hair from a two-inch circle on the front of the scrotum, just below the base of the penis. Or you may choose to leave the shaving to the doctor.
- Wear a clean pair of briefs or boxer-briefs, rather than boxers. Don’t own briefs? Wear bike shorts or a Speedo to provide support to the scrotum.
- Maintain your normal diet on the day of your procedure.
- Shower the morning of your appointment. After the procedure, you will not be permitted to shower until the following morning.
Patients typically find themselves pleasantly surprised that they didn’t need sedation. Sedation and general anesthesia effects can be more unpleasant and have lasting effects that aren’t necessary for a relatively quick procedure. We prefer you leave the clinic with a clear head.
Every person is unique, and some men are more sensitive to pain or even just discomfort, especially in this area. (For many men, thinking about vasectomy may be more uncomfortable than the procedure itself.) We do not promise a “pain-free vasectomy,” but we are committed to making your vasectomy experience as comfortable as we can. An overwhelming majority of our patients say there was only mild or minimal pain/discomfort after their procedure.
Not a problem – we’re here to make this experience as comfortable as possible. If you need pain medicine to rest comfortably, we can prescribe a painkiller. We also encourage patients to keep in touch if they are experiencing significant discomfort or pain post-procedure to determine whether they might be experiencing a complication.
We would like to remind you that while you may be eager to return to activity, pain medicine is not a substitute for rest during the recovery period.
The hypospray, or jet injector, used for the DrSnip Vasectomy is a MadaJet®. The MadaJet was introduced in the 1970s by the late Ralph Adam, M.D., founder of Mada Medical, Inc. The MadaJet is most commonly used for dental anesthesia and one of several designs of needle-free jet injectors used for the administration of medications, vaccines, and local anesthetics.
When used in vasectomy, patients typically describe the sensation as a mild snap, like a rubber band against the skin. So, while it is not entirely painless, the hypospray has been widely preferred over a needle among our thousands of vasectomy patients.
Yes, it is our policy to require that patients arrange for transportation home after their procedure. On rare occasions a patient may feel lightheaded or faint, which would be hazardous while driving.
You may notice a mild ache in the testicles or the lower abdomen appearing later in the day or the next day. This ache, if it occurs, is usually mild and may be felt from time to time over the first few days, perhaps with activities such as getting up or moving quickly. It should not feel acute or severe. It will go away by itself. Anti-inflammatory medications can be of benefit, if needed.
You aren’t likely to notice the anesthetic wearing off because the numbed area is small, about the size of a dime, and the opening in the skin is closed with no stitches (this is not usually a source of pain).
Life After Vasectomy
Almost all men (99.2%) who have vasectomy are completely satisfied with the operation afterward. They enjoy freedom from other contraceptive methods that can interfere with sexual activity, freedom from worry about an accidental pregnancy, and freedom from concern about the effects of the pill or IUD on their partner’s health. A small number of men later regret having the operation. That is why it is so important you make the decision carefully, without any outside pressure. Your satisfaction depends largely upon your own preparation and thoughtful decision-making.
Vasectomy has been in use since the early 1900s and over 20 million American men have had one. To date, no long-term adverse effects have been proven to be caused by vasectomy. Ongoing studies have not demonstrated vasectomy plays any role in prostate cancer, heart disease, or autoimmune diseases. Chronic pain affecting the genital tract does develop in a small number of men, with or without a vasectomy. Medical scientists continue to explore the minor changes in the body associated with vasectomy. While it is possible there are undiscovered health risks caused by vasectomy, you would weigh this possibility against the known benefits.
Sex drive, erection, orgasm, and ejaculation are not disturbed by the procedure. Vasectomy only blocks the sperm cells from entering the semen. The male sex hormones in the blood do not change. However, if you or your partner had negative feelings about vasectomy, like other feelings it could affect your sexual performance. That said, many men and women have said that the relief from worry about pregnancy has improved their sex lives after vasectomy.
Prostatitis and epididymitis are both common conditions in men, whether or not they have had a vasectomy. There does not appear to be a long-term increase in these conditions due to vasectomy. Vasectomy probably helps protect against bacterial epididymitis, since the offending bacteria are unable to ascend the vas deferens to reach the epididymis.
How to Avoid Complications
As with any surgical procedure, complications do occasionally occur. With vasectomy, the risk is about 5%, or 1 in 20 men, and most of these complications are minor, temporary, and are easily treated with rest and medication.
Serious complications, by comparison, occur in less than 1% of all vasectomies, and less than 1 in 1000 at DrSnip.
Uncommon: 5 in 100:
- Inflammatory response, tenderness along the vas or around the testis and epididymis, may occur, usually just on one side, starting after 3 to 5 days in about 5% of patients. It is usually mild and it will resolve spontaneously, but it subsides more rapidly with anti-inflammatory medicine, such as Aleve or ibuprofen.
Rare: Less Than 1 in 100:
Bleeding: from the skin incision, normally absent or limited to a few drops. If it persists, you can control it with direct pressure, pinching the skin between gauze.
Sperm Granuloma: a tender lump, larger than the normal pea-size scar where the vas deferens was blocked. It can occur in about 1% of patients, where sperm has leaked out of the vas deferens and stimulated a local tissue reaction in the scrotum. Delaying ejaculation during your first week after vasectomy may reduce sperm leakage, but it can occur at later times, as well. Usually no treatment is required and it will resolve spontaneously over time. However, you can use anti-inflammatory medication if you wish.
Very Rare: Less Than 1 in 1000:
Scrotal Hematoma: a large collection of blood inside the scrotum that occurs when a blood vessel leaks, usually within hours after vasectomy. This requires immediate treatment and possibly surgery to stop internal bleeding.
Infection: in the scrotum and can be avoided by not disturbing the incision. Medical evaluation and antibiotics may be required.
Scarring or neuroma: may form along the vas at the site of vasectomy and be sensitive to touch. This is rarely bothersome enough to require medical attention or surgical removal.
Allergy or other reaction to local anesthetic or other medications: can occur even without a history of a drug allergy. These reactions are very rarely serious or life threatening and may require medication or observation.
When this rare complication occurs, it is usually painful, with a large purple lump, the size of a golf ball or larger, in the scrotum. Most hematomas occur within the first few hours after vasectomy, though they could also occur later in the week. A hematoma is not always due to overexertion or straining; it results from bleeding internally, which can occur spontaneously at the site of any surgery. Resting, especially on the first day, is the best prevention.
There is a scar in each vas deferens where we cut and sealed it. It usually feels like a knot the size of a BB or a pea. It may swell to the size of a lima bean and it may be tender for a few weeks after the vasectomy, but then becomes smaller and non-tender. Most men are unaware of the scar unless they are searching for it. It may be difficult for you to find on one or both sides.
About 5% of patients have a more vigorous than usual inflammatory response. It feels like a vague ache on one side, which might be felt in the groin or abdomen and aggravated by movement. Even though it typically doesn’t start until the 3rd to the 5th day, it is not caused by excessive activity, it is just part of the way your body heals. There is no way to predict who will experience this, but it is nothing to worry about. It is readily treated with an anti-inflammatory regimen, as mentioned in the After Vasectomy Guidelines, which you will continue for 7 days to prevent a recurrence.
Insurance & Costs
Vasectomy is usually covered by insurance plans. If your plan covers the procedure, your cost is determined by your insurance company. If the procedure is not covered by insurance and you are paying out of pocket, we charge $1,250, which includes your consultation and procedure.
If you are unsure if your insurance includes coverage for vasectomy, we will check on your coverage for you. Please start the registration process by clicking here and providing us with the necessary information on the insurance page. We will do our best to provide you with an accurate estimate of your share of costs.
You can also call your insurance company’s member services and inquire directly. Use the phone number on the back of your card. If you like, you can call us first and we will tell you exactly what to ask, so that you can obtain an accurate estimate from the insurance representative.
If you don’t have an active health insurance plan, if your plan excludes vasectomy, or if our doctors are not contracted with your plan, we offer a discounted rate that includes your consultation, procedure, and follow-up testing. Please feel free to call us to discuss.
We are contracted with most insurance companies, including CIGNA, Aetna, First Choice, UnitedHealthcare, Premera, and Regence. We also have many affiliate agreements through BlueCross and BlueShield. If you would like to know if your insurance company is contracted with us, please start the registration process by clicking here and providing us with the necessary information. We will do our best to determine if your insurance plan covers your vasectomy with DrSnip. You can also give us a call and give us the necessary information over the phone.
As with many medical procedures, many plans that cover vasectomy will first apply the cost of your annual deductible. If you have not met your deductible for the year, your patient share may total up to the full cost of the procedure. In such cases, any payment you make will be credited to your deductible and your out-of-pocket maximum for the year. If your deductible is partially or fully met, your plan may still have co-payment and/or co-insurance costs that you will have to pay.
We will check your benefits with your insurance company on your behalf and try to provide you with an accurate estimate of what your share of costs will be.
Please be aware that insurance companies will not guarantee your coverage, and you may owe a balance after they process your claim.
No. Your insurance companies use guidelines to determine which plan is considered primary and secondary. If you have one plan in your name and another in your spouse’s name, your plan will usually be designated the primary plan. If both plans are in your name, the plan that you have had longer is typically deemed the primary one. Similarly, commercial plans through an employer or the state marketplace plans are typically always primary to military and Medicaid plans. If you are unsure which of your plans is the primary payer, please call the Member Services phone numbers on the back of your insurance cards and tell each plan about the other. The insurance companies will determine which plan should be billed first. Ensuring this information is accurate and understood before your appointment will help us accurately estimate your out-of-pocket costs, submit your claims, and reduce your out-of-pocket expenses.
We are not contracted with Tricare. We might be able to bill them as a courtesy. In such instances, we will collect a flat rate from you, and once Tricare processes your claim, it should reimburse you a percentage of your payment. Your reimbursement amount is based on your current Tricare benefits and deductible status. Please call us to discuss your particular Tricare plan.
We accept Medicaid plans in some states. Please call us to inquire if we can accept Medicaid in your area.
Absolutely! Please see our glossary of terms.