Understanding the Vasectomy Procedure: Fact from Fiction

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With between 300,000 to half a million vasectomies performed in the US each year, you would think this elective procedure would be well understood. Unfortunately, myths and downright misinformation about vasectomies still abound. While any competent urologic surgeon will review the procedure in detail – including the technique, recovery, risks, limitations, and benefits – with their patients prior to their vasectomy procedure, it can be very helpful to be familiar with the facts about vasectomy before you ever visit your surgeon.

It’s also important to dispel the false myths surrounding vasectomy. Since the decision to have a vasectomy is an intimate and personal choice, it’s not always easy to find someone to talk with who has undergone the surgery. I find in talking with patients that even friends and family members may be reluctant to open up about their experience. This guide will provide you with frank and honest information about vasectomies as well as answers to common questions.

Myth #1: A Vasectomy is Incredibly Painful

This myth likely stems from the fact that vasectomies are performed in a delicate area. The psychological effect of picturing surgery around your penis and testicles can be intense. Understandably, there is often a “squeamishness factor” at play. The fact is a vasectomy is a minor surgical procedure, but it’s still surgery.

The procedure itself is completely painless as you’ll be under sedation. The recovery is also usually not that bad. No, you won’t be running a marathon the day after your procedure, but most patients are able to return to work within several days. If you have a very physically strenuous job, you may need a few extra days or to limit yourself to light duty. There will certainly be some pain and swelling immediately after the operation, but this is typically easily controlled with medications.

Myth #2: You Won’t be Able to Ejaculate After a Vasectomy

A vasectomy only prevents sperm from entering your semen. It in no way interferes with your semen production, which originates from your prostate and various glands. In fact, sperm comprises only about 1%-5% of your total semen volume. So, you will still be able to ejaculate and experience orgasm just as you did prior to your vasectomy.

Myth #3: A Vasectomy is the Male Equivalent of Birth Control Pills

This myth is not at all accurate. While oral birth control pills for females and vasectomies are both intended to prevent fertility, that’s where the similarities end. A vasectomy eliminates fertility by making physical changes to your anatomy that prevent your sperm from exiting your urethra.

Birth control pills work by changing hormone levels. A vasectomy won’t raise your estrogen or make you less masculine. The actual nearest female equivalent to a vasectomy would be a surgical tubal ligation (tube tying).

Myth #4: Vasectomies Negatively Affect Libido and/or Sexual Performance

Nothing could be further from the truth. Men who have had a vasectomy are still able to achieve erections, perform sexually, and reach orgasm. A vasectomy only affects your fertility. While you probably won’t be very interested in sex the first few days after your operation, the vast majority of men with a vasectomy have normal sex lives.

Myth #5: You’ll Need to Provide Daily Semen Samples After Your Vasectomy

This one could be a bit awkward if true. The fact is that it is necessary to submit a semen sample several months after your vasectomy but certainly not every day. The sample is needed to check your fertility, making sure your vasectomy was successful and that there are no sperm present in your semen. You will need to ejaculate several times after your vasectomy in order to clear out any remaining sperm, but there’s no need to bring all the semen to your surgeon’s office.

Myth #6: A Vasectomy is Irreversible

Vasectomies are intended to be permanent, but the procedure is certainly not irreversible. In fact, the majority of men who undergo vasectomy reversal procedures see successful results. This means that sperm is once again present in their ejaculated semen and that they’re fertile. These men can, of course, still run into problems fathering a child if there’s a fertility issue with their female partner.

Myth #7: About Half of All Patients Want to Reverse Their Vasectomy

This number is vastly inflated. In my experience, only about 2%-6% of patients eventually seek a vasectomy reversal. Choosing to have a vasectomy is a big decision since there is no absolute guarantee of a successful reversal. Most men who undergo a vasectomy already have children and don’t desire more.

That said, situations do change. Relationships end and new ones begin. No one can say for certain what the future holds, so some men do indeed decide to get a vasectomy reversal. If you reach this decision, it’s important to choose an experienced urologic surgeon who specializes in vasectomy reversal surgery.

If you’re contemplating a vasectomy or vasectomy reversal in New York, please contact Dr. Harry Fisch for a consultation.

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