UVA Health urologist Ryan Smith, MD, has performed hundreds of vasectomies and vasectomy reversals. Commonly called the ‘snip’, a vasectomy keeps sperm from making it to the penis. A reversal restores a man's fertility. Smith hears a lot of myths from patients so he regularly shares vasectomy facts. Probably most important: It's a safe and effective form of permanent birth control. And men shouldn't assume it can be easily undone.
“We try to reassure men that a vasectomy is not going to negatively affect erections, ejaculation, or testosterone levels,” Smith says.
“Those are common questions we get about vasectomy. Also, a vasectomy doesn't have negative impacts on their sexual or overall health.”
Smith shares more myths and vasectomy facts.
After a landmark Supreme Court decision made abortions harder to come by, more people began searching online about vasectomies. In the past year, the Supreme Court decision has come up in many consultations Ryan Smith, MD, has had with men considering a vasectomy.
Myth 1: A Vasectomy Is Painful
Fact: You’ll Feel Some Discomfort
Your doctor will numb the area to keep you comfortable. While you may feel a little tugging during the procedure, most men don’t need more than local anesthesia during the procedure. You’ll then have some achiness for a couple of days after the procedure. This can be managed with over-the-counter pain medications and ice. Severe or chronic pain is a rare complication.
Myth 2: A Vasectomy Is Major Surgery
Fact: It’s Done in the Doctor’s Office
Men have asked Smith if a vasectomy means removing the testicles. “That's clearly not what's happening here,” he reassures. Instead, the surgeon makes a tiny puncture through the skin and then cuts and blocks the vas deferens — the tube that carries sperm from the testes to the penis.
Another vasectomy fact: Insurance often covers a vasectomy. And “Men with non-strenuous jobs, can return to work the next day,” Smith says.
Myth 3: After a Vasectomy, I Won’t Be Able to Ejaculate
Fact: You’ll Continue to Ejaculate & Orgasm Just Fine
Most of the ejaculation fluid comes from body parts that aren’t affected by a vasectomy. A vasectomy only blocks the vas deferens tube. And very little fluid comes from the vas deferens.
Myth 4: I’ll Stop Producing Sperm
Fact: You’ll Make Sperm Forever
A vasectomy just keeps sperm from getting out. “Just as cells in every other body system, the sperm cells will die and get cleaned up by other specialized cells,” Smith explains.
Myth 5: A Vasectomy Gives Me Instant Protection
Fact: You’ll Need to Use Birth Control for 12 Weeks
That’s when you’ll come back to the clinic for a semen analysis. Doctors will look at your semen to make sure no viable (moving) sperm remain.
“At this point, we can say the vasectomy is now an effective form of birth control,” Smith says.
“But we also advise that no birth control is 100%. After a vasectomy, there’s a 1 in 2,000 chance of failure going forward.”
Myth 6: If I Change My Mind, I Can Reverse It Any Time
Fact: A Doctor Might Be Able to Restore Your Fertility But There’s No Guarantee
An important vasectomy fact: Don’t wait decades to reverse it. In the first 10 years after a vasectomy, the reversal success rate is about 95%.
“But it's different for every patient,” Smith says. “And once you get beyond 10 or 15 years, the chance of a secondary obstruction developing goes up.”
This makes restoring fertility more challenging. Smith says, “We then have to do what's called a vasoepididymostomy. It’s kind of like a bypass procedure. And that can carry a lower chance of success.”
Find a Vasectomy & Reversal Expert
UVA Health urologists have extensive expertise in men’s fertility.
Myth 7: Insurance Covers a Vasectomy Reversal
Vasectomy Fact: For a Reversal, You’ll Have to Pay Out of Pocket
A bigger surgery than the snip, a vasectomy reversal will require general anesthesia (you’ll be asleep), and a few days off work.
Before undergoing the expense of a reversal, Smith says, “You’ll want to know if your partner has any fertility issues.”
Another thing to consider is opting to do a sperm extraction. This can be done at the same time as the reversal. The sperm is stored and can be used for a pregnancy later. Smith says, “A sperm extraction just gives you a backup plan if the reversal isn’t successful.”
Final Key Vasectomy Fact
To have the best experience with a vasectomy or a reversal, you’ll want to look for a urology surgeon like those at UVA Health who have fellowship training in microsurgery and lots of experience doing them.
