For most men... not at all. Vasectomy does not affect the male hormones produced by the testicles. Sensation, erection, and ejaculation are the same except the ejaculate no longer contains sperm. Some men (and their partners), in fact, feel more comfortable with sex and note an INCREASED sex drive after a vasectomy. It's nice not having to worry.

Your vasectomy will be pain free... or almost. You will have little or no discomfort during the vasectomy. The majority of men say that it is better than going to the dentist or getting blood drawn! The doctor uses a very fine needle (the size of a hair) for local anesthesia. This completely numbs the skin and area around the tubes. General anesthesia is not needed. The vasectomy site does NOT touch the testicles, penis, or other sensitive areas.

Most men feel some soreness for a night or two and then they feel fine. Relax with your feet up on the day of your vasectomy. If you choose, you can return to work or light activity the following day. We recommend wearing tight underpants or a jock strap for the first few days after your vasectomy to decrease discomfort and chances of bleeding. Avoid any vigorous activity, including sports and sex, for the first 3-7 days after your vasectomy.

No. You will not notice a difference in your semen, or cum. Most of the semen is made in the glands above the vas tubes (the prostate and seminal vesicles). Vasectomy does not prevent ejaculation. The amount of sperm in semen is so small that men do not notice any change when it is no longer there. In fact, after a vasectomy the only way to tell the difference in the semen is with a microscopic semen analysis.

The sperm is reabsorbed by your body. Our bodies are very good at recycling old or unused cells. For example, we make red blood cells every day and our bodies do not become overloaded with excess blood. Our bodies simply reabsorb the older blood cells and recycle their proteins and parts. Likewise, the body reabsorbs the sperm cells that the testes continue to produce after vasectomy.

Vasectomy is a very safe, low-risk procedure. That being said, with any surgery some complications can occur. Mild bruising is the most common reaction. (See "Aftercare Instructions" for suggestions to prevent bleeding.) Other rare complications include: infection (very rare and can be treated with antibiotics), bleeding into the scrotum causing a collection of blood (scrotal hematoma), and a painful bump on the vas (sperm granuloma). Sperm granulomas tend to occur several weeks after the procedure. Some men (about 5%) experience pain in the testicles that usually only lasts a few days and resolves with oral anti-inflammatory medications, like ibuprofen or naproxen. Chronic pain is very rare (about <1%). The continuing ability to get someone pregnant is also a risk of vasectomy. All of these potential complications are unlikely, and any physician will work hard to help prevent complications, but you must remember that every surgery has its risks.

During a vasectomy, the physician performs multiple steps to block the flow of sperm. She or he will separate each vas (the sperm tubes), cauterize the inside, and cover over the ends of the tubes to keep them apart. Even after all this, and in spite of the best surgical technique, the tubes can sometimes re-join (called “recanalization”). This is very rare. The odds of it happening are less than 1 in 1000. Rare reconnection of the tubes usually happens within the first few months after a vasectomy as the body heals and forms a scar that allows channels to form. In the rare instance that the tubes have healed together the doctor can simply repeat the vasectomy. A big problem would be if your tubes healed back together and you didn’t know it. Thus it is very important that you bring in your post-vasectomy semen sample for analysis. “Late recanalization” (when the tubes heal together several years after a vasectomy) happens to about one per 2,000 men after vasectomies. This is very rare, but it does happen. Every contraception method has a failure rate. Compare the failure rate of vasectomy to typically-used oral contraceptives (“birth control pills”): 1-2 pregnancy per 2000 men who use vasectomy versus 2-8 pregnancies per 100 women/year who use pills. Vasectomy is one of the best birth control methods available, but no method is 100% certain.

Vasectomy is permanent. After vasectomy a man is no longer able to get a woman pregnant. If you are unsure about wanting (more) children some day, or don’t know, vasectomy might not be a good choice for you. Even if you feel 100% sure today about having a vasectomy, it is always possible that in the future your life will change and so will your desires about children. Some men, especially those who are young or who have no children, may want to consider sperm storage. We would be happy to provide resources for sperm storage. A surgical procedure does exist to reverse vasectomy; but this operation, called “vasovasostomy,” is expensive and does not always work. On average, only half of couples that try having children after reversal do have a child. We do not do reversals. For information about this, we can refer you to a urologist who does reversals.

The semen check is a very important part of a vasectomy. Vasectomy is extremely effective but it can take up to 3 months to start working. You should not consider yourself “clear” until a semen check under a microscope verifies that your semen no longer contains viable sperm. Until then, another method of birth control must be used or pregnancy can occur. The semen check is an important part of vasectomy, but bringing the sample in too soon can give you a scare. Sperm can hide in the prostate and seminal vesicles for 2-3 months, so early on a sperm count could be positive even though the vas tubes were sealed. Waiting allows the hidden sperm to be flushed out. There is a very rare chance that the tubes can grow back together after a vasectomy. After three months, the semen analysis should show if this occurred. The sample can be collected in the comfort of your own home, in the sterile container provided by the clinic. Most men have no more sperm in their semen the first time it is tested. Sometimes it takes more than one test before it is clear of sperm. For most men, the semen check is a simple, last step in the process to ensure a successful vasectomy.

In New York City, the minimum age for a vasectomy is 21. For men who are 21 or older, common sense applies. Vasectomy is permanent, so don’t enter into the choice lightly. This is a decision that will influence the rest of your life. From a physician’s point of view, it is important to do the right thing and that means not performing a procedure on anyone who is not able or mature enough to consent. (This means that he must be able to understand how the procedure works including its permanent nature, risks, benefits, and alternatives.) Remember that you change and grow much in your 20's and 30's. Relationships change and partners change. All men, especially young men or those with no children should consider this decision very carefully. From a practical point of view, US federal funding also will not cover a vasectomy unless the patient is over 21. The Title X program from the Public Health Service requires that “the individual is at least 21 years old at the time consent is obtained” and “the individual is not a mentally incompetent individual.” (section 50.203 of Subpart B from the Title X document from the US Department of Health and Human Services).

Major chronic pain after a vasectomy is very rare. The vast majority of men have no issues with pain at all. Some studies have reported various levels of chronic pain or discomfort after a vasectomy. Most men aren’t bothered by this, but there have been reports of a small minority (1%) of patients who feels substantial ongoing pain after a vasectomy. No-one really knows what causes this, but it is thought to be similar to the pain some people feel years after relatively small injuries. The only way to avoid any chance of chronic pain after any surgery is to not have the surgery. Fortunately, significant chronic pain after a vasectomy is so rare that most men will never have to worry about it.

Absolutely. No method of contraception is perfect, but vasectomy is an excellent method for people who want permanent contraception. The vast majority of men are extremely happy with their vasectomies. We feel honored to help men achieve this excellent method of contraception.

New York law has established standards governing the performance of sterilization in New York City. "Sterilization" means any procedure or operation, the purpose of which is to render an individual permanently incapable of reproducing, and includes vasectomy. These laws, written in NY Code - Section 17 Chapter 4: Standards Governing the Performance of Sterilizations, include standards to ensure that patients have all the information they need to make an informed decision that is free of coercion. N.Y. ADC. LAW § 17-404 : NY Code - Section 17-404 includes a waiting period of 30-180 days. In New York City, therefore, it is illegal to perform a vasectomy less than 30 days or more than 180 days after voluntary informed consent to sterilization has be given. This consent must be documented by signing a special Sterilization Consent Form LDSS-3134. A witness must also sign. Signing reaffirmation of consent on the same form on the day of the procedure is also a legal requirement in New York City. These laws parallels the Federal regulations for federal funded-sterilizations. The wait period is not intended to be a burden. It is meant to protect individuals and "to ensure that every patient has a reasonable time to consider his or her decision and possible alternative methods of contraception before the operation is performed." We understand the inconvenience this may cause.

As family physicians, all of our associated doctors, female and male, have extensive experience with male patients. Our clinical expertise and communication styles allow us to put our patients at ease and to provide excellent care. Your safety and comfort are our goals. Because we treat men with dignity and respect, our male patients find our female doctors comfortable to talk with. We are extremely gentle with procedural care, and have the utmost respect for the privacy of our patients. You are welcome to come in or call for a consultation prior to scheduling any procedure.