Vasectomy is a simple surgical procedure for permanent male fertility control, in which the tube leading from each testicle is cut and sealed in order to stop sperm from reaching the prostate, where it mixes with the semen. This tube is called the vas deferens, hence “vasectomy.” Without sperm in the semen, a man cannot make his partner pregnant.

A vasectomy leaves the patient unchanged except for the fact that the sperm cord (vas) is blocked. The testes still produce sperm, but they die and are absorbed by the body. The level of male hormones remains the same and all sexual characteristics remain the same. The ability to have an erection is also entirely unchanged.

Over 500,000 vasectomy procedures are performed each year in the United States.  The procedure is usually done in an office setting with the use of a local anesthetic such as Xylocaine and takes between 10 and 40 minutes, depending on the surgeon, his technique, and the patient’s specific anatomy. A vasectomy is far safer and far less expensive than female tubal ligation. Furthermore, the effectiveness of a vasectomy can be verified after the surgery with a semen analysis; the only way a woman could know her tubal ligation was ineffective would be if she became pregnant of had expensive X-ray tests.

As with any surgical procedure, the primary risks are infection and bleeding. These risks are generally low for vasectomy. While vasectomy can be reversed surgically at times, its successful reversal cannot be guaranteed, and vasectomy is done with the intent of being permanent. Conversely, the vas deferens can rarely grow back together on its own and cause a pregnancy. This is called recanalization and occurs substantially less than one percent of the time.

Over the years, many questions have been raised regarding possible long-term effects of vasectomy. Issues as to whether vasectomy causes arthritis or atherosclerosis of heart disease have long been put to rest. Most recently, some studies have suggested that vasectomy may cause a slight increase in the risk of getting prostate cancer. By and large, these studies have also been refuted by other urologic data. Studies including tens of thousands of vasectomy patients have shown no clear trends regarding an association between vasectomy and heart disease, arthritis, atherosclerosis, or cancer.

A recent advancement in the vasectomy technique is the no-scalpel vasectomy. In a conventional vasectomy, the physician may make one or two small incisions with a scalpel, and then use sutures or stitches to close them at the end of the procedure. In the no-scalpel method, rather than making an incision, the doctor makes only one tiny puncture into the skin with a special instrument. This instrument is used to gently stretch the skin opening so that the tubes can reached easily.

The tubes are then blocked, using the same method as a conventional vasectomy, but because no incision was made, there is very little bleeding and no stitches are needed to close the tiny opening. The opening will heal quickly with little or no scarring.

A recent advancement in the vasectomy technique is the no-scalpel vasectomy. In a conventional vasectomy, the physician may make one or two small incisions with a scalpel, and then use sutures or stitches to close them at the end of the procedure. In the no-scalpel method, rather than making an incision, the doctor makes only one tiny puncture into the skin with a special instrument. This instrument is used to gently stretch the skin opening so that the tubes can reached easily.

The tubes are then blocked, using the same method as a conventional vasectomy, but because no incision was made, there is very little bleeding and no stitches are needed to close the tiny opening. The opening will heal quickly with little or no scarring.

The technique of the no-scalpel vasectomy was developed in 1974 by a Chinese physician,  Dr. Li Shunqiang, and has been performed on over 8 million men in China. No-scalpel vasectomy was introduced to the United States in 1988 and is now used by many doctors in the U.S. and elsewhere.

Compared to the traditional incision techniques, the no-scalpel vasectomy usually takes less time, causes less discomfort, and may have lower rates of bleeding and infection. Recovery following the no-scalpel procedure is usually complete in five to seven days.

The vasectomy only divides the vas and has no effect on sperm that are already beyond that point. It is important not to have unprotected intercourse until the absence of sperm from the ejaculate has been confirmed with a negative sperm sample after 12 weeks.

Overall, vasectomy is a simple and safe form of birth control which is often preferable to birth control pills, a tubal ligation, diaphragms, or spermicidal. Some men say that without the worry of accidental pregnancy and the bother of other birth control methods, sex is more relaxed and enjoyable than before.