Vasectomy is a simple, outpatient procedure that provides safe, permanent birth control for men. It causes minimal discomfort or downtime and prevents pregnancy better than all other available options out there—except abstaining from sex altogether. So, if you’re looking for a permanent option for family planning, vasectomy may be an excellent choice.

“Vasectomy is quick and easy. While I am doing it, my patients and I talk about sports, their kids, and their jobs. Then, 15 minutes later, we’re done,” says Yale Medicine urologist Stanton Honig, MD, director of the Male Reproductive Sexual Health program at Yale and one of the authors of the national urologic guidelines on vasectomy for physicians.

Vasectomy is a very common and safe procedure that does not negatively affect male sexual performance. In fact, in many cases, it actually improves the experience for both patient and partner as worries about an unintended pregnancy are gone.

“After a vasectomy, a man still has erections and ejaculates like normal during orgasm; vasectomy just stops sperm from entering semen,” says Dr. Honig.

A vasectomy is an in-office procedure performed under local anesthesia that prevents sperm from reaching the semen. So when a man ejaculates, he will release semen that does not contain sperm. (Sperm is still produced but is reabsorbed by the man’s body.)

It is a minor, outpatient surgery for men performed by a urologist. About 500,000 men a year have vasectomies, according to the Urology Care Foundation.

This birth control method has the lowest failure rate of all available options: only 1 in 2,000 women gets pregnant following a partner’s vasectomy surgery, according to Dr. Honig. The operation is less painful and less invasive than tubal ligation (an operation to block the fallopian tubes in women, which requires general anesthesia). Depending on your insurance, it may end up being less costly than birth control pills over time.

First, be absolutely sure you don’t want to have children in the future. While a vasectomy can be surgically reversed, you’re smart to be sure that your future plans don’t include having a child, because pregnancy isn’t guaranteed after a vasectomy reversal, and the procedure can also be costly.

There is no preparation needed before a vasectomy other than making sure you have a ride home afterward.

Surgeons use two techniques to perform vasectomies:

• Conventional vasectomy: The surgeon makes one or two small openings in the skin of the scrotum to access the vas deferens (the tube that allows sperm to travel to the semen). He or she then removes a small section of this tube, blocking the passage of sperm. The ends of the vas deferens are cauterized and separated by placing tissue between the ends, a technique called fascial interposition. This is the procedure that results in the lowest failure rate. The scrotal incisions may be allowed to heal on their own or they can be closed with one stitch that dissolves over a few weeks’ time.
• No-scalpel vasectomy: During this procedure, the urologist locates the vas deferens under the skin in the scrotum and clamps it to hold it in place. A small opening is then made through which the vas deferens is gently lifted out. The doctor can then cut, tie, or cauterize the two ends, which are then put back in place. The small opening in the scrotum heals on its own.

Following the procedure, there is a small risk that you’ll have bleeding or infection. Many men also experience minor achiness for a day or two. Although most patients experience no long-term discomfort after a vasectomy, about 1% of men encounter post-vasectomy pain syndrome, which means they have an ongoing ache in the scrotal area.

Studies have shown that vasectomy does not put men at greater risk for heart problems, prostate cancer, or testicular cancer.

After your vasectomy, you should go home to rest. A mild pain medication such as ibuprofen should take care of the postoperative discomfort, which is typically very mild. If you feel sore, apply an ice pack to the testicles.

If your job is sedentary, you can likely return to work within 48 hours. If your job requires heavy lifting, you should rest at home for three to five days before going back to work. Don’t have sex for about a week.

A cautionary note: Although vasectomy prevents new sperm from entering semen, a man will still have plenty of sperm stored in his semen. After a vasectomy, you must continue some form of contraception until you are cleared by your urologist to have unprotected intercourse. For most men, this is within three months. You provide a semen sample either in person or by mail, and your provider will determine if you are cleared for unprotected intercourse.

At Yale Medicine, our urologists have vast experience with this procedure. Dr. Honig is a member of the American Urological Association vasectomy guidelines committee, teaches other urologists how to handle difficult cases, and performs both conventional and no-scalpel vasectomies. He is the chairman of the course on vasectomy at the national urology meeting each year. Our experienced microsurgeons, Dr. Honig and Katherine Rotker, MD, are highly skilled in microscopic vasectomy reversals.

Yale Medicine Urology regularly receives referrals for more challenging vasectomy cases and also performs simple, straightforward cases.

We are experts in male fertility (and infertility) and leading researchers in the field of men’s sexual and reproductive medicine. This ensures you’ll get quality care from a highly skilled surgeon using the latest and best-researched techniques available in vasectomy care today.