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How Painful Is a Vasectomy, Really?

Oftentimes the decision to get a vasectomy is the toughest part of the whole procedure. That said, there are ways to ease discomfort.

So you’re thinking about getting a vasectomy. Doesn’t that hurt? For most men, a vasectomy isn’t too painful, but there may be some discomfort involved. Plus, these days, urologists offer options for how they perform a vasectomy, which makes it less painful than ever before.

The most important thing to realize is that you should view a vasectomy as a permanent form of birth control. Once you make the decision to get one, it can be difficult or impossible to reverse.

“You should never go into a vasectomy with a plan to have a reversal,” says Dr. Kevin Cwach, MD, a urologist at The Iowa Clinic’s West Des Moines campus. “This is not a temporary contraceptive method. Getting a vasectomy is something you want to be sure about before you have one.”

A visit with a urologist will help you learn more about the procedure before moving forward with a vasectomy. In this blog post, we’ll cover general information about the procedure. You'll learn about some options available to help reduce pain. And we’ll provide some recovery tips.

How complex is a vasectomy procedure? And does it hurt?

A vasectomy is a permanent form of male birth control that blocks sperm from leaving the testicles and reaching the urethra where it joins with the fluid portion of the ejaculate. After a vasectomy, a man can still produce semen like normal but it will no longer contain sperm.

Vasectomy Fast Facts

A vasectomy is a simple sterilization procedure that:

  • Is typically performed right in your urologist’s office. You’ll want to show up to your appointment freshly bathed or showered with your scrotum trimmed of excess hair.
  • Takes less than 30 minutes and does not require a hospital stay.
  • Does not affect libido (sex drive) or testosterone levels.
  • Permanently — but not immediately* — prevents pregnancy.

*You’ll want to use a secondary form of contraception for about three months after your vasectomy until your doctor gives you the all-clear following a semen analysis.

“It’s a pretty straightforward procedure,” says Dr. Cwach. “Urologists do them frequently and we follow the same steps across patients. A typical procedure takes about 10 to 20 minutes. The patient lies awake on the table. Everything is done in a sterile environment. We use a local numbing medicine. There is a quick burning sensation, kind of like a bee sting.”

“It’s mostly pulling and tugging pressure after that,” adds Dr. Cwach.

But don’t they use a scalpel? Doesn’t that part hurt?

Vasectomies have changed over the years. A conventional vasectomy is the original procedure that uses a scalpel, but that method is a little old-fashioned now.

The Iowa Clinic uses the no-scalpel vasectomy method in most instances. Instead of making incisions, a dissecting clamp or hemostat — essentially locking forceps with a sharp tip — is used to make 1 or 2 openings in the scrotal sac. Your urologist will gently spread the skin to reveal the vas deferens (tube that transports mature sperm to the urethra). There is one vas per testicle. Another tool, called a ring clamp, holds each vas in place and a small section is removed.

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The no-scalpel vasectomy has a lower complication rate than a conventional vasectomy. Stitches used during the procedure are absorbable. There’s also minimal blood loss with this method.

A Quick Note About Vasectomy Success Rate and Contraceptive Use

Vasectomies have a very high success rate. Less than one percent fail. In rare cases, a vasectomy may reverse itself and one or both vas deferens reattach. Again, this is extremely uncommon.

That said, you’ll still want to use contraception for a little while after the procedure. The Iowa Clinic recommends at least three months, as there may be residual sperm in the tube. A semen analysis at three months will let you know whether there is sperm left or if you’re all clear.

Do I have any alternative options to reduce pain?

The no-scalpel vasectomy method used by The Iowa Clinic is a well-tolerated office procedure that uses local anesthesia to minimize pain in most patients. However, someone with a lower pain tolerance may opt to use nitrous oxide gas to help relieve anxiety and further reduce pain.

“In the last couple of years, we started giving vasectomy patients the option of using nitrous oxide gas — the same kind used at the dentist — to provide more comfort,” says Dr. Cwach. “A nurse monitors the patient and provides oxygen. They can drive themselves home afterward.”

At The Iowa Clinic, the use of nitrous oxide instead of a local anesthetic for a vasectomy is considered an out-of-pocket expense, but the urology department works to keep the cost relatively affordable for patients who are worried about pain during the procedure.

Tips for easing your vasectomy recovery.

Everyone’s experience is variable and everyone has a different pain tolerance. While there may be some residual pain for a few days after a vasectomy, most men feel better after a week or so. That said, there are some vasectomy recovery tips that can make you feel more comfortable.

  • Use acetaminophen or ibuprofen and ice to ease discomfort. An over-the-counter pain reliever and a moldable ice pack or bag of frozen peas can help reduce pain.
  • Wear tighter or more supportive underwear. Athletic underwear or compression shorts are helpful for keeping things in place and supported right after the vasectomy. You may find that loose-fitting clothing is more comfortable once the area heals more.
  • Take it easy for a couple of days. Relax in a recliner or lie down with your feet elevated. You did undergo a medical procedure after all and your body needs rest to heal.
  • Avoid strenuous activity for at least a week. This falls in line with taking it easy, but we’re referring to avoiding activities like strenuous exercise and sexual intercourse.
  • You can shower, but avoid taking a bath. Most people are fine to shower 1-2 days after or even the day of surgery. Just don’t take a bath for about a week or so.

“I have yet to ever need to prescribe a narcotic for anyone,” says Dr. Cwach. “Local numbing often lasts for a few hours and from there you can use pain relievers, ice and elevation.”

After a vasectomy, as with any medical procedure, there is a slight risk of infection and long-term testicular discomfort. That’s in addition to things like bleeding, bruising and/or swelling. Get in touch with your physician if you experience worsening pain or notice any signs of infection.

I’ve decided I want a vasectomy. What now?

Whether you’ve decided you want a vasectomy or you are still weighing your options, an appointment with a urologist will help you get better informed before moving forward.

“At The Iowa Clinic we cater to both types of people,” says Dr. Cwach. “There is the type of person who wants a vasectomy that has done their homework and knows what they are getting into. We offer same-day counseling and can actually move ahead with the procedure.”

“We also have patients with more questions that are not mentally or physically prepared to move forward with a vasectomy,” adds Dr. Cwach. “They may come in just to talk about the procedure and their reasoning for it. We’ll counsel them and they can choose a date in the future.”

You should never feel rushed or pressured into getting a vasectomy. Make an appointment with a urologist to talk things over and take the time you need. In the end it’s your own decision.

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