Vasectomy: what to expect, honestly

Vasectomy is one of the most effective forms of birth control there is. It's usually done in the office under local anesthesia, often with a no-scalpel technique, and takes about 15 to 30 minutes.

What to expect

• Recovery: rest, supportive underwear and ice for a couple of days. Most men return to desk work within two to three days and to heavy exercise in about a week.
• It is not effective right away. Sperm stay in the system for weeks. Use other contraception until a semen test confirms there are none, usually about three months later.
• No protection against STIs. Condoms are still needed for that.

The honest part about pain

Guidelines put chronic scrotal pain after vasectomy at around 1 to 2%. Some urologists think the real number is higher, because men with lingering discomfort often don't go back to the surgeon who operated. Most cases are mild and settle with time, but you deserve to hear this before you decide.

Reversal

Vasectomy should be considered permanent. Reversal is microsurgery, is usually not covered by insurance, and its success falls the longer it has been since the vasectomy. Sperm banking beforehand is an option if you're unsure.

Questions to ask

• Do you use a no-scalpel technique, and is it done in the office?
• When and how do I get my semen test?
• What do you see in your own patients for long-term pain?