The main factor affecting vasectomy success is the lack of follow-up by the patient, who may mistakenly believe the procedure is instantly effective. It may take up to three months for sperm to leave the reproductive tract, so other forms of birth control are necessary during that time. Any pain or infection should be brought to the attention of a medical professional to avoid lasting injury and harm.
Vasectomy is an outpatient procedure that usually takes place in a urologist’s office. After local anesthesia is administered, small incisions or punctures are made in the scrotum and the vas deferens leading from the epididymis are pulled through. They are then cut and a section may be removed, after which the ends are tied or cauterized shut. Complications are rare, and sexual function should not be impaired. The surgery takes about 15 minutes.
The patient should use back-up birth control methods for three months to allow sperm to leave the reproductive tract completely. Follow-up fertility testing monitors their decline. Two negative tests are necessary before back-up methods can be discarded. Yearly checks are recommended to monitor vasectomy success.
Surgical error and spontaneous reattachment of the tubes are not usually factors affecting vasectomy success. If the patient does not allow sufficient time for the residual sperm to leave the system, an accidental pregnancy may result. Some patients do not listen to their doctors and discard birth control too soon. They may assume that the vas deferens recanalized, but this rarely happens.
Vasectomy success is highly assured as a permanent form of birth control. Reversals, called vasovasostomies, are more expensive and less guaranteed than the initial procedure. Patients should be as confident as possible that they do not wish to have children. In about 40% of men, sperm antibodies can develop that make it difficult to maintain viable sperm after a reversal. With a long interval between the initial procedure and the reversal, the chance of a pregnancy occurring drops to 30% or less.
It is very important to heed the doctor’s instructions and schedule follow-up testing. After surgery, pain can usually be managed with over-the-counter medications or a bag of ice. There is no other way to know when sperm has been cleared unless a pregnancy occurs. Without good information prior to surgery, patient expectations of effectiveness could be unrealistic. Doctors should provide adequate counseling and instruction before the procedure to ensure compliance and vasectomy success.
