FREQUENTLY ASKED QUESTIONS:

1. Can my partner tell I have had a vasectomy?
   There is no significant change in the ejaculate after a vasectomy. Your partner may be able to feel the vasectomy site.
2. Will my sense of orgasm be altered by having a vasectomy?
   Ejaculation and orgasm are generally not affected by vasectomy. Rarely, long-term pain can develop after vasectomy (post vasectomy pain syndrome) which can be somewhat difficult to treat.
3. Can I become impotent after a vasectomy?
   An uncomplicated vasectomy should not cause impotence.
4. Can a vasectomy fail?
   Yes. Sometimes during the healing process, the cut ends of the vas deferens “heal themselves” allowing sperm to get into the ejaculate. Occasionally, even after semen samples have shown clearance of sperm, new channels can form bypassing the vasectomy. This “re-canalization” is found to happen in approximately 4/1 000 vasectomies. Repeat vasectomy is often required.
5. Can something happen to my testicles after a vasectomy?
   Rarely, the testicles may be injured during a vasectomy as a result of injury to the testicular artery. In addition, a hematoma or blood clot may develop in the scrotum next to the testicles.
6. Can I have children after my vasectomy? What if I change my mind after my vasectomy?
   The purpose of vasectomy is to create sterility, or an inability to father children. Vasectomy reversal requires reconnection of the vas deferens ends microsurgically and is not always successful. This procedure may be expensive and may not be covered by standard medical insurance. Alternatively, sperm can be aspirated from the testicle or the epididymis and used for in-vitro fertilization. The success of the above techniques decreases as the number of years after vasectomy increases. The best way to avoid this situation is to carefully and thoughtfully consider non-surgical contraceptive alternatives prior to proceeding with vasectomy if you are not certain permanent infertility is desired
7. Will I be sterile immediately after the procedure?
   NO. Because living sperm are found along the vas deferens tube beyond where it was divided, you will still be fertile immediately after the vasectomy. It generally takes over 20 ejaculations for the sperm to disappear, but we can not be certain that you are surgically sterile until a semen sample is examined using a microscope and no sperm are seen. You need to bring a semen sample for evaluation to the office at about 6 - 8 weeks after your procedure, and if sperm are still present, this evaluation will be repeated approximately monthly until your sample is clear. Other forms of birth control are required until the semen sample is clear.
8. When can I resume sexual activity after my vasectomy?
   Generally within 7-10 days you can resume normal sexual activity. You will not be sterile at this point and need to continue to use other forms of birth control until the semen sample is clear.
9. What are non-motile sperm and what is the significance of persistent non-motile sperm after a vasectomy?
   Living sperm typically move when examined under the microscope. Large series of vasectomies have all shown that in approximately 1-3% of men have persistent non-motile (non-moving) sperm after a vasectomy. The management of people with this finding is controversial, and will be individualized based on your situation. Many men initially with persistent non-motile sperm are eventually found to have no sperm in their semen.

REFERENCES:

1. Griffin, et al.: How little is enough? The evidence for post-vasectomy testing. J Urology. 29-36, July 2005.
2. Halder, et al.: How reliable is vasectomy? Long-term follow-up of vasectomised men. The Lancet. 43-44, July 2000.
3. Christiansen and Sandlow: Testicular pain following vasectomy: A review of postvasectomy pain syndrome. J Andrology. 293-298, May 2003.
4. Simon: When are the chances for an unexpected pregnancy after a vasectomy?. University of Maryland Medical Center Patient Education. September 2002
5. Horan: Long-Term complications of vasectomy. Infections in Surgery. 323, May 1988. UrologyHealth.org

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