Men who are interested in family planning may want to look into vasectomy. This simple procedure is fairly quick and can be reversed. VCU Health offers advanced techniques and diagnostic workups for both vasectomy and reversal. Learning more about vasectomy will help you make the family planning decision that’s right for you.

In this article, Luriel Smith-Harrison, M.D., an assistant professor in the Division of Surgical Urology at VCU Health, dispels misinformation on the process, recovery and reversal of vasectomy.

Vasectomy: From consultation to surgery

Your first step in exploring vasectomy is to visit a doctor for a consultation. Smith-Harrison indicates that men typically attend this consultation by themselves, but sometimes their partner is present to ask questions. You will have a full exam plus a complete and honest discussion about the full procedure. It is not uncommon for men to take a few months after the initial exam to proceed with the vasectomy.

The procedure takes about 15 minutes and requires no hospital stay. “Basically, we put the vas (the two little tubes that take sperm from the testicle to the outside world) in discontinuity,” Smith-Harrison explains. “We block them. We now use what we call a ‘no-scalpel procedure’ so the discomfort and pain is significantly less than the ‘olden’ days.”

Insurance coverage for the procedure varies by carrier. Some insurance companies have specific pre-prescribed protocols for coverage eligibility. Many companies cover at least some portion of the procedure.

Recovery from vasectomy

The good news about current vasectomy procedure is the abbreviated recovery time. Smith-Harrison advises taking it easy the first day after your surgery. He recommends no heavy lifting for about a week, limiting the amount you carry to 10 pounds or a jug of milk. Expect to take two weeks off from heavy exercise. “That’s to just limit the likelihood of one of the postoperative risks, which is a hematoma or blood clot in the scrotum,” he explains.

It’s worth noting that your pipes aren’t clear of sperm immediately. “You still have swimmers in the tubes, and we have to flush them out,” Smith-Harrison states. A semen analysis after two or three months should indicate when there are no more sperm. To prevent unplanned reproduction, use other birth control methods until your doctor says it’s OK.

Reversing a vasectomy

Circumstances may change and you may one day wish to reverse your vasectomy. “While you have a vasectomy, your testes are still working,” Smith-Harrison points out. “The factory is on. It’s just blocked.” Your team at VCU Health can discuss options for having children after vasectomy.

Reversal is a bit more involved than the original procedure. “We are basically trying to take a hollow piece of spaghetti and sew it back together with a suture that is finer than your hair.”

The reversal takes about two to four hours and requires an incision, so you may experience some discomfort.

“If you look at the data, the success rate of getting sperm back in the ejaculate is about 95 percent,” Smith-Harrison says. “There are some instances where it’s a little bit more complicated of a surgery, where it drops down to about 65 to 70 percent. But a reconstructive surgery has pretty good odds for a good result.”

Additional men’s health care

Men’s health concerns extend beyond vasectomy or vasectomy reversal. VCU Health can work with you to address:

• Infertility issues, including those related to spinal cord injuries and varicoceles (enlarged scrotal veins that can impede sperm production)
• Conditions relating to the penis, such as Peyronie’s disease or erectile dysfunction
• Hormone management/hormone therapy.

We also address non-reproductive urology concerns, such as prostate cancer and genitourinary cancers. They offer surgical and non-surgical treatment options for a wide spectrum of urinary tract, bladder and kidney issues.

With the heightened safety considerations of the COVID-19 pandemic, VCU Health is providing patient care through both in-person visits and virtual appointments. “The same excellent care is accessible from anywhere,” Smith-Harrison notes. For virtual visit scheduling, call (804) 828-9331. Learn more at vcuhealth.org/urology.

Click here to listen to an interview on this topic with Dr. Luriel Smith-Harrison, an assistant professor in the Division of Surgical Urology at VCU Health.