The first vasectomy was performed on a dog in 1823, when British nobleman Sir Ashley Cooper tied the artery and vein in one of its testicles together and observed no adverse effects (meanwhile, everyone else observed that Cooper was the creepiest dog owner of the 19th century). It wasn’t until World War II that the surgical process of cutting, cauterizing, and blocking the vas deferens (the duct that transfers sperm from the testicles to the urethra) went mainstream for US men.
Since then, vasectomies have taken off thanks to their low cost, simple technique, measurable success (and oddly, marketing around March Madness). It’s doubtless one of the safest and most effective forms of male birth control. But how do vasectomies work, and why is a such an invasive procedure championed by health care professionals? Arash Akhavein, a urologist at Comprehensive Urology at Cedars-Sinai Medical Center in Los Angeles, tells Fatherly what exactly makes these snips go down into a snap.
Vasectomies Are Quick and Relatively Painless
Vasectomies only take 20 to 30 minutes and “can be done in an office setting with local injection of anesthetic with minimal discomfort, or under minor sedation in the operating room,” Akhavein explains. (Tell that to HR). Some surgeons may opt to inject anesthetic around the vas deferens as well, meant to soothe patients further (although that somehow sounds more painful).
It Takes Two, Baby
Most men have two functioning testicles, which means doctors have to address two vas deferens. Special clamps capture each vas tube through the skin of the scrotal sac, and the tubes are then exposed through one or two small incisions. Surgeons then have a choice—they can either make two nicks on each side, or address both with a single, deft cut up the middle. It’s really a matter a personal preference and technique. Hopefully, you’re numb enough not to know the difference.
Brace Yourself, It’s Going to Smoke
Since vasectomies are minor surgeries that only include local anesthesia, yet involve cauterization, men are completely conscious as they watch their balls burn. This is completely normal, painless, and nothing to be alarmed by (but not exactly pleasant, either). Once each vas is exposed, a small piece is removed to create a gap in the tube, then each side is cauterized twice.
“All these measures help assure the complete disruption and closure of the vas to prevent failure of vasectomy because the cut ends do have a strong tendency to reconnect,” Akhavein says, contributing to the estimated 0.15 percent failure rate. Simply, the smoke is good and just because it’s there doesn’t mean there’s a fire. Put the water down.
The Very Minor Aftermath
Once each vas is double-sealed and tied off, the incisions are sealed up with skin glue or a single stitch, which dissolve in one to two weeks. Men can return to work within 24 hours, but are instructed to wear supportive underwear for about a week, and can have sex and masturbate again right around when they can get back to their boxers. It is important to note that the first 10 to 15 times a man ejaculates after a vasectomy there may still be some sperm hanging around, which is why the man should return to have his sperm count tested before discontinuing other forms of birth control. Other minor side effects include pain, bruising, and bleeding, which typically resolve without intervention. Occasionally, a small marble-like mass remains from the knotted vas.
From There, Nothing Really Changes. And That’s the Point
Vasectomies do not impact the production of sperm or the male hormone testosterone and, as a result, do not alter men’s libido in any way. Instead of building up sperm and being sentenced to blue balls for the rest of your life, the sperm is simply reabsorbed into the body, Akhavein says. In other words, the only thing that changes about your sexual experience is the baby that shows up afterwards. And if that’s part of your family’s plan, well, then thank you for smoking.