Last updated: 02/17/2009

Vasectomies are often performed in the doctor's office or an outpatient clinic using local anesthesia. The area around the patient's scrotum (the sac containing the testicles that produce sperm) will be shaved and cleaned with an antiseptic solution to reduce the chance of infection. A small incision is made into the scrotum. Each of the vasa deferentia (one from each testicle) is tied in two places with nonabsorbable (permanent) sutures and the tube is severed between the ties. The ends may be cauterized (burned or seared) to decrease the chance that they will leak or grow back together.

"No scalpel" vasectomies are gaining in popularity. Instead of an incision, a small puncture is made into the scrotum. The vasa deferentia are cut and sealed in a manner similar to that described above. No stitches are necessary and the patient has less pain. Other advantages include less damage to the tissues, less bleeding, less risk of infection, and less discomfort after the procedure. The no-scalpel method has been used in the United States since 1990; as of 2003, about 30% of vasectomies are performed with this technique.

The patient is not sterile immediately after the procedure is finished. Men must use other methods of contraception until two consecutive semen analyses confirm that there are no sperm present in the ejaculate. It takes about four to six weeks or 15–20 ejaculations to clear all of the sperm from the tubes.

In some cases vasectomies may be reversed by a procedure known as a vasovasostomy. In this procedure, the surgeon reconnects the ends of the severed vasa deferentia. A vasectomy should be considered permanent, however, as there is no guarantee of successful reversal. Vasovasostomies are successful in approximately 40–50% of men.