About Vasectomy

How it works, benefits & risks

Table of Contents

Vasectomy icon showing 2 x blocked vas deferens

Vasectomy Overview

Vasectomy is the only form of reliable male contraception, and the most effective type of contraception for men and women.

This safe and simple procedure is done under local anesthesia. Complications or side effects are unusual, making it an increasingly popular choice for long-term contraception among couples who want to avoid pregnancy without undergoing other medical treatments or procedures such as tubal ligation or hormonal birth control implants or pills.

Many men believe that getting a vasectomy will stop them from producing semen (the ejaculate), but this is a common misconception. After a vasectomy, ejaculation still feels and looks the same as before because semen is produced by the prostate gland and seminal vesicle glands, which are located downstream from the vasectomy site, just below the bladder. The only difference is Semen no longer contains sperm.

You’ll be glad to know that it has a success rate of over 99% But before you breathe a sigh of relief, there’s one crucial step you shouldn’t skip: the semen test. The test, which should be done about 12-14 weeks after the vasectomy, will determine if there are any sperm present in the semen. This is important as it confirms the success of the surgery in preventing pregnancy. But the good news is, if the semen test is negative, the likelihood of ever getting pregnant is very low – around 1 in 3,000. So you can finally enjoy peace of mind and full control over your reproductive health.

Let’s look at the anatomy. A vasectomy blocks the vas deferens, the two tubes that carry sperm from each testicle to the ejaculatory ducts under the bladder.

Illustration of male genital anatomy before and after a vasectomy
Ring forceps used for no-scalpel vasectomy

Vasectomy Techniques

Introducing no-scalpel and open-ended Vasectomy.

Vasectomy requires that both vas deferens or tubes, are cut and sealed.

The first step is to get to a tube on one side (starting with the left) and bring a loop out through the skin. There are two ways of doing this: traditional vasectomy and no-scalpel vasectomy.

Traditional vasectomy requires two separate incisions on each side of the scrotum to access the vas deferens. This method leaves two wounds that require stitches. In contrast, no-scalpel vasectomy only requires one small incision in the middle of the scrotum. This method is less invasive and has a quicker recovery time. Most vasectomies these days are performed using the no-scalpel technique.

The next step is to block the tube so that sperm cannot pass through. This can be done by occluding (sealing) both the upper and lower ends of the vas deferens (called a closed vasectomy) or by sealing just the upper end while leaving the lower end open (‘open-ended’). The upper end can be sealed with its outside connective tissue layer using a clip or absorbable stitch.

The following flow diagram shows you the steps required to achieve an open-ended vasectomy using an absorbable stitch.

Route to the perfect vasectomy: Illustration of technique from left to right (pre-vasectomy, no-scalpel.v.traditional, open .v. closed, clip .v. suture, absorbable suture .v. non-absorbable suture)
Booking vasectomy icon (calendar with two hands and a heart)

Reasons to get a Vasectomy

How do you play ball with your partner who drops the hint that she is ‘over hormones?’ How do you handle the bombshell? ‘Honey, I’m pregnant!’ Men are not used to grabbing a front-row seat in the contraception department. ‘No worries, mate, she’ll be right’ doesn’t work for contraception.

The top ‘six’ reasons why vasectomy is the contraception of choice for many men:

  1. Plan your life – now more relevant than ever before, with almost half of children in their 20s still living with their parents.
  2. Support your partner who has done the hard yard and says she is ‘over hormones!’
  3. No Oopsie – Vasectomy offers almost bulletproof protection against unintended pregnancy, allowing you to enjoy worry-free sex.
  4. Set & Forget – with no pill to forget. Snip and let slip – free from hormones and medical devices.
  5. Price -Vasectomy is the cheapest form of contraception, with an out-of-pocket cost similar to that of a single five-year cycle of the Mirena intrauterine device.
  6. The environment – an issue cited by a few guys – though rarely a reason on its own.

Ultimately, it’s about setting family size rather than leaving it to chance.

Six reasons why men or couples chose vasectomy as their choice of contraception: life planning, supporting their partner, effectiveness, set and forget, price, the environment
Bar Chart at the top of which is a sperm icon that replaces an arrow upwards

How successful is Vasectomy?

You will, understandably, want a cast-iron guarantee there will be no future pregnancy. However, the vas deferens (tube) can rarely re-join (recanalization).

The first three months are the most common time for recanalisation. These failures should be known failures after the post-vasectomy semen test. The failure rate of known failure should be well under 1%.

Late Failure refers to pregnancy after getting the all-clear from the post-vasectomy sample. Thankfully, this is rare at less than 1 in 2,000 lifelong risk of pregnancy. Note that  the failure rate of other methods of contraception is quoted over a 12-month period. Vasectomy is remarkably effective.

The saying ‘A stitch in time saves nine’ has a certain ring to it when you think of traditional vasectomy!

Comparing Birth Control

Female Contraception Overview
Risk of Pregnancy PER YEARMain BenefitsMain RisksIssues
Combined Pill7% per year (normal use)Low Failure Rate, can reduce period bleeding, can have cycles back-to-back. Often Beneficial for conditions like acne or hirsutism.Deep Vein Thrombosis & Cardiovascular Risk Factors to evaluate include Body mass index, Smoking, Migraine with aura, Family history, increasing age, high BP, Cholesterol, Diabetes, kidney disease etc.Can forget to take the pill.
Progestogen Only Pill9% per year (normal use)Used as a 2nd line oral contraceptive when the combined pill is not recommended. No increased cardiovascular or thrombotic risks.Australian licensed mini pills need to be taken in a 3 hour window each day.The minipill is unforgiving when forgotten – failure rates are high.
Progestogen Injection6% per yearNo increased cardiovascular or thrombotic risks. Periods often disappear completely within 12 months.Progestogenic side effects are usually manageable but women may sometimes report weight gain, mood or changes. Periods often erratic to start with.3 monthly visits to your doctor & practice nurse to get the injection. Need a pregnancy test if late for your next injection.
Progestogen Implant (rod)0.05% per yearPeriods often disappear completely within 12 months.Persistent bleeding beyond 6 months in around 15% of women may require the implant to be removed.3 yearly implant in the inner side of the left upper arm.
Intrauterine Device – Mirena0.2% per yearPeriods usually disappear completely within 12 months – often good for heavy or painful periods.Risk of uterine perforation is around 1 in 1000. Rarely infection or migration of the device.5 yearly re-insertion. Few GPs currently provide this service & most women need a referral to a gynaecologist.
Condom, Cap, RingCondom 18% Cap 12%Caps, Diaphgragm & Vaginal Ring.no systemic risks. Higher rate of failure than many other methods of contraception.Suits only a few women and couples – comes down to personal preference & guidance on use from a health practitioner.
Female Sterilisation0.5% riskLow failure rate at around 1 in 200Higher failure rate & risks (surgical + Anaesthetic) than The Snip.Day Case in a hospital.
Vasectomy1 in 3000 lifetime (after test)The lowest failure rate. Men can get involved!Post vasectomy discomfort affects around 1 in 50 guys.The most important thing is to continue contraception until you get the all-clear after the semen analysis.
Contraception Infographic: comparing price and no. of pregnancies over 10 years (vasectomy, female sterilisation, the combined pill, IUD, female contraceptive implant)
Two curved arrows in opposite directions, for example depicting side-effects

Side effects & Risks

Vasectomy is a surgical procedure, and as with all surgery, side effects are possible.

Bleeding. Haematoma describes internal bleeding that is sufficient to lead to scrotal pain and visible swelling. The haematoma will eventually go away on its own, although a large haematoma may take several months to resolve. On the other hand, minor pin-point bleeding from the skin is a minor inconvenience that is usually solved by pinching the skin for 10 minutes.

All Vasectomists ‘get’ haematomas, but a large Haematoma is rare.

Ultimately, it’s about setting family size rather than leaving it to chance.

Infection. Thankfully, infection after vasectomy is rarer than most people think. Pain, mild swelling and bruising are more likely to reflect temporary inflammatory healing and usually go away without antibiotics. Clinical assessment and experience dictate when to start antibiotics – but vasectomy specialists find that antibiotics are rarely required.

An abscess is very rare but requires surgical drainage. Fornier’s gangrene is (thankfully) exceptionally rare, perhaps 1 in 10,000, although the risk is higher in men with poorly controlled diabetes.

Post Vasectomy Pain. Post-Vasectomy Pain Syndrome is defined as discomfort three months after the procedure that is sufficient to interfere with the quality of life. A granuloma, nerve pain, or epididymal congestion can cause persistent Post vasectomy pain which ccurs in approximately 1-2% of men. Around 1 in 1000 men who have had a vasectomy require an operation for post-vasectomy pain, which is in keeping with the experience of Dr Dick Beatty, who refers patients to a specialist in this field.
It’s worth noting that a small minority of men read extensively about post-vasectomy pain syndrome before their procedure. Being informed is essential. However, anxiety about something that has not happened could make any niggle afterwards seem like impending doom. There is a general correlation between chronic pain and anxiety to the point that science is overwhelming. The pain is certainly not in the guy’s head. However, excessive anxiety may excite the pain pathways and also make post-operative discomfort more difficult to tolerate.
Therefore, men who are excessively anxious about the possibility of PSP prior to the procedure should reconsider all options. After all, you can only accept the small risk or not get a vasectomy. However, the vast majority of men to not experience persistent pain after a vasectomy.
Prostate Cancer. There was some media concern in 2013 that vasectomy may slightly increase the risk of prostate cancer. The American Association of Urology have provided a reassuring statement in 2014 following a detailed analysis. They state that ‘vasectomy is not a risk factor for prostate cancer or for high-grade prostate cancer. It is not necessary for physicians to routinely discuss prostate cancer in their preoperative counselling of vasectomy patients.’
There is further strong reassurance about vasectomy and prostate cancer in a Urology journal. The article was published in 2016 and is called ‘Vasectomy and prostate cancer risk: a historical synopsis of undulating false causality.’
icon depicting a myth


I don’t have time to get a Vasectomy.

Seriously? Do you have time for a baby? At the very least, ensure good contraception that will last until you and/or your partner no longer require contraception.

Expert no-scalpel vasectomy with optimal use of local anaesthetic is not a painful experience.

Your dad may have referred to ‘blue balls’ – now, mostly, a thing of the past.

Good try! Dogs don’t get a vasectomy, they get the lot taken out (castration). The word ‘Sterilisation” includes both vasectomy and castration, which is one reason why vasectomy doctors don’t use the word. Check the history of vasectomy for other reasons including eugenics.

Research suggests that sex is enhanced by vasectomy by eliminating the fear of unwanted pregnancy.

Testosterone is completely unaffected.

Semen is the same afterwards in all five senses.

icon showing regret - eyes down and un-smiling face


Up to 6% of men who have had a vasectomy seek a reversal within ten years of the procedure‎.

Dr Beatty ranks risk factors for regret in the following order:

  • Age under 30 (particularly 25)
  • Not fathered any children
  • Coercion into having a vasectomy
  • Being Single
  • Relationship with a partner is unhappy
  • A recent change of partner
  • There has been the death of a child
  • A very short time between pregnancy and getting a vasectomy


Couples with babies might want to defer a vasectomy until their baby is more than six months of age because of the small risk of Sudden Infant Death Syndrome (SIDS). The risk of SIDS  (‘cot death’) is around 1 in 2000 babies. The age of maximum risk occurs between the age of 2 and 4 months of age.

Younger men, particularly who have not fathered a child, are much higher risk of seeking reversal later. A comparison of men who a vasectomy compared with men who had a reversal of vasectomy found that Vasectomy reversal ‘occurred 12.5 times more often in men who underwent vasectomy in their 20s than in men who were older.’

Therefore, younger men should have a chat with friends and family – just as with any major life decision. Try to get some balanced answers by asking older men and fathers. Try to postpone the decision and use other reliable forms of contraception.

A minority of Vasectomy doctors wouod be comfortable, after a long consent process, operating on a 20-year-old man who has not fathered a child, whilst others doctors would not operate until age 30.

Dr Beatty’s ‘age threshold’ is around 24-25 years of age for a man who has not fathered. Anecdotally, this is about the same age as other vasectomy doctors in Australia.

A man of that age wouldn’t be seeking a vasectomy without being sure now. However, he will be asked to accept the possibility that you would seek a reversal at some time in the future. After all, that’s what the research shows. Saying that ‘I know that I will definitely never ever want kids’ isn’t acknowledging that they might change their mind in the future, whereas saying  ‘I know there is a chance that I may change my mind later, but I still want to get a vasectomy’ is acknowledging uncertainty.

Brain development, and life events may change your priorities.

icon depicting 3 x matching sperm in a fruit (slot) machine ie. sperm banking

Sperm Banking

Consider a vasectomy when you are certain that you do not wish to father any or any more children.

However, some men consider sperm banking prior to vasectomy as a form of insurance against unknown unknowns.

The costs of sperm banking is approximately $600 for the initial banking, and $500 per year for freezing.

A referral from your GP may help to reduce the costs of the service.

Men rarely want to pay thousands of dollars over a 10 year period banking their sperm ‘just in case.’ What risk are you prepared to accept? What price would you pay for certainty? Younger men who have not fathered should consider putting off the vasectomy. However, a young man who is determined to get a vasectomy should certainly consider sperm banking because the risk of regret is so high.

Tests prior to sperm banking will generally include a semen analysis and blood tests. The precise blood tests required vary between providers, and include:

  • HIV
  • Hepatitis B&C
  • Syphilis
reversal of vasectomy icon showing stitching together the 2 ends of the vas deferens


Vasectomy can be reversed though is expensive and does not always work.

The success rate of vasectomy reversal ranges from 50% to 90% depending on the length of time that has elapsed since the vasectomy. Reversal is more successful after a Vasectomy performed <5 years ago compared to a vasectomy performed >10 years ago.

See your doctor for a referral to a urologist who performs vasectomy reversals. Most capital cities have a few urologists who perform reversals, with perhaps 2 to 3 who perform most of them.

You will want to research the success rate of the reversal specialists in your area. A 2021 study of 107 reversal providers in the USA found that ‘ Only one provider provided complete information as defined by REVERSAL score of 12, with the majority (61.7%) of providers achieving score ≤6.’ They concluded that ‘There is significant lack of transparency in publicly available information from VR practices.’

The total price for vasectomy reversal is typically in the order of $10,000 AUD with a medicare rebate of under $1,000. Private health cover can reduce out of pocket expenses by several thousand dollars. The ‘out of pocket’ for a reversal may be as low as $3,000.