How permanent are vasectomies?

July 8, 2020

Why are we a leader in performing vasectomies? First of all, we have some of the friendliest, kindest, and best staff around. When I started the practice, I was reminded that we’d only be as good as the people we surrounded ourselves with.  Years later, we are proud to live by that motto, and it shows.

Secondly, repetition breeds results. Some of the best surgeons I worked with did the same surgery, the same way, over and over.  And as a junior assistant, it got boring.  But over my years of training, I learned that those were the best surgeons, with the best outcomes.  And with our vasectomies, after about 5000 cases, I’d like to say we’re the Le Bron or Steph Curry of vasectomies in Austin.  Repetition has made us continually evolve and improve our technique to minimize complications, improve outcomes, and truly make this a 20 minute procedure with a fast weekend recovery.

Using multiple techniques within the vasectomy, we aim to have a success rate that approaches over 99%.  In the literature, vasectomies have a lower failure rate than condoms, birth control pills, IUD and most other sterilization techniques.  We use a combination of cautery to seal both ends of the vas deferens, tie off both ends, as well as removing a segment of vas.  In addition, one side of the vas is turned pointed in the opposite direction from the other vas.  Most techniques use one of the methods.  We use each of the methods to maximally improve our success rates.

The biggest danger in vasectomies is the false belief that you are sterile after the procedure.  FALSE.  It takes 30 ejaculations typically, over a 90 day period to clear the pipes, at which point we have our patients do a simple at-home test to verify success of the procedure. After and ONLY after verification of success, can you have intercourse without protection.

Once cleared of sperm, no further checks are typically necessary, unless requested.  In some situations, people may request a reversal of the vasectomy.  Literature suggests that there is a 90-95% success rate in return of sperm in the first 5-7 years following vasectomy.  Having said that, as the male ages, and the length of time since the vasectomy increases, especially 10+ years out, the success rate drops precipitously. Important to note, in some cases, although there is return of sperm after a reversal, it may be at lower numbers, requiring IUI or IVF (assisted reproduction) to achieve pregnancy.