How Does Vasectomy Work? Fact VS Fiction

A common myth among the general public is after having a vasectomy your scrotum will hang lower. This is not true.

A vasectomy procedure results in both vas deferens being divided. Although it would seem like the vas deferens provide support to the testicles, the truth is the vas deferens do nothing to provide support of the testicles.

The scrotum is composed of skin, very thin layers of muscular tissue, and a very tough layer of connective tissue called fascia.

The scrotum is actually several smaller internal sacs within a single larger external sac of scrotal muscle and skin.

The smaller internal fascial sacs each contain, support, and protect each testicle. The thin muscular layer surrounds the fascial sacs and testicles and the muscular layer contracts or relaxes to raise or lower the scrotum to help regulate the internal temperature. 

The scrotum holds the testicles outside the body because human sperm require a lower temperature than normal body temperature for proper sperm production and development.

Testicular support is exclusively provided by the fascial sacs that surround each testicle and, to a lesser extent, the skin and muscle of the scrotum. 

The vas deferens (the tubes divided during a vasectomy) do not provide testicular support or regulate the height of the testicles. When you have a vasectomy you will not experience a drop in your testicles or an elongation of the scrotum because the main support structures of the testicles are not for the vas deferens tubes.

The scrotal muscle supports the testicles. When the scrotal muscle contracts (ie when you are cold or frightened) the testicles are held close against the body. When the scrotal muscle relaxes (ie when you are hot or relaxed) then the testicles are lowered to their lowest position.

Vasectomy Myth: After vasectomy your testicles will drop.

Vasectomy Fact: Vasectomy will not cause your testicles to drop because the vas deferens are not the main support for the testicles. The scrotal muscle and internal sacs provide support for the testicles. Vasectomy does nothing to the scrotal muscles or internal support sacs.

The blood vessels provide blood supply to the scrotal structures and provide nourishment to the sperm and hormone making cells in the epididymis and testicles. 

The blood vessels absorb hormones produced by the testicles and transport these hormones to the entire body. The nerves are adjacent to the blood vessels. The nerves provide the necessary feedback to let you know when your ‘family jewels’ are in harm’s way.

A vasectomy has minimal impact upon the blood vessels and the nerves of the scrotum. 

The scrotal nerves are part of the visceral nervous system. The visceral nervous system is a primitive network of nerves that work well to transmit sensation but are not smart enough to always help the brain localize where pain is coming from.

Although we all know scrotal nerves transmit pain extremely well, these nerves are much easier to anesthetize with local anesthetic when compared to other types of nerves. This is why vasectomy can easily be performed under local anesthesia.

Vasectomy Myth: After vasectomy sex will be less pleasurable.

Vasectomy Fact: Vasectomy does not involve the nerves and does not change the blood supply to the testicles. Many studies suggest improvement in sexual satisfaction after vasectomy for both men and women due to the removal of the fear of pregnancy. 

Most patients report no changes after vasectomy and some will even say everything about sex gets better!

The testicles are responsible for producing testosterone. 

Testosterone is absorbed by the blood vessels and transported throughout the body by the circulatory system. The hormones produced by the testicles also help sperm development in the epididymis. Vasectomy does not change the production of hormones. 

Vasectomy only causes blockage in the vas deferens. The vas deferens only transport sperm. The vas deferens does not make testosterone and the vas deferens does not transport testosterone.

Vasectomy Myth: After vasectomy your hormones will change and you will be less of a man.

Vasectomy Fact: Vasectomy does not decrease or change testosterone production.

This myth does have some truth to it.

Sperm are made by the testicles. Hormones are also produced by the testicles.

Hormones produced in the testicles assist with sperm creation and maturation. 

The sperm move into the epididymis where they further develop and mature. The epididymis is the collection of small tubes located on the back of the testicles. 

As sperm graduate from the epididymis, they move into the vas deferens and up into the body.

After vasectomy, the sperm collect in the vas deferens below the vasectomy site. These sperm remain there and are gradually degraded and absorbed by the body. Overtime this causes a slow down in the creation of new sperm in the testicles 

As time after vasectomy increases sperm production gradually decreases. 

It has been estimated sperm production decreases about 3% each year after vasectomy. This is one reason vasectomy reversal success is highest in the first five years after vasectomy and reversal success is the lowest fifteen or more years after vasectomy.

Vasectomy Myth: Vasectomy makes you stop making sperm.

Vasectomy Fact: As the length of time increases after vasectomy, the testicles may begin to produce less sperm as a direct result of a vasectomy procedure. 

Decreased sperm production often goes unnoticed after vasectomy. This is only a problem if you are seeking a vasectomy reversal to restore fertility.

As sperm are produced in the testicle, they slowly travel through the epididymis and mature. These mature sperm then travel from the epididymis, up the vas deferens, and are stored inside the pelvis in storage areas located just behind the prostate.

Vasectomy interrupts the transport of sperm. The vas deferens can best be thought of as the ‘transport highway for sperm’. Interruption of the vas deferens stops the transportation of sperm but does not alter or otherwise change the testicles’ production of hormones or the continued creation of sperm.

Vasectomy Myth: After vasectomy everything changes.

Vasectomy Fact: Vasectomy only blocks the tubes that allow sperm to travel up from the testicles.

Using a comparable analogy: if a plumber turns the water off to your house then your house will not have any water. You can safely be assured your electricity, heating and air, and television will continue to work because these are different systems.

Vasectomy is a procedure which only blocks transport of sperm up the vas deferens. After vasectomy the only thing that changes is your fertility.

When you have a vasectomy procedure you can safely be assured your other bodily systems will continue to work as intended!

Vasectomy does one thing…and one thing only. Vasectomy causes blockage of the vas deferens and permanently prevents pregnancy.

Erections are caused by increased blood filling the penis. Sexual drive is caused by the brain interpreting external arousal stimuli. The vas deferens has nothing to do with sexual arousal, erection, or orgasm. 

In general, 80% of our patients report no change in erections or sexual drive after vasectomy. In fact 10% of patients report improvement in these same areas!

Medical studies have revealed many couples report improvement in their sexual lives after vasectomy. This improvement is mainly due to the removal of fear or anxiety over possible pregnancy. 

Vasectomy may improve your sexual life!

Each vas deferens travels from the scrotum and into the pelvis. The vas deferens then becomes larger once inside the pelvis and just before the tubes enter into the prostate. 

This larger area is called the dilated ductus deferens and this is the sperm storage area. This is where sperm ‘hang out’ until they are released with ejaculation.

A vasectomy interrupts the transport of sperm to the internal sperm storage areas. Although the blockage caused by the vasectomy is instant there are millions of live sperm in the storage areas above the vasectomy site.

Even with a successful vasectomy, live sperm will remain in the sperm storage areas until they are released.

Failure to use a back up method during the first three months after vasectomy is the most common reason for pregnancy. Pregnancy caused within the first three months of having a vasectomy is usually the result of sperm in the storage areas made before the vasectomy procedure.

Vasectomy Myth: Vasectomy is instantly effective.

Vasectomy Fact: Vasectomy instantly causes interruption of sperm transport but vasectomy is not instantly effective at preventing pregnancy. 

After vasectomy you have live sperm stored in the vas deferens above the vasectomy site and you can cause pregnancy until these sperm are cleared.

Technically this is accurate but the amount of decrease is so small it goes unnoticed by most people.

Each vas deferens travels up from the scrotum and into the pelvis. The vas deferens each get larger and then join with the seminal vesicles and prostate. 

The seminal vesicles create fluid that nourishes sperm and assists with sperm transport during ejaculation. The fluid from the prostate also assists with sperm transport but also energizes the sperm during ejaculation.

The seminal vesicles and the prostate secret over 95% of the fluid released during ejaculation. The actual volume of sperm in the ejaculate is very small (less than 5% of the total volume of the ejaculate).

Describing a large cup of coffee provides a great analogy for how much fluid the prostate and seminal vesicles provide during ejaculation. The coffee in the cup is comparable to the fluid released during ejaculation. The sperm in the ejaculate add as much volume as would several packets of sugar when added to a large cup of coffee, which is essentially an unnoticeable amount of volume.

After vasectomy some may notice a slight change in the color of their ejaculate because of the absence of sperm but the volume of fluid is only minimally decreased and often unnoticeable.

Vasectomy Myth: After vasectomy the amount of fluid you ejaculate during intercourse decreases.

Vasectomy Fact: Vasectomy will minimally decreases the amount of fluid during ejaculation. Most patients will not notice a difference in their semen volume or appearance after a vasectomy procedure.

There is a widely believed myth that vasectomy causes prostate cancer. This myth has been supported by poorly conducted research that shows a link between vasectomy and prostate cancer.

Prostate cancer is common. In the medical field there is a saying, ‘Most men die with prostate cancer and not from prostate cancer.”

Asymptomatic small areas of prostate cancer are commonly discovered in patients who die from other causes. This is how we know prostate cancer is common. 

Vasectomy is a common procedure among patients who have good access to health care. People who have vasectomy are more likely to see physicians regularly and take better care of themselves. These same people will have more opportunities for a doctor to diagnosis them with asymptomatic prostate cancer than when compared to those who don’t get regular healthcare.

People who don’t have vasectomy are typically not as connected to the health care system and don’t see doctors as often as people who have vasectomy. These people are less likely to be diagnosed with asymptomatic prostate cancer because they do not access the health care system as often as people who take better care of themselves.

Most research showing a link between vasectomy and prostate cancer suffers from observation bias. Well done medical studies demonstrate no association between vasectomy and developing prostate cancer.

Myth: Vasectomy causes prostate cancer.

Fact: Prostate cancer is usually silent and common. Patients who get vasectomy usually have better access to the health care system and have more opportunities to be diagnosed with common asymptomatic cancers than compared to patients who only see a doctor when they have a problem.