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Vasectomy

How it is done, who can have one, recovery, semen analysis and risks.

Dr. Petronio Melo, urologistCRM-SP 157.598 · RQE 70.275
Reviewed by Dr. Petronio Melo on November 8, 2026
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Drawing of the path of sperm, with the vas deferens interrupted
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Quick answer

A vasectomy is a minor operation, which I do with local anesthesia and sedation, that interrupts the vas deferens, the tubes that carry sperm.1,2 It is a permanent method of contraception, and the other method can only be stopped after a semen test confirms the result.1,5 In Brazil, the law requires being over 21 or having at least 2 living children, with 60 days between the request and the operation.3 A vasectomy does not protect against sexually transmitted infections.2

What it is

Sperm leave the testicle through the vas deferens and join the fluid from the prostate and seminal vesicles. A vasectomy interrupts this path. Semen still comes out at ejaculation, without sperm.

Schematic animation: the tube is interrupted, and sperm no longer reach the semen.

Who can have one

Brazil's family planning law allows a vasectomy for people with full legal capacity who:3

  • are over 21, or have at least 2 living children
  • have waited at least 60 days between expressing the wish and the operation
  • have recorded the decision in writing, after receiving information about risks, side effects, the difficulty of reversal and reversible methods

Since Law 14,443 of 2022, spousal consent is no longer required.4

How it is done

I do the vasectomy in hospital, for safety, with local anesthesia and sedation. I use the traditional technique, through a small opening in the scrotum. The operation takes about 30 minutes, and the stitches are absorbable.

There is also the no-scalpel vasectomy, and the American guideline recommends minimally invasive techniques such as this one.1

The tubes are interrupted on both sides. The techniques recommended by the guideline have occlusion failure rates consistently below 1%.1

Recovery

  • Pain and swelling for about a week are common, and a simple painkiller usually takes care of it.5
  • I advise returning to work after 1 week.
  • Sport and lifting wait until after 1 to 2 weeks.5
  • Snug underwear helps for about a week.5
  • Sex can resume after 1 week, still with protection, because of the risk of pregnancy.
  • At first, erections may hurt and there may be a little blood in the semen. This usually passes quickly.5

When the vasectomy starts to work

Protection is not immediate. There are still sperm along the path after the operation, so another method of contraception is still needed until the test confirms the result.5 I order a single semen analysis, 3 months after the operation.

Vasectomy timeline: written request, at least 60 days of waiting, operation, about 3 months with another method of contraception, semen analysis and, once the result is confirmed, stopping the other method.
Diagram: from the request to being able to stop the other method.

The American guideline allows the other method to be stopped when a fresh semen sample shows no sperm or up to 100,000 non-moving sperm per mL.1

Risks

A vasectomy is usually safe, and serious effects are rare.8 Possible problems include:

  • bruising and mild swelling8
  • infection that needs antibiotics8
  • a granuloma, a small lump, usually of no importance8
  • chronic testicular pain. In a review of studies, post-vasectomy pain syndrome occurred in 5%, with variation between studies6
  • failure, which is rare, in which the tubes reconnect1

Prostate cancer. A review of 37 studies found a small association with localized prostate cancer. In studies adjusted for PSA screening, there was no link with high-grade, advanced or lethal tumors.7

Sex life. There is no evidence that a vasectomy affects sexual performance or pleasure in the long term.5

Is a vasectomy reversible?

Reversal may be possible, but it does not always work.2 That is why the choice should be made as permanent, and the law requires the difficulty of reversal to be explained beforehand.3

When to see a urologist

  • If you want to talk about vasectomy and clear up doubts before deciding
  • If you have fever, growing swelling or discharge from the incision after the operation
  • If testicular pain does not go away
  • If the semen analysis still shows sperm

Frequently asked questions

What is a vasectomy?

It is a minor operation that interrupts the vas deferens, the tubes that carry sperm from the testicles. It is a permanent method of contraception.1,2

Who can have a vasectomy in Brazil?

Men with full legal capacity who are over 21 or have at least 2 living children, with 60 days between expressing the wish and the operation.3

Does my wife need to authorize it?

No. Law 14,443 of 2022 revoked the requirement for spousal consent.4

Does a vasectomy hurt?

I do the operation with local anesthesia and sedation. Afterwards, some pain for 1 to 2 weeks is common.2

How long does recovery take?

I advise returning to work after 1 week. Sport and lifting wait until after 1 to 2 weeks.5

When can I have sex again?

After 1 week, still with protection, because there is a risk of pregnancy until a test confirms the result.

When can I stop using another method?

Only after a test confirms the result. The American guideline allows stopping when a semen sample shows no sperm or up to 100,000 non-moving sperm per mL.1 I order a single semen analysis, 3 months after the operation.

Does a vasectomy affect sex life?

There is no evidence that it affects sexual performance or pleasure in the long term.5

Is a vasectomy reversible?

Reversal may be possible, but it does not always work.2 That is why the decision should be taken as permanent.

Does a vasectomy cause prostate cancer?

A review of 37 studies found a small association with localized cancer, but not with high-grade, advanced or lethal tumors in studies adjusted for PSA.7

References

  1. Sharlip ID, Belker AM, Honig S, et al. Vasectomy: AUA guideline. J Urol. 2012;188(6 Suppl):2482-91. AUA
  2. National Health Service (NHS). What is a vasectomy? NHS
  3. Brasil. Lei nº 9.263, de 12 de janeiro de 1996. Planejamento familiar. Planalto
  4. Brasil. Lei nº 14.443, de 2 de setembro de 2022. Planalto
  5. National Health Service (NHS). Recovering from a vasectomy. NHS
  6. Auyeung AB, Almejally A, Alsaggar F, Doyle F. Incidence of Post-Vasectomy Pain: Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020;17(5):1788. PubMed
  7. Baboudjian M, Rajwa P, Barret E, et al. Vasectomy and Risk of Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol Open Sci. 2022;41:35-44. PubMed
  8. National Health Service (NHS). Complications of a vasectomy. NHS

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