Doctor talking to the patient

If you and your partner have decided that you don’t want more children or don’t want to have children at all, you may be considering permanent contraception, also known as sterilization. But once you’ve decided that one of you should be sterilized, you’ll need to decide who will have the surgical procedure, prompting the great debate of vasectomy vs tubal ligation.

Here’s what’s involved in each procedure, including the pros and cons of each, so you and your partner can make an informed decision.

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What Is a Vasectomy?

Vasectomies are usually performed under local anesthesia. During the procedure, a surgeon cuts the vas deferens, the tube that carries sperm from your testicles to your penis; this makes it so that sperm are no longer able to exit your body. After cutting the vas deferens, the surgeon will either burn or tie off the ends.

During a conventional vasectomy, a surgeon makes two small cuts in each side of the scrotum to access the vas deferens. At the end of the procedure, the cuts are stitched closed. The newer, no-scalpel vasectomy involves the surgeon clamping the vas deferens from the outside after identifying it by feel, and then puncturing the scrotum for access to cut and tie the vas deferens. This type of vasectomy doesn’t require stitches and often has a shorter recovery time.

Regardless of the vasectomy method, you’ll probably need a few days to recover. Your doctor will likely recommend that you limit strenuous physical activity and ice the area to reduce swelling and pain. Follow-up is necessary to confirm there are no sperm in your ejaculate fluid.

Having a vasectomy should not affect your sex drive or your ability to have sex. If you have the procedure, seminal fluid will still be produced and will release during ejaculation; the only difference is that the fluid won’t contain sperm.

Vasectomy reversal is possible, but much more complicated; in a reversal procedure, the surgeon reconnects the vas deferens to allow sperm and seminal fluid to mix again.

What Is Tubal Ligation?

Tubal ligation cuts or blocks the fallopian tubes, which carry a woman’s eggs from the ovaries to the uterus. The operative procedure is often performed with a small camera and light called a laparoscope.

First, the surgeon makes small incisions in the abdomen. They may inflate the area with gas for a better view. Then, they’ll insert the laparoscope and instruments to block the fallopian tubes, which are either tied off, clamped, or burned. The incisions are stitched up at the end. Tubal ligation usually involves general anesthesia, though some surgeons use local or spinal anesthesia.

After the surgical procedure, the woman will spend a few hours in the recovery room, but she may be sent home the same day. She may have some discomfort from the gas and will need to rest at home for several days. She may also need to return to have her stitches removed.

Like a vasectomy, tubal ligation should not affect a woman’s sex drive. It also should not affect her period. Tubal ligation is sometimes successfully reversed.

The Pros and Cons of a Vasectomy vs Tubal Ligation

Which is better — a vasectomy or tubal ligation? While both are generally safe, tubal ligation is more complicated than a vasectomy. General or spinal anesthesia are sometimes used for tubal ligation, while a vasectomy only involves local anesthesia. Also, the tubal ligation surgery occurs in the abdomen, where there are more organs and blood vessels exposed than in a vasectomy, which only involves the scrotum.

It’s important to discuss the benefits and potential risks of each procedure with your doctor, and your partner, before making a decision.

To learn more about the vasectomy procedure, visit the UPMC Men’s Health Center or call 1-877-641-4636(4MEN) to make an appointment.

Sources
UPMC, Vasectomy https://www.upmc.com/services/urology/conditions/vasectomy

UPMC, Vasectomy Reversal https://www.upmc.com/services/urology/conditions/vasectomy#vasectomyreversal

UPMC, Tubal Ligation https://www.upmc.com/health-library/article?hwid=abq4875

About Urology

The UPMC Department of Urology treats all manners of conditions involving the urinary tract and male reproductive organs. We treat those disorders both in children and adults. We have a multifaceted team of physicians and researchers working together to provide the best care. We provide cutting-edge treatments, and we continue to lead research into even better methods for diagnosis and treatment. U.S. News & World Report ranks UPMC Presbyterian Shadyside as among the best hospitals in the country for urological care.