Before having this procedure, all men must be sure that they are done having or do not ever want to have children. The reason for this is simply that a vasectomy is meant to be a permanent means of male sterilization. While we can do vasectomy reversals, these can be costly procedures which result in successful pregnancies in only about one half of cases. The bottom line - make sure you and your partner (if you have one) do not want any more children... ever!
Potential vasectomy patients should know that there is a failure rate of around 1 in 1,000 to 1 in 2,000. All men should have a negative post vasectomy semen analysis prior to commencing with unprotected intercourse. Men also have the option of having a secondary sample checked as well, which can be done at any point after the first collection, even years later for those that just want to be sure. Current AUA guidelines recommend that only a single negative sample (defined as fewer than 100,000 non moving sperm) needs to be collected, but it is very very important to obtain this sample. Samples are usually collected two to three months after the procedure to allow time to "clean out the pipes" and eliminate residual sperm.
There are many different variations of the technique used to perform these procedures. Current guidelines state that cautery (burning, welding closed) of the vas deferens (tube that carries the sperm) comes with the lowest risk of failure. These are usually done as brief in office procedures with a local anesthetic and minimal discomfort. Rest and ice after the procedure are critical to aid the healing process. Men should avoid strenuous activity and sexual intercourse for about one week after the procedure. All men should also be aware that this procedure does not protect against sexually transmitted diseases.
As with any surgical procedure, talk to your doctor and make sure that you feel comfortable with him or her before proceeding.