It’s Not Castration: A Urologist Debunks the Most Persistent Vasectomy Myths

Ever since it was leaked that the Supreme Court may soon be overturning Roe v. Wade, online interest in vasectomies has skyrocketed. With approximately half of states expected to deny women abortion rights, men are looking into the surgery with renewed interest, but unsurprisingly, the internet is rife with misleading and flat-out false information about them. 

Simply put, a vasectomy is merely the surgical separation of the vas deferens — the tube that carries sperm to the urethra — from the testes. It’s a minor procedure that takes just 10 to 30 minutes to perform, and it doesn’t affect the production of sperm in someone’s body. Instead, it prevents sperm from leaving the body, making it nearly impossible to impregnate someone. 

But despite its ease, many people still harbor misconceptions about vasectomies. From fears about a decrease in testosterone to the absurd belief that vasectomies are the same as castration, vasectomy myths have the very real potential to frighten men into not getting one, even when they feel it’s the best choice for them and their families. 

And so, I reached out to Darshan Patel, a urologist at the UC San Diego School of Medicine, to address these myths and explain the actual — albeit rare — risks associated with vasectomies.

Claim: Your Sexual Performance Will Suffer

This includes concern about impotence, a decrease in sex drive and even how far and hard you can cum. But according to Patel, there’s no need for worry. “There’s basically no concern regarding worsening cases of erectile dysfunction afterwards, because erections and sperm creation are two separate mechanisms,” he explains. “Also, how far a guy shoots shouldn’t be affected by a vasectomy. A lot of that is the function of the muscles down there,” which, in case you’re wondering, are untouched by a vasectomy. 

There’s also little reason to believe a vasectomy would decrease your sex drive. In fact, Patel says that studies have shown an increase in sexual satisfaction among many men, thanks to not having to worry about condoms or other contraceptives. 

All that said, there have been cases where men report that sex feels different after surgery, but Patel says this is most often a psychological issue where men think it’ll feel different, so it does. In that case, talk therapy can be a solution. Again, per Patel, “anatomically and physiologically, there should be no effect on the things that impact sexual function.”

Claim: Your Testosterone Levels Will Plummet.

If your body was creating testosterone normally before a vasectomy, there’s no reason a vasectomy should change that. This is because the testicles, which produce testosterone, are unaffected. “The testicles will continue to make testosterone that your body will utilize,” Patel explains. “This won’t be affected by a vasectomy, which simply prevents sperm from leaving your body.”

Claim: A Vasectomy Can Change the Appearance of Your Ejaculate.

“We’re just dividing the tube that brings sperm from the testicles to the rest of the ejaculate, so you shouldn’t notice the difference in terms of ejaculation volume or consistency,” Patel explains. “Sperm makes up just about two percent of your ejaculate, and most of your ejaculate comes from your prostate, which will be unaffected by a vasectomy.”

Claim: Sperm Will Build Up in Your Body.

Some guys fear that, since they can no longer release sperm from the body, that sperm will build up inside of them. This is another thing Patel says not to worry about, as the body has natural mechanisms to break down sperm and reabsorb it into the body.

Claim: It’s Major Surgery That Will Leave a Noticeable Scar.

“Nowadays, 95 percent of vasectomies are done in the office with local numbing medicines, so you’re completely awake for the procedure,” Patel explains. “It’s kind of like going to the dentist — you’ll feel us tugging around down there, but you shouldn’t feel anything sharp.” 

Vasectomy procedures can vary. Some doctors use absorbable sutures to close off the vas deferens, while others use titanium clips. He says that most doctors will remove a centimeter or two of the tube, then electrocauterize the ends to scar them off. All of these methods are highly effective, and Patel says that most people who perform vasectomies will use a combination of methods, which further decreases the chances of a failed vasectomy. 

No matter which method they use though, it’s not major surgery, and the scar is tiny. The incision is usually done right along that seam line of your nutsack (also known as your perineal raphe), so it’s hard to see once it heals. Additionally, the cut takes place when the skin is stretched, so the tiny incision is made even tinier when everything relaxes back into place.

Claim: It’s Painful.

While rare, pain can be a concern for vasectomies. “For most guys, this is a minor procedure, and in about a week or two, you should be back to your baseline,” says Patel. “Most pain will be in the first 24 to 48 hours, and over-the-counter pain medications will do the trick, along with the use of an ice pack. However, some guys — about one percent — do experience chronic, lingering pain after a vasectomy, which never gets better. It’s a challenging scenario, and there are other procedures and treatments to help those guys, but it’s an unfortunate complication.”

He adds epididymitis may also occur in about one to two percent of people who get vasectomies. Epididymitis is inflammation where the surgery was performed, and it may progress to an infection. Every now and again, a vasectomy may have to be reversed to treat it, but Patel says that antibiotics and anti-inflammatory medicine will usually take care of it first.  

Claim: The Results of a Vasectomy Are Immediate.

“Immediately after a vasectomy, you’re not necessarily sterile,” says Patel. “There can still be sperm in the tubes that needs to be cleaned out, so we usually tell guys to ejaculate 20 or 30 times over several weeks, then we have them come back for a confirmatory semenalysis.” He also says that he generally advises guys to wait a week before having sex after a vasectomy.

Claim: You Can Still Get Someone Pregnant After a Vasectomy.

“In terms of reliable forms of contraception, a vasectomy blows everything else out of the water,” says Patel. “The success rate is about 99.9 percent in terms of preventing pregnancy. It’s not 100 percent because there have been cases where the two ends of the tube that were cut reconnect, but it’s very, very, very rare. This happens in about one out of every 2,000 cases.”

Claim: A Vasectomy Increases the Risk of Prostate Cancer.

A vasectomy does not increase the risk of prostate cancer. This myth was perpetuated by several old studies that suggested it might, which has led to a bit of confusion. But, even in this case, Patel’s clear that it’s false. “In the past, there were a couple of studies that may have suggested that it increases the chance of getting high-grade prostate cancer,” he says. “But then, about four or five years ago, there was a big, meta-analysis of a bunch of studies on this subject, and it was found that the opposite turned out to be true. There isn’t a relationship between guys getting a vasectomy and getting any prostate cancer.” 

As for what was wrong with those older studies, Patel says that guys with vasectomies are generally a little more aware of their health care and will typically get their regular screenings more often. Because of this, researchers may have found more cases of prostate cancer, but that was likely only because these men got the screenings that all men are supposed to get.

Claim: A Vasectomy Can Shorten Your Lifespan.

Strangely enough, a lot of guys have Googled “Does a vasectomy shorten your life?” Again, the answer is no. As with the prostate cancer myth, Patel says that guys with vasectomies are just more plugged into their health care, and as a result, they may be more likely to catch a health problem earlier than someone who doesn’t get regular screenings.

Claim: It’s Reversible.

If you’re getting a vasectomy, you should be sure that you don’t want more kids — or kids at all. “When guys come in to talk about getting a vasectomy, we tell them that this is considered to be a permanent form of contraception,” Patel says. However, he adds that, in some cases, it can be reversible. This can be done by reattaching the two ends of the severed vas deferens.  

The thing is, vasectomy reversals aren’t guaranteed to work, and they’re much more involved than a vasectomy. They take about three hours, you have to be put under and their done with a surgical microscope. On top of that — unlike a vasectomy — a reverse vasectomy is probably not going to be covered by your insurance, so it’ll cost you upwards of $10,000.

Claim: It’s Castration.

Finally, there’s the most ridiculous claim of all: Despite the fact that your balls remain on your body after a vasectomy, many men equate it with castration. To that, Patel reiterates one last time, “Castration is the removal of the testicles, which create testosterone and sperm. After a vasectomy, you’re still making the same amount of testosterone and the same amount of sperm. The only difference after a vasectomy is that the sperm is now blocked from leaving your body.” 

Or, to put it all very simply — for what is a very simple procedure — Patel says, “A lot of guys think of a vasectomy as getting their pet neutered — this is not that.”