Vasectomy in NYC

Medically reviewed by David Shusterman, MD · Updated September 11, 2026

A vasectomy is a short office procedure that makes a man permanently unable to father children. The vas deferens, the tube that carries sperm from each testicle toward the urethra, is divided and sealed through a tiny opening in the scrotum. Sperm are still made afterward, but they are reabsorbed by the body instead of leaving it. Nothing about testosterone, erections, orgasm or the volume and appearance of semen changes.

At NYMD Center, vasectomy is done in the office by a urologist under local anesthesia. It takes about twenty to thirty minutes, and you walk out afterward. We consider it a reasonable choice for most men who are sure they do not want more children, and we will not try to talk you out of it. What we will do is tell you plainly what it involves, including the one risk we think is understated in most patient literature.

That risk is pain that lingers. Published guidelines put the rate of ongoing post-vasectomy tenderness at around 1 to 2%. In Dr. Shusterman's experience it is closer to 10 to 15%. The gap is not hard to explain: men with chronic discomfort after a vasectomy often do not go back to the urologist who did it, so the problem is under-counted. For most of those men the discomfort is a dull ache that comes and goes, is worse with certain activity or ejaculation, and improves over months. For a small number it is more than that. You should know this before you decide, not after.

Who it affects and the symptoms that bring people in

Men come in for vasectomy for the same reason: their family is complete, or they have decided not to have children, and they want a contraceptive that does not depend on remembering anything. Many are married men in their thirties and forties whose partners have carried the burden of contraception for years and who would like to take their turn. Some are men who have decided against children entirely. We ask about your reasoning as part of the consultation, but the decision is yours.

There is a seasonal pattern. Requests cluster in summer and around long weekends and sporting events, when a couple of days on the couch with an ice pack fits neatly into a schedule. That is fine with us; plan it around your calendar.

Vasectomy does not protect against sexually transmitted infections. If you are not in a mutually monogamous relationship, you still need condoms for that purpose, and our STD and STI testing services remain available.

How we evaluate it at NYMD Center

The evaluation is a consultation and a physical exam. We go over your health history, any prior scrotal surgery, hernia repair or injury, bleeding disorders, and medications such as blood thinners. The exam confirms that each vas can be felt easily through the skin, which tells us the procedure will be straightforward. Very rarely, an anatomic variation such as an undescended testicle or a vas that cannot be located calls for a different approach or imaging, and we would tell you then.

We spend the rest of the consultation on informed consent: what the procedure does, the permanence, the pain risk described above, the small risks of bleeding and infection, the need for a semen test afterward, and the alternatives. Men who are unsure, or whose partner is not in agreement, are encouraged to take more time. We also raise the option of banking sperm beforehand for men who want insurance against a change of heart.

Treatment options

Vasectomy

The procedure itself is the same whichever way it is described: the vas is reached through a small opening, a segment is removed, and the ends are sealed. It is done with local anesthetic in the office, and you are awake. Most men describe a tugging sensation and brief discomfort when the anesthetic goes in. Afterward you will have mild swelling and bruising for a few days, managed with an ice pack, snug underwear and over-the-counter pain relief. Desk work is possible the next day; heavy lifting and vigorous exercise wait about a week; sex can resume when it is comfortable, usually within a week.

Vasectomy is not immediately effective. Sperm remain downstream of the cut for weeks. You must use another method of contraception until a semen analysis, done about three months and twenty or more ejaculations later, confirms there are no sperm. Skipping this test is the most common reason vasectomy "fails."

Treating it as permanent

Vasectomy reversal exists, and we can refer you for it, but success falls with the years since the vasectomy and is never guaranteed. The right way to approach a vasectomy is as a permanent decision. If you can imagine wanting children later, sperm banking before the procedure is the more reliable safeguard than counting on a reversal.

Alternatives

For couples who are not ready for a permanent step, long-acting reversible contraception for the partner, including IUDs through our gynecology team, is an effective option. Condoms remain the only method that also protects against infection.

What to expect at your visit

Your consultation and your procedure are usually separate visits, though we can combine them for men who are certain and have already reviewed the information. On procedure day, shave the front of the scrotum, eat a normal meal, wear snug supportive underwear, and bring someone to drive you home if you prefer not to travel alone. The procedure is done in an exam room, not an operating room, and takes about half an hour including the anesthetic. You will leave with written instructions, a prescription if needed, and the semen-analysis order. We see you or speak with you again once the analysis is back to confirm the result.

When to seek care urgently

A rapidly enlarging, tense or very painful scrotum in the first day or two can mean bleeding inside the scrotum and should be examined the same day. Fever, spreading redness, or drainage from the incision suggests infection. Both are uncommon, and both are easier to treat early.