The Effect of Vasectomy on Erections: Facts and Medical Research Findings

The effect of vasectomy on erections is one of the main concerns for men who are considering this procedure. Various studies, including an article published in the Journal of Psychosomatic Research, show that vasectomy itself does not cause erectile dysfunction (ED). However, scientific studies on erectile function indicate that low acceptance of vasectomy by men, or feeling forced to undergo the procedure, can psychologically lead to sexual problems, including erectile dysfunction.

In this article, we discuss the effect of vasectomy on erections and men's sexual function after vasectomy. If you also have questions or concerns about this topic, we recommend reading the article to the end.

What is a vasectomy, and how is it performed?

Vasectomy is considered a permanent method of male contraception. In this procedure, the tubes that carry sperm are cut, divided, and tied so sperm cannot enter the semen. Erectile function does not change after the procedure, and semen is still released during sex; however, this fluid does not contain sperm, so it cannot cause pregnancy.

Looking at statistical studies from the Department of Urology at the University of North Carolina shows that vasectomy, or occlusion of the vas deferens, is the most effective and efficient available method of contraception, with an estimated pregnancy-prevention success rate of 99.95%. This method is appropriate for men who, either on their own or after discussion with their spouse, have concluded that they are 100% certain they do not want any future children.

How vasectomy is performed and the role of the seminal vesicles and vas deferens in fertility

A vasectomy is usually performed in a urologist's office. After the examination and sterile preparation, local anesthetic is injected into the skin at the front of the scrotum. With this anesthesia, the patient does not feel pain during the procedure, although he may feel some pressure on the testicles.

In the older vasectomy method, doctors used a scalpel and made 1- to 2-centimeter cuts in the scrotal skin to access the tubes that carry sperm. These tubes, the vas deferens, carry sperm from the testicles.

In the modern method, the doctor rarely uses a scalpel. Instead, a special instrument is used to make a small opening in the scrotal skin. The vas deferens on each side is then brought out, the surgeon ties both ends of the tube, cuts the middle portion, and finally returns the tube under the scrotal skin.

In the modern method of vas deferens occlusion, the small opening made in the scrotal skin is not closed so that fluids and minor bleeding from the procedure can drain through it. This opening closes on its own within three to four days. The modern vasectomy procedure takes about 15 to 30 minutes in total. If you would like complete information about this procedure, we recommend reading the article What is vasectomy?.

The role of the seminal vesicles and vas deferens in fertility

The seminal vesicles are two small glands located behind the bladder that produce 60% to 70% of semen volume. The seminal vesicles do not produce sperm themselves, but the fluid they make contains substances such as fructose, prostaglandins, alkaline fluid, and clotting proteins that are necessary for sperm survival.

In short, by producing fluid that nourishes sperm, the seminal vesicles protect sperm, help them move, and play an indirect but vital role in fertility.

Regarding the role of the vas deferens, or sperm-carrying ducts, in fertility: these are two muscular tubes that carry mature sperm from the epididymis, the site where sperm are stored and mature in the testicles, to the urethra.

Sperm are produced in the testicles and then move to the epididymis. The epididymis is where sperm are stored and mature. From there, during sexual arousal, sperm travel through the vas deferens toward the ejaculatory ducts. Near the prostate, sperm passing through the vas deferens mix with secretions from the seminal vesicles and prostate to form semen.

In other words, the vas deferens are the pathway that carries sperm from the testicles out of the body. If these tubes are blocked by vasectomy, sperm can no longer travel from the testicles to the ejaculatory ducts; as a result, semen leaves the body without sperm, and pregnancy does not occur.

How does an erection happen? Reviewing the anatomic structures responsible for erection

In this section, we review the anatomic structures responsible for erection. Erection is a complex physiologic process that occurs through interaction among the nervous system, hormones, blood vessels, and muscles in the penis. Below, we explain the stages and function of erection in more detail:

1. Sexual stimulation occurs mentally, psychologically, or through touch.

2. Stimulation causes nerve messages to travel from the brain to the spinal cord and then to the nerves of the penis. These messages are transmitted through the parasympathetic nervous system, which is usually active during relaxation.

3. After receiving these nerve messages, the penile nerves begin releasing a substance called nitric oxide. This substance relaxes the walls of blood vessels in the penis and widens the arteries. As a result, blood flow increases into two cylindrical structures called the corpora cavernosa and, to a lesser extent, into a third structure called the corpus spongiosum.

4. The corpora cavernosa are made up of sinus-like spaces, similar to a sponge. As blood flow increases, these spaces fill with blood; as a result, the penis increases in size and becomes firm.

5. As the corpora cavernosa fill, blood pressure inside them rises. This pressure compresses the veins that carry blood out of the penis and partly blocks them; as a result, less blood leaves the penis, and the erection is maintained.

6. An erection ends when sexual stimulation stops or ejaculation occurs. In that situation, nerve signals decrease, nitric oxide levels fall, the blood vessels contract, and the blood inside the corpora cavernosa drains through the veins. At this point, the penis returns to its non-erect, flaccid state.

Is there a connection between vasectomy and erectile dysfunction?

The key questions we want to answer in this section are: Is there a connection between vasectomy and erectile dysfunction? What is the effect of vasectomy on erections? What is the effect of vasectomy on men's sexual function?

In answer to this question, vasectomy only cuts and blocks the vas deferens, the tubes that carry sperm, and it has no effect on sex hormones, especially testosterone, the nerves responsible for producing and maintaining erections, blood flow, or sexual desire.

When a person has a vasectomy, his erections and the quality of his sexual relationship do not change, and sex hormones continue to be secreted as they were before the procedure. Semen volume is also usually the same after vasectomy as before, although it may be slightly lower than before the procedure.

Is reduced erection after vasectomy real? Does vasectomy cause sexual impotence?

Most people who are considering vasectomy, or thinking about it, ask doctors these questions. The short answer to both questions is that vasectomy does not change a person's erections.

Some men who experience sexual problems after vasectomy are affected by psychological factors, and the reason for reduced erections is not physiologic. Some of these men believe their masculinity has decreased after vasectomy. Others feel that the decision to have the procedure was imposed on them by their spouse, which can create psychological distress.

Not accepting vasectomy, or having low acceptance of it, especially when the decision feels imposed by a spouse, can negatively affect men's sexual function psychologically and lead to erectile dysfunction. Medical research on the effect of vasectomy on erections also suggests that older age at the time of vasectomy may be a risk factor.

Can vasectomy reversal cause sexual impotence?

One topic in the scientific review of the relationship between vasectomy and erections is whether vasectomy reversal can cause erectile dysfunction (ED). The answer is that, in most cases, vasectomy reversal has no effect on a person's sex life or erections. Vasectomy reversal also does not affect male sex hormones or the nerves and blood vessels responsible for erections. That said, psychological factors such as stress, anxiety, or depression related to surgery, as well as concern about the success of the reversal or issues related to becoming fertile again, can temporarily affect sexual function, including erections.

Question: Can a man's partner become pregnant after vasectomy?

Yes. For up to 4 months after vasectomy, pregnancy is still possible because sperm may remain in the tubes after the procedure. Doctors recommend using other contraceptive methods for about 4 months after vasectomy. To confirm that vasectomy has been effective, a semen analysis is needed to show that the semen is completely free of sperm.

Summary

In this article, we discussed the effect of vasectomy on erections and explained that, in most cases, vasectomy does not affect erections. When sexual function decreases after vasectomy in some people, it is usually related to psychological factors and low acceptance of the procedure. We hope this article has helped increase your awareness of the relationship between vasectomy and erections.

Fortunately, today vasectomy can be performed with a no-scalpel, minimally invasive method through a small opening in the scrotum. If you are considering vasectomy and want to use this method, you can consult a skilled urologist with specialist training and up-to-date knowledge.

Frequently Asked Questions

In this section, we discuss and answer several frequently asked questions about sex and erections after vasectomy: