Can having a vasectomy lead to ED?

Erectile dysfunction can be defined as the inability to achieve or maintain an erection long enough for satisfactory sexual intercourse. It is a very common concern for men who are considering having a vasectomy. It is very rare for vasectomy to cause erectile dysfunction.

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What is involved when you have a vasectomy?

Vasectomy is a quick outpatient procedure that may be carried out in some sort of medical setting such as a doctor's office; it does not have to involve a visit to the hospital. The pain is minimal and is performed with the use of a local anesthetic.

A vasectomy is a permanent form of contraception. In order to prevent pregnancy, the sperm produced in the testicles must be prevented from entering the semen. This is done by cutting, tying or searing two tubes called the vas deferens which carry sperm from the testicles to the urethra. It is from the urethra that sperm would be expelled from the penis during ejaculation.

Once cut, the sperm are unable to travel down into the urethra as the path is blocked reducing the chances of sperm being able to the female and fertilising the egg. After the procedure, you may be advised to take 2 - 3 days off work and to avoid any heavy manual work and sexual intercourse for about a week

The contraceptive effects of vasectomy will not be immediate as sperm will remain in the vas deferens for up to three months and couples should use an alternative form of contraception for this time.

Whilst it is a very reliable form of contraception it is not 100% foolproof, failing in 1 - 2 women in every thousand

Side effects of vasectomy

Short term

There are some short term risks associated with having a vasectomy and they include the following:

As mentioned earlier, do not give up on contraception until three months have elapsed. This will allow any sperm which are still hanging around in the vas deferens to be ejected
Immediately after surgery, there may be some tenderness or pain in the genital region or scrotum. Over the counter, painkillers will help with this
Infection may be an issue for some people; this may result in extreme pain and swelling in the area. Your healthcare professional may prescribe antibiotics to clear up a bacterial infection
It is common for a man to have swelling and irritation in the genital area and there may also be some bruising

Long term

Some long term consequences of vasectomy are positive and may include an improved sex life. This is likely to be a result of the couple being less anxious about the chances of becoming pregnant accidentally.

There are other risks following the procedure, however, including the following:

Recanalisation is the term used when the vas deferens grow back and create a new connection. This means that sperm would, again be able to enter the semen and urethra so reversing the vasectomy.
A failed vasectomy can sometimes happen when, for whatever reason, the passage of the sperm has not been cut off. It may be that surgery needs to be repeated.
Regret and uncertainty may be an emotional reaction to vasectomy for some people. Whilst they may have been sure about having the procedure prior to surgery, they may question themselves as to whether or not they really do not want any more children; this may arise particularly after beginning a new relationship.
Whilst vasectomies are usually reversible there are no guarantees and success will be dependent on the type of vasectomy that was performed and the skill of the surgeon reversing the procedure.
A 2019 study in Denmark which had followed 2.1 million men for 38 years found a small but what was considered to be a statistically significant increase in cancer among men who had vasectomies.
Decreased sexual function is a worry for some men; they may be concerned that post vasectomy they have weaker or less pleasurable orgasms. This is unlikely unless postoperative complications arise.

Complications

Serious complications are very rare after a vasectomy. Possible complications can include:

Infection and serious postoperative bleeding are, as a rule, treatable but in some very rare cases, they can be dangerous or even result in death. If an infection remains untreated or turns out to be antibiotic resistant, this can put the entire body at risk. Any injury to the vasculature in the area can also cause excessive bleeding which may necessitate having a blood transfusion
A condition called post vasectomy pain syndrome involves a person suffering from long term pain in the scrotum as a result of the surgery. This form of complication can affect erectile function and the ability to orgasm
Any damage to nerves during the procedure will run a risk of causing erectile dysfunction

Why the procedure will not cause erectile dysfunction?

We have looked at the extremely rare complications that might result in a person developing erectile dysfunction, so let us look more closely at how the procedure is actually carried out and why the risks of this happening are minimal

The most commonly carried out vasectomy procedure is called a non-scalpel vasectomy. During this procedure, the surgeon uses his fingers to feel for the vas deferens under the skin in the scrotum. They will simply make a tiny hole in the skin, pull the vas through then cut, tie or sear it.

Consider that in the process of achieving erections, the following happens:

The brain causing sexual arousal - the brain sends nerve impulses to the penis
The nervous system causes nerve stimulation - this causes the blood flow to the penis
The cardiovascular system allows free blood flow - the increased blood flow will facilitate the erection by filling the chambers of the penis and making it hard

When a vasectomy is carried out, none of the above procedures are interfered with, the only part of the body which is affected is the vas deferens and the sperm which cannot travel down the vas deferens after the procedure. The body will absorb all the sperm that are produced.

Conclusion

There are many misconceptions that surround vasectomies. The only result of vasectomy is that the semen ejaculated will not contain any sperm and so are unable to fertilise an egg.

What a vasectomy will not do is:

Change the volume of your ejaculate as sperm amount to less than 3% or sperm
Affect testosterone levels in the body
Affect masculinity or sexuality
Prevent sexually transmitted infection
Damage other sexual organs

The one thing that must be considered at length before deciding to have a vasectomy is whether or not you are likely to want some or more children in the future. The procedure should be considered as a permanent form of contraception

If you have a partner it is important that you discuss the decision with them as the outcome will affect both of you. You may also need to consider life changes that may happen in the future such as relationship break ups and the possible death of a partner, both of which are major changes in circumstances.