Vasectomy is an out-patient, office-based procedure that is done under local anesthesia. It is minimally invasive. The puncture is a single puncture into the scrotum. Any bleeding is usually readily identifiable in the scrotum by office physical examination with no risk of transfusion. Infection risk is 0.5 to 1% and is again scrotal. It is cheaper than tubal, less invasive, and safer. There has never been a reported death from vasectomy in the United States. Success is verifiable by semen analysis.
Tubal requires a general anesthetic and is an out-patient hospital-based procedure. Due to hospital place of service, tubal usually costs more than a vasectomy. It requires 2-3 punctures ¼ to ½ inches each into the abdomen. All infections, bleeding, and scarring are intra-abdominal and may require a CT scan for diagnosis. Success is assumed and is not usually verified. Sterility can only be verified by way of hysteroscopy and tubal injection of contrast, but this is rarely done.