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External Condom vs Vasectomy

A side-by-side comparison of two birth control methods — efficacy, cost, how they work, and who shouldn't use them.

Last verified October 11, 2026Updated October 11, 2026

Side-by-side comparison

External Condom A barrier method worn over the penis that also lowers the risk of STIs, available over the counter.
Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.

Method	External Condom A barrier method worn over the penis that also lowers the risk of STIs, available over the counter.	Vasectomy A permanent outpatient procedure that blocks the vas deferens so sperm cannot enter the semen.
Efficacy	External Condom 87% typical use Least effective: under 90 out of 100 people successfully prevent pregnancy per year.	Vasectomy 99.85% typical use Most effective: over 99 out of 100 people successfully prevent pregnancy per year.
Cost	External Condom $0–$2 per unit Insurance: Varies	Vasectomy $0–$1,000 Insurance: Varies
Duration	External Condom Single use	Vasectomy Permanent
Reversibility	External Condom Reversible	Vasectomy Permanent
STI protection	External Condom Yes	Vasectomy No
How it works	External Condom A sheath worn over the penis that keeps sperm from entering a partner's body. Latex and plastic condoms also block contact with semen and vaginal fluids that can carry STIs.	Vasectomy A clinician cuts, seals, or blocks the vas deferens so sperm cannot mix with semen during ejaculation. The body absorbs the sperm, and the semen remains normal in appearance and volume.
Prescription	External Condom Not required Over-the-Counter	Vasectomy Required In-Person Procedure
Side effects	External Condom Allergic reaction to latex in people with a latex allergy	Vasectomy Mild pain or swelling for a few days Bruising or bleeding at the site Sperm granuloma (swelling from leaked sperm that usually goes away on its own) Chronic post-vasectomy pain syndrome (5% in a 2020 meta-analysis)
Who shouldn't use this	External Condom Known allergy to latex (use polyisoprene or polyurethane instead)	Vasectomy Uncertainty about future fertility desires Known allergy or hypersensitivity to materials used in the procedure

Key differences

With typical use, 13 in 100 people using External Condom get pregnant in a year, vs 0.2 in 100 with Vasectomy (least effective vs most effective). How long it lasts: External Condom, single use; Vasectomy, permanent. External Condom: reversible. Vasectomy: permanent. STI protection: only with External Condom. A prescription is needed for Vasectomy, not for External Condom. External Condom: costs $0–$2 per unit. Vasectomy: costs $0–$1,000.