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Explanation
The Joke
In the first panel, a doctor explains a vasectomy procedure to a couple: they will make a tiny incision, cut a small section of the vas deferens, and the patient will never deliver sperm again. The woman enthusiastically says "Yeah! Hey, maybe you could put new stuff in there!" The doctor's expression suggests this is not how the procedure works.
In the second panel, labeled "Later," the couple is at home and the woman asks why Darth Vader's theme (the Imperial March) plays every time her partner has an orgasm. The man sheepishly responds: "Wait... is that not what I got? I thought I got the 'cool stuff' upgrade." The joke is that they apparently convinced someone to wire a sound system into the vas deferens tract, replacing the reproductive function with a novelty sound effect.
The Humor
The humor comes from the absurd escalation of a routine medical procedure into body modification madness. The comic plays on the idea that once you are "in there" surgically, why not add some fun features -- treating the human body like a gadget that can be upgraded. The specific choice of the Darth Vader theme as the "upgrade" is perfectly juvenile and funny, and the woman's bewildered reaction in the final panel suggests this was not at all what she had in mind when she suggested putting "new stuff in there." The title "vas" is a shortening of "vas deferens," the anatomical tube cut during a vasectomy.