Vasectomy is an effective and permanent form of contraception. The operation is quicker, easier and more effective than female sterilisation. There is a very small failure rate. Sterilisation is only for people who have decided they do not want children, or further children in the future. It is considered a permanent method of contraception, as reversal is a complicated operation which is not always successful. In addition, reversal is not usually available on the NHS.
What is a vasectomy?
Vasectomy is a small operation to cut the vas deferens. This is the tube that takes sperm from the testes to the penis. Sperm are made in the testes. Once the vas deferens is cut, sperm can no longer get into the semen that is ejaculated (comes) during sex.
How reliable is vasectomy?
Vasectomy is very reliable - but not quite 100%. About 1 in 1,000 operations are not successful and tests show sperm are still present in semen after the operation. Even after a successful operation about 1 in 1,000 men who have had a vasectomy will become fertile again at some point in the future. This is because, rarely, the two ends of the cut vas deferens re-unite over time.
About the Operation
How is a vasectomy done?
Vasectomy is usually done under a local anaesthetic. Very rarely it is done under a general anaesthetic .Local anaesthetic is injected into a small area of skin on either side of the scrotum above the testes. A small cut is then made to these numbed areas of skin.
The vas deferens can be seen quite easily under the cut skin. The vas is cauterised with a diathermy machine. Diathermy is electrical current that cuts the skin and stops bleeding at the same time. This method (non scalpel vasectomy)is now much more common than the traditional vasectomy where scalpels (surgical knives) were used. The operation takes about 15 minutes.
There is usually some discomfort and bruising for a few days afterwards. This normally goes away quickly. The discomfort can be helped by wearing tight-fitting underpants day and night for a week or so after the operation. It is also best not to do heavy work, exercise or lifting for a week or so after the operation.
Are there any risks to the operation?
Most men have no problems after a vasectomy. Problems are uncommon but include the following:
- As with any operation or cut to the skin, there is a small risk of a wound infection.
- The bruising around the operation site is sometimes quite marked, but will go in a week or so.
- Rarely, sperm may leak into the scrotum and form a swelling which may need treatment.
- A small number of men have a dull ache in the scrotum for a few months after the operation. This usually settles over time.
- If you have a general anaesthetic, as with any operation, there is a small risk associated with the anaesthetic.
How do I know it has been successful?
Some sperm survive in the upstream part of the vas deferens for several weeks after vasectomy. These can get into the semen for a while after the operation. About sixteen weeks after the operation you will need to produce a semen sample. This is looked at under the microscope to check for sperm. If these have no sperm in them, you will be given the all clear.
You still need to use additional contraception, such as condoms, until you get the all clear.
Advantages and Disadvantages
What are the advantages of vasectomy?
It is permanent and you don't have to think of contraception again. It is easier to do and more effective than female sterilisation.
What are the disadvantages of vasectomy?
It may take a few months before the semen is free from sperm.
As it is permanent, some people regret having a vasectomy, especially if their circumstances change.
Frequently asked questions
Will it affect my sex drive?
No. The sex hormones made by the testes (for example testosterone) continue to be passed into the bloodstream as before. Also, vasectomy does not reduce the amount of semen when you ejaculate (come) during sex. Sperm only contributes a tiny amount to semen. Semen is made in the seminal vesicles and prostate higher upstream.
Sex may even be more enjoyable, as the worry or inconvenience of other forms of contraception are removed.
What happens to the sperm?
Sperm are still made as before in the testes. The sperm cannot get past the blocked vas deferens and are absorbed by the body.
Some other points about vasectomy
Don't consider having the operation unless you and your partner are sure you do not want children, or further children. It is wise not to make the decision at times of crisis or change, such as after a new baby or termination of pregnancy. It is best not to make the decision if there are any major problems in your relationship with your partner. It will not solve any sexual problems.
Doctors normally like to be sure that both partners are happy with the decision before doing a vasectomy. However, it is not a legal requirement to get your partner's permission.
Is vasectomy done on the NHS?
Yes most men have a vasectomy done on the NHS.
Does the operation hurt?
No more than any other minor operation that uses local anaesthetic. The injection of local anaesthetic may sting a bit for a few seconds. It is put in just a small area of skin, so it is nothing to worry about. After this, the operation is usually painless. After the operation, when the local anaesthetic wears off, the top part of the scrotum is normally mildly sore for a few days. Ignore any scare stories that seem to be a favourite joke topic for some men.
What if I change my mind?
Vasectomy is considered permanent. There is an operation to re-unite the two cut ends of the vas deferens. It is a difficult operation and not always successful. It is also not available on the NHS, so you would have to pay for this yourself.
How soon after the operation can I have sex? You can resume sex as soon as it is comfortable to do so. However, remember you will have to use other methods of contraception (such as condoms) until you provide two semen specimens which are clear of sperm. Some sperm will survive upstream from the cut vas deferens for a few weeks.
I have heard that there is an increase in the risk of prostate cancer after vasectomy. Is this true?
No. A few years ago there was a scare about a possible link. Since then several surveys have been done and have shown that there is no link between vasectomy and an increased risk of any cancer.
Here are the instructions for BEFORE your vasectomy.
- PLEASE EAT AND DRINK NORMALLY ON THE DAY OF YOUR PROCEDURE. THERE IS NO NEED TO STARVE
- Please trim back the hair from the front of the scrotum. This can be done with nail scissors. It is not necessary to have a complete shave of the area.
- Please bring tight underpants with you because these give much better support to the scrotum. Boxer shorts are not adequate.
- You need to bring someone with you who is able to drive, as it is advisable for you not to drive following your procedure.
- If you would like your partner to sit with you when the procedure is performed, please make arrangements with her in advance.
- Plan your life so that you can have 48 hours of peace and quiet after the operation. For the whole of the first week you will need to avoid heavy work.
Here are the instructions for AFTER your vasectomy.
- Please take it easy for 48 hours, resting at home and doing as little as possible.
- You have a small wound on the front wall of the scrotum and we would like you to keep this dry for 24 hours. The wound is not covered by any dressings and will normally heal up over 7 to 10 days.
- Avoid heavy lifting and energetic exercise for the first 7 days.
- You can start having sex as soon as you are comfortable, but remember to use some other kind of birth control until we let you know you are sterile.
- A little pain and bruising are usual. Paracetamol should be adequate but if you are worried in any way, please contact us on 01900 233170 between 9am-4.30pm. Outside these hours contact CHOC on 03000 247 247.
- There are no stitches used in this form of vasectomy, and so there is no need for a follow-up appointment.
- We will, during your consultation, run through the instructions of how to provide your semen sample
- Very, very important! Remember to use other contraception until you have had a negative semen check. You must not give up your other contraception until you have a letter from us saying that you are sterile and it is safe to do so.
INSTRUCTIONS FOR SEMEN TESTS AFTER VASECTOMY
A semen sample is required at approximately 16 weeks after your vasectomy. You will be given the sample bottle and form on the day your vasectomy is performed.
Remember it takes about 40 ejaculations to clear semen.
Please put the whole of a single ejaculation into the sample bottle provided, and add the date and time of when your sample was produced to the sample pot and the specimen form.
Seal the sample in the plastic bag then place the sample and specimen form into the pre-paid envelope provided.
The envelope can then be posted into any Royal mail post box.
After you have sent in your sample, we will write to you within 3 weeks to let you know the
Unfortunately we are unable to give these results over the telephone
Do not give up contraception until you have received the letter confirming that you are sterile
PLEASE, PLEASE DO NOT FORGET TO SEND YOUR SAMPLE