A vasectomy is a minor operation designed to make a man infertile or sterile. The operation is normally performed under local anaesthetic in the clinic. The whole process usually lasts about an hour.
A vasectomy works by blocking the passage of sperm, as they travel along a small tube called the vas deferens or vas. The two vas deferens carry sperm from each of the testicles to the prostate, so that the sperm can be added to the semen during ejaculation.
Is a vasectomy right for me?
A vasectomy is a safe, simple and permanent way for a couple to avoid having any more children. The procedure is more minor and easier to perform than a woman having her tubes tied, also called a tubal ligation.
Vasectomy prevents the need for other types of contraception, such as condoms, intra-uterine device (IUD) or the pill. The procedure is permanent however, so as a couple you need to discuss it carefully before you decide to go through with it.
Is a vasectomy reversible?
Yes it is, with a success rate of approximately 50% if performed within 10 years. However if you are already thinking about reversal, you shouldn’t have a vasectomy…
How is a vasectomy performed?
Dr Davies will greet you at his clinic and have a thorough chat with you before the procedure. If possible, please bring your partner with you. If not, you will still need someone else to drive you home. Dr Davies will go over the steps of the operation carefully and explain the risks and benefits.
You, and ideally your partner also, will then be asked to sign a consent form to indicate that you understand the risks and benefits of the vasectomy. You will then go through to the treatment room, where your partner is welcome to join you. You will meet Dr Davies’ assistant and get into a gown. You will be given anti-biotic tablets and pain killing tablets.
A small drip will be placed in your arm so that we can administer a mild sedation. This will make you feel calm and a little drowsy. You are welcome to decline the sedation, but we find it makes the whole thing a lot more relaxing.
The scrotum will then be cleaned with anti-septic and a drape placed over you. Local anaesthetic will be injected through a tiny needle into the scrotal skin and a small cut made, approximately 5mm long. Each vas is brought out through the cut in turn, and a small section of the vas removed.
The ends of the divided vas are also heat sealed to prevent sperm from escaping. Occasionally two small cuts are needed in the scrotum. The scrotal skin is then sealed with glue, preventing the need for stitches. The whole vasectomy takes about 30 minutes.
What are the risks of a vasectomy?
Because this is a minor operation, there are the usual risks of pain, bleeding and infection afterwards. It’s important to avoid any strenuous exercise or exertion for at least the next 72 hours please. Keep the wound(s) clean and dry. We ask that you don’t shower until the day after your vasectomy.
Simple pain killers like panadol and ibuprofen might be needed for a few days. Some men find a bag of frozen peas is helpful! Mild swelling and bruising of the scrotum is not unusual. If you have severe swelling or active bleeding, you should call the clinic please.
You may notice a small hard lump where the vas has been cut. This is called a sperm granuloma. It may be tender but will generally settle within a few weeks. On very are occasions the lump may need to be cut out if the pain is severe and long lasting.
Because the body is so good at healing, there is a 1/1000 chance the operation will not work and the cut ends of the vas will rejoin. It is essential therefore, that you continue to use alternative contraception for the next 4 months.
After 3 months we will ask you to do a semen analysis to check for live sperm. We will also ask you to do a semen analysis after 4 months. A few days after the second test, please ring the clinic for the results of the two tests. If they are both negative for sperm, we will advise you that it is safe to stop using contraception.
If there is any doubt, we may ask you to do a third semen analysis. In very rare circumstances the tubes can rejoin much later despite the negative semen tests, with a risk of approximately 1/2000.
Even though the vas has been cut, the testicles continue to make sperm for up to 10 years. Whilst the volume of the sperm is tiny, some men will get a feeling of congestion or an ache in their testicle.
The discomfort is usually short lived but there is a 1/1000 risk of it persisting long-term. If this happens to you, please let us know and we will do our best to help.
There is no increased risk of prostate or testicular cancer after vasectomy.
There is no affect on your male hormones or your ability to get an erection.
There is no noticeable change in the volume or appearance of your semen.
After the vasectomy
We will ask you to stay in the clinic until you are fully recovered from the sedation. You are welcome to tea, coffee or water. You mustn’t drive for the rest of the day and alcohol should be avoided please.
You will be given forms and sample pots so that you can perform two semen analyses at 3 and 4 months post vasectomy. We can also give you a script for pain killers if you need.
Generally we don’t arrange any further follow up appointment, but if you have any concerns or worries please don’t hesitate to call the clinic. If we can’t help over the phone, an appointment can be arranged easily, free of charge.
When can I have sex again after a vasectomy?
Generally we advise against sex for the first 72 hours after vasectomy. After that, it is whenever you feel comfortable and confident to do so. Please remember to use contraception though, until you have done your semen tests at 3 and 4 months after vasectomy and called for the results.
When can I go back to work?
Again we advise against work for the first 72 hours after vasectomy. If you have a desk job and you feel comfortable, you might feel able to work sooner than this. If you have a very physical job, you may wish to take a few extra days off.
Similarly, you may wish to avoid vigorous sport or exercise for more than 72 hours if you are still uncomfortable.
Before the vasectomy
Please advise the clinic if you are on any blood thinning medications. Some of these may need to be stopped a week before the surgery.
Please advise us of any medication allergies.
Please advise us of any previous surgery or problems in the scrotal area.
Please shave the scrotum shortly before the procedure.
Please arrange someone to drive you home if your partner isn’t joining you.
Please advise us if you would like to have the vasectomy performed under general anaesthetic and we will make the necessary arrangements.