Vasectomy

Page last reviewed: 13/07/2011

Vasectomy or 'male sterilisation' is a simple and reliable method of contraception. It is usually considered permanent, although in some cases the procedure can be reversed - although this is not always successful.

How does a vasectomy work?

Sperm is prevented from reaching the semen ejaculated from a man's penis during sex. It is a quick and relatively painless surgical procedure, usually carried out under local anaesthetic. In most cases, you will be able to return home the same day as your procedure.

A vasectomy has no effect on sex drive or ability to enjoy sex. You will still have erections and ejaculate normally. The only difference is that your semen will not contain sperm.

Availability of vasectomy services

Vasectomy services are available in some hospitals, family planning clinics and from some specially trained GPs. You can speak to your GP about availability of vasectomies in your area.

What are the benefits?

A vasectomy may be appropriate when a man does not want more children, or has decided not to have any at all. It may be chosen as a simpler, safer and more reliable alternative to female sterilisation.

A vasectomy is normally permanent, so once it has been carried out successfully and semen tests have shown there is no sperm present, long-term partners may not need to use other forms of contraception.

However, a vasectomy does not protect against HIV infection or any other sexually transmitted infection, so you should continue to protect yourself by using condoms with any new partner.

Page last reviewed: 13/07/2011

Having a vasectomy should always be viewed as permanent sterilisation. This is because, although reversal is sometimes possible, it takes delicate microsurgery to join the tubes together again. Even when a surgeon successfully joins them, conception (fertilisation of an egg) is not always possible.

When it should be done

You should only have a vasectomy if you are certain that you do not want to have any more children. If you have any doubts, consider another method of contraception until you are completely sure.

It is not advisable to make your decision about having a vasectomy following a crisis or a big change in your life - for example, if your partner has just had a baby, or if they have just terminated their pregnancy.

If you have a partner, discuss it with them before deciding to have a vasectomy. If possible, you should both agree to the procedure. Some doctors prefer both partners to agree to the procedure after providing information and counselling. However, it is not a legal requirement to get your partner's permission.

A vasectomy can be performed at any stage of adult life. However, many GPs are reluctant to carry out the procedure on men aged under 30, particularly if they do not have any children, as younger men are most likely to regret having a vasectomy later on in life.

Points to consider

You might find the following points helpful in making your decision:

  • Vasectomy is most suited to men in a stable relationship who have decided, with their partner, not to have more children or any at all.
  • If you enter a new relationship at a later point in your life, you may not be able to father a child if you have had a vasectomy.
  • A vasectomy is a simple procedure, more reliable and with fewer complications than permanent sterilisation in a woman.
  • The proportion of vasectomies that fail is generally considered to be less than 2% (two in every 100).

Frequently asked questions

What other contraception is available for men?

The other main contraception choice for men is condoms. Several choices are available for women, which your GP or a family planning expert can advise on.

Can I use IVF to father a child?

If you have a vasectomy, and then decide later that you want a child, there may be the option of doing so by IVF. To do this, sperm would be retrieved from your testicles by a trained surgeon and used to fertilise your partner's egg. However:

  • it tends to be expensive, and
  • IVF is not always successful, so you cannot rely on it as a type of 'fertility insurance policy'.

Can I store sperm in a sperm bank, just in case?

You could, but as with IVF, sperm stored in a sperm bank cannot be relied on to bring about a pregnancy. It can also be expensive.

Can I have the operation if I am single?

Yes - but if you are under 30, you will find many surgeons are reluctant to do it in case your circumstances change and you regret it later.

Could being sterile affect me emotionally?

It is a big decision to end the part of your life where you could father a child - another reason to think it over carefully.

If you are sure about your decision to have a vasectomy, you may feel relieved that the worry of possible pregnancy is over and you do not need to think about contraception again.

If you feel anxious or uncomfortable about the procedure, or if you think you would suffer mentally from being sterile, then it is not the best type of contraception for you. You can discuss alternatives with your GP or with a professional at a family planning clinic.

Page last reviewed: 13/07/2011

A vasectomy is a quick and simple procedure that can be performed at:

  • your local GP surgery,
  • a hospital as a day-patient appointment, or
  • a private clinic.

It usually takes 15-30 minutes to perform and you should be able to go home the same day.

There are two types of vasectomy. The 'conventional' and most widely used type of vasectomy involves making two small incisions in the scrotum (the pouch of skin that surrounds your testicles). The other type uses a newer 'no scalpel' technique. Your GP will discuss with you which is best for you.

Conventional vasectomy

During a conventional vasectomy, the skin of your scrotum will first be numbed with local anaesthetic. Two small incisions, about 1cm long, are made on each side of your scrotum.

The incisions allow your surgeon to access tubes that carry sperm out of your testicles, known as vas deferens. Each tube will be cut and a small section removed. The ends of the tubes are then closed, either by tying them or sealing them using a diathermy (an instrument that heats to a very high temperature).

The incisions are stitched, usually using dissolvable stitches, which will disappear naturally within about a week.

No-scalpel vasectomy

A no-scalpel vasectomy is more commonly available through private clinics, but many GPs are now being trained to carry out the procedure. During this procedure, your surgeon will feel the vas deferens underneath the skin of your scrotum and then hold them in place using a small clamp.

A special instrument is then used to make a tiny puncture hole in the skin of the scrotum. A small pair of forceps is used to open up the hole, allowing the surgeon to access the vas deferens without the need for an incision. The tubes are then closed in the same way as in a conventional vasectomy, either by being tied or sealed.

During a no-scalpel vasectomy, there will be little bleeding and no stitches. The procedure is also thought to be less painful, and less likely to cause complications.

Anaesthetic

Most vasectomies are carried out under local anaesthetic. This means only your scrotum and testicles will be numbed and you will be awake for the procedure. You will not feel any pain, although it may feel slightly uncomfortable.

In rare cases, a general anaesthetic may be required. This means you will be asleep during the procedure. A general anaesthetic may be used if you are allergic to local anaesthetic or have a history of fainting easily. However, most people will only need a local anaesthetic.

Choosing your doctor 

You can request a male doctor, but in some cases this may mean you have to wait longer. Your GP may be able to offer you options where the vasectomy can be carried out. The operation is also available privately.

 

 

 

Page last reviewed: 13/07/2011

You will normally experience some mild discomfort, swelling and bruising of your scrotum for a few days after the vasectomy.

Painkillers

If you have pain or discomfort, you can take paracetamol or ibuprofen. However, ibuprofen is not suitable if you have asthma, a history of stomach ulcers or kidney or liver problems. Contact your GP for advice if you are still experiencing considerable pain after taking painkillers.

Underwear

Wearing close-fitting underwear, such as Y fronts, during the day and at night will help to support your scrotum and will also ease any discomfort or swelling. Make sure you change your underwear every day.

Hygiene

It is safe for you to bathe or shower after your operation, but make sure you dry your genital area gently and thoroughly.

Going back to work

Most men will be fit to return to work one or two days after their vasectomy, but should avoid sport and heavy lifting for at least one week after the operation, to minimise the risk of developing complications. If any symptoms continue after a few days, consult your GP.

Having sex

You can have sex again as soon as it is comfortable to do so, although it is best to wait for a couple of days. However, you are not sterile immediately after the operation, as it takes time to clear the remaining sperm in your tubes. Until you have had two clear semen tests, you will still need another method of contraception.

Page last reviewed: 13/07/2011

How will I know if my vasectomy has been a success?

After a vasectomy has been performed, some sperm will survive in the upper part of the vas deferens tubes. This is because sperm are left in the system beyond the point of the cut. It takes more than 20 ejaculations to clear these sperm, although the rate can vary among men.

Until it has been confirmed that your semen is free of sperm, there is still a risk of pregnancy and you should continue to use another form of contraception.

At least eight weeks after the procedure you will need to produce a semen test, which will be checked for sperm. This will also help to identify the rare cases in which the tubes naturally rejoin themselves. Once tests have confirmed your semen is free of sperm, the vasectomy is considered successful and further contraception can be stopped.

A few men continue to have small numbers of sperm in their system, but these sperm do not move (they are known as 'non-motile' sperm). It is not always clear whether this means you could make your partner pregnant. If you are one of these men, your doctor will discuss your options with you.

Is reversal possible?

It is possible to have a vasectomy reversed, but the procedure is often unsuccessful. You have a better chance if it is done soon after the vasectomy.

If a reversal is carried out within 10 years of your vasectomy, the success rate is estimated to be 55%. This falls to 25% if your reversal is carried out more than 10 years after your vasectomy.

Even if a surgeon manages to join up the vas deferens again, pregnancy may still not be possible. This is why you should be as sure as you can be before going ahead. Your doctor should help you in making your decision.

When can I ditch the condoms?

Although a successful vasectomy is a completely effective method of contraception, it does not protect you against sexually transmitted infections (STIs). You should continue to protect yourself with condoms if you are at risk of catching an STI.

Will it affect my sex drive?

After a successful vasectomy, your testicles will continue to produce the male hormone (testosterone) just as they did before the procedure. Your sex drive, sensation and ability to have an erection won’t be affected. The only difference is that there will be no sperm in your semen. Your body still produces sperm, but they are reabsorbed without harm.

Page last reviewed: 13/07/2011

Following a vasectomy, complications are rare. Most men feel sore and tender for a few days after the operation, and will usually experience some bruising and swelling on or around their scrotum (sack surrounding the testicles).

However, in some cases, a vasectomy can cause more serious problems, some of which are outlined below.

Haematoma

A haematoma is when blood collects and clots in the tissue surrounding a broken blood vessel. Following a vasectomy, you may develop a haematoma inside your scrotum.

Haemtomas are mostly small in size (pea-sized), but can occasionally be large (filling the scrotum) and rarely, can be very large (going beyond the scrotum).

This can cause your scrotum to become extremely swollen and painful. In severe cases, you may need further surgery to treat the blood clot.

Sperm granulomas

When the tubes that carry sperm from your testicles (vas deferens) are cut, sperm can sometimes leak from them. In rare cases, sperm can collect in the surrounding tissue, forming hard lumps that are known as sperm granulomas.

Your groin or scrotum may become painful and swollen either immediately, or a few months after the procedure. The lumps are not usually painful and can often be treated using anti-inflammatory medication, which your GP will prescribe. If the granulomas are particularly large or painful, they may have to be removed surgically.

Infection

After a vasectomy you may be at risk of developing an infection, as a result of bacteria entering through the incisions (cuts) made in your scrotum. Therefore following the operation, it is important to keep your genital area clean and dry to minimise the risk of infection.

Long-term testicular pain

Some men get pain in one or both of their testicles after a vasectomy. It can happen immediately, a few months or a few years after the operation. It may be occasional or quite frequent and vary from a constant dull ache to episodes of sharp, intense pain. For most men, however, any pain is quite mild and they do not need further help for it.

Long-term testicular pain is usually the result of a pinched nerve or scarring that occurred during the operation. You may be advised to undergo further surgery to repair the damage and to help minimise further pain.

Full feeling in your testicles

After a vasectomy, some men may develop the sensation that their testicles feel 'fuller' than normal. This is usually caused by the epididymis becoming filled with stored sperm. The epididymis is the long, coiled tube that rests on the back side of each testicle. It helps to transport and store sperm.

Any such feelings should pass naturally within a few weeks. However, speak to your GP if you are still experiencing fullness after this time.

Fertility

In a very small number of vasectomy cases, the vas deferens can sometimes reconnect over a period of time. This means that the vasectomy will no longer be an effective form of contraception. However, it is rare for this to happen.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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