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Vasectomy

Published by Bupa's health information team, September 2008.

This factsheet is for men who are planning to have a vasectomy, or who would like information about it.

A vasectomy is an operation to cut and seal the tubes (each called the vas deferens) that carry sperm from the testicles to the penis. This means that you will no longer be able to have children.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your doctor's advice.

How a vasectomy is carried out

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About vasectomy

Research shows that vasectomy is a very reliable form of permanent contraception. It's estimated that pregnancies occur from only one in 2,000 men who have had a vasectomy.

A vasectomy won't affect your sex drive or ability to enjoy sex. You will still have erections and produce the same amount of fluid (semen) when you ejaculate. The only difference is that your semen won't contain sperm. Your body will still produce sperm, but they can't travel out through your penis and are naturally reabsorbed by the body.

It's important to note that a vasectomy doesn't protect you from getting sexually transmitted infections (STIs). 'Safer sex' methods involve using condoms.

Illustration showing the cut vas deferens after a vasectomy

The cut vas deferens after a vasectomy

Can a vasectomy be reversed?

A vasectomy should be considered a permanent operation.

Some men come to regret the operation and want it reversed. A vasectomy reversal operation rejoins each of the tubes that carry sperm from the testicles that were cut during a vasectomy. However, this doesn't guarantee that your fertility will be restored.

What are the alternatives?

The alternatives to a vasectomy include long-term contraceptive options for women such as:

  • the intra-uterine device (IUD)
  • the levonorgestrel intra-uterine system (IUS)
  • progestogen implants

Before deciding on a vasectomy, it's worth discussing the options with your GP or family planning nurse.

Preparing for your vasectomy

Your doctor will explain how to prepare for your operation. For example, if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection and slows your recovery.

A vasectomy may be performed in a hospital, GP practice or private clinic.

The operation is usually done as a day case under local anaesthesia. This completely blocks feeling from the scrotum and you will stay awake during the operation. Alternatively you may prefer to have the surgery under general anaesthesia. This means you will be asleep during the operation.

Your doctor will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

About the operation

The operation usually lasts about 10 to 15 minutes.

Once the anaesthetic has taken effect, your doctor will feel your testicles to find the vas deferens.

Your doctor will usually use the "no-scalpel" technique. He or she will use a special forceps-like instrument to make a small opening in the skin. The opening in the skin is so small that it doesn't require stitches. Sometimes it isn't possible to use this instrument and it's necessary to make one or two cuts (1 to 2cm long) in your scrotum.

A section of each vas deferens will be carefully pulled out through the cut or small opening. Each tube will be cut and a small section will be removed. The ends of the tubes will then be closed off by either tying them or sealing them using an instrument that heats to a high temperature (diathermy).

The vas deferens will then be placed back into your scrotum and the cuts will be closed using dissolvable stitches or adhesive strips (eg Steristrips). You may not need a dressing.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed. After a local anaesthetic it may take several hours before the feeling comes back into your scrotum. Take special care not to bump or knock the area.

You may need pain relief to help with any discomfort as the anaesthetic wears off.

You will usually be able to go home when you feel ready.

You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.

Your nurse will give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment. You may be provided with supportive, disposable underwear to help relieve any discomfort from your testicles, which will be sore for a few days.

Dissolvable stitches will disappear on their own in seven to 10 days.

Recovering from a vasectomy

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If you're in any doubt about driving always follow your doctor's advice and please contact your motor insurer so that you're aware of their recommendations.

It's sensible to take it easy for a couple of days, but you can go back to work as soon as you feel able.

For as long as you need, wear close-fitting, supportive underwear, such as a jock strap, day and night. This will support your scrotum and help to ease any discomfort and swelling.

Don't do any heavy lifting or vigorous exercise during the first week after the operation.

You can bathe and shower but you should dry the area gently and thoroughly afterwards.

Sex and contraception

You can have sex as soon as you feel comfortable but you should use another form of contraception until the sperm that remain in the tubes have gone.

You will need to have semen tests to ensure that your tubes are clear of sperm. You will have to wait at least eight weeks before you can take a test and will need to be retested a few weeks later if there are still sperm in your semen.

When tests show that your semen is clear of sperm, you will no longer need to use other methods of contraception.

What are the risks?

Vasectomy is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted, but mostly mild and temporary effects of a successful treatment.

Anyone having a vasectomy can expect a sore and tender scrotum for a few days. You may also have some bruising and swelling.

Complications

This is when problems occur during or after the operation. Most men aren't affected. The possible complications of any operation include an unexpected reaction to the anaesthetic or developing an infection.

Specific complications of vasectomy are rare but include those below.

  • Bleeding inside your scrotum can make it swollen and painful. This is called a haematoma and may require further surgery.
  • Sperm may leak out of the cut tubes and collect in surrounding tissues. If this happens, hard lumps, called sperm granulomas, can form. Sperm granulomas aren't harmful, but occasionally they can be painful and need to be removed.
  • It's possible you may develop long-term testicular pain. This may be due to pinched nerves or scarring, and may require further surgery.
  • You may have a full feeling in your testicles. This is caused by the epididymis (sperm sacks near the surface of each testicle) filling with stored sperm.
  • Very rarely, even when performed correctly, there is a very small risk that your tubes can rejoin naturally and you will become fertile again.

The exact risks are specific to you and differ for every person, so we haven't included statistics here. Ask your doctor to explain how these risks apply to you.

Further information

Related topics

Sources

  • Male and female sterilisation. Royal College of Obstetricians and Gynaecologists. 2004, Evidence-based Clinical Guideline Number 4. www.rcog.org.uk
  • Brechin S, Bigrigg A. Male and female sterilisation. Curr Obstet Gynaecol 2006; 16:39-46. www.elsevier.com
  • Sterilisation for women and men: what you need to know. Royal College of Obstetricians and Gynaecologists (RCOG), 2004. www.rcog.org.uk
  • Male and female sterilisation. fpa (Family Planning Association). www.fpa.org.uk, accessed 22 May 2008
  • Cook LA, Pun A, van Vliet H et al. Scalpel versus no-scalpel incision for vasectomy. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No: CD004112. pub3. www.cochrane.org

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: September 2008

 

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