Choosing to have a vasectomy

Your vasectomy assessment appointment will take approximately 20-30 minutes. We ask that if you have a partner, they are also available for this. It is important if your assessment is a video/telephone call that you and your partner are available to talk without distraction. During this appointment, a nurse will discuss your medical history, talk to you about vasectomy and the risks and complications of the procedure in detail, so you are aware of what will happen on the day and afterwards when at home. An appointment for the vasectomy procedure will be made on this day unless otherwise indicated.

Prior to your assessment appointment we ask you to read this information thoroughly and watch this video which explains the vasectomy. You can use the assessment to ask any questions you may have. 

Vasectomy is a popular method of contraception chosen by millions of men worldwide. It involves cutting and sealing or tying the tubes (vas deferens) that carry sperm from the testicles to the penis. You will still ejaculate, but your semen will not contain sperm. Vasectomy is a safe and effective permanent method of contraception.

The intention of a vasectomy is to make a man infertile permanently, so you must be sure about your decision.

Vasectomy is usually carried out under local anaesthetic (but can be done under a general anaesthetic) and takes about 15 minutes. A vasectomy is a quick and relatively painless surgical procedure. Here in Rotherham we use the “no scalpel” technique. It is effective and causes very little bleeding. Stitches are rarely needed as the skin heals well without them. 

The doctor first numbs the skin with local anaesthetic. This can be a little painful but this should only last a minute or so. Once the local anaesthetic starts to work, you should not feel any pain during the operation but you may feel a pressure sensation and some mild discomfort. A small pair of forceps is used to access the tubes, which are then sealed using heat (cauterization). You will be awake for the procedure but will not be able to see it.

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

• Bleeding wound (<5% patients).
• Haematoma (<5% patients) - a small collection of blood may form. These are usually small lumps but can sometimes lead to severe swelling and discomfort.
• Infection (<5% patients) - the risk can be minimised by ensuring hands are washed before and after touching the wound site and that the area is kept clean and dry. If it’s red, hot to touch or oozing, please contact our clinic.
• Sperm granuloma (<5% patients) - you may feel a small lump at the side of the procedure on one or both sides. They are usually painless. As with all lumps please seek medical advice.
• Long-term testicular pain (<5% patients) - Some men get pain in one or both of their testicles after a vasectomy. It can happen immediately, a few months later or a few years after the operation. For most men, however, any pain is quite mild and they do not need further help for it.
• Surgical complications following a vasectomy, although rare, could result in the loss of a testicle. This risk is less than 1 in 20,000 procedures.

No contraceptive method is 100% effective, but vasectomy is over 99% effective and it is one of the most reliable methods available. However, even after successful operation, about 1 in 2000 men who have had a vasectomy will become fertile again at some point in the future, despite having had negative sperm tests. This is because in some rare cases, the two ends of the tube reunite over time. 

A vasectomy is more than 99% effective at preventing pregnancy. Long-term effects on your health are rare. It doesn’t affect your hormone levels, sex drive or interfere with sex. You will still have an erection and ejaculate normally. It is a quick and relatively painless procedure. It may be chosen as a simpler, safer and more reliable option than female sterilisation.

It involves a small operation and usually a few days off work. It is not effective immediately. Contraception must be used after the operation until semen tests show that no sperm are left in the ejaculate. This will take at least 12 weeks. A vasectomy doesn’t protect against STIs. A vasectomy is difficult to reverse, and reversal is not usually available on the NHS. For this reason, a vasectomy has to be viewed as irreversible and some men do regret having the procedure.

Shaving

Please shave around the pubic area (the operation site) 24-48 hours prior to your appointment.

Washing

Please bath or shower on the morning of your operation.

Food

Please eat as normal on the day of your operation. It is important to eat before attending, it will aid your recovery. Please bring a drink and a snack with you, for after your procedure. Unfortunately, due to infection control guidelines we are unable to provide refreshments.

Underwear

Please bring a pair of good fitting, stretch cotton underpants to wear after the operation. These will support the affected area and help relieve any discomfort. You may find a size smaller than you usually wear will offer the best support.

Footwear

Please bring a pair of slippers or clean indoor shoes to wear whilst in the theatre environment.

Driving

We strongly advise that you arrange for someone to drive you home after the operation and for you to avoid driving for the next 48 hours. 

Please arrive 10 minutes before your allocated appointment time and please attend alone.

We are unable to accommodate any accompanying family or friends. Unfortunately, they will not be allowed to enter the theatre suite.

On the day of your vasectomy procedure you will be asked to read and sign your consent form with the doctor, confirming that you understand the procedure, the possible risks and complications.

A sexually transmitted infection screen is routinely offered and recommended to all patients. This involves a urine sample for chlamydia and gonorrhoea and a blood test for HIV and syphilis. We ask that you hold your urine for at least 1 hour prior to your appointment.

When the local anaesthetic wears off, the top part of the scrotum is normally mildly sore for a few days.

There is usually some discomfort and bruising for a few days afterwards, but this normally goes away quickly. The discomfort can be helped by wearing tight fitting underpants in the day and at night for a week or so after the operation. It is also best to avoid any heavy work, exercise, or lifting for at least a week after the operation. You should also avoid all forms of sport for 2 weeks. You may also find some blood in your semen after your first few ejaculations, this is not unusual and not harmful.

In order to check if the procedure was successful, we will arrange to check your semen sample 12 weeks after the procedure to ensure that there is no sperm in it. We will write to you to let you know if your operation has worked. You must continue other contraception until you receive your “all clear” letter.

Work

We advise 3-4 days off work after a vasectomy operation, however if your job involves heavy lifting you may require up to a week off or possibly longer. Please note that we do not provide sick notes. Should you require a sick note please contact your GP.

Should you experience any problems in the first 4 weeks after your operation, please contact the Integrated Sexual Health Service direct. We will be able to advise accordingly. (After 4 weeks, please contact your GP).

Should a problem occur outside of our opening hours please contact your GP, NHS 111, pharmacy services or in the case of an emergency A&E.

If you are treated for a post-operative wound infection by a service other than ourselves (eg. Your GP), we would still like to know, so please contact to let us know.

• Are you sure this is the right method of contraception for you? Before the final decision you should give consideration to any potential changes in your personal circumstances. Consider all sorts of situations, including a tragedy in the family or a relationship breakdown. You should only have a vasectomy if you’re certain you don’t want any more children or don’t want children at all in those situations.
• It is unwise to make the decision at times of crisis or change, such as a new baby or after an abortion or bereavement.
• It is best not to make the decision if there are major problems in your relationship - are you making the decision for the right reasons?
• Consider alternative contraceptive methods - There are other long acting reversible methods of contraception that have very low failure rates that women can use. These include coils, the progestogen injection and the implant. If you want to know more about these alternatives, please contact your GP or sexual health clinic.
• If you have a partner, discuss it with them before you decide. If possible, you should both agree to the procedure, but it’s not a legal requirement to get your partner’s permission.
• If possible, please ensure that your partner is present during your pre-op assessment with the nurse.
• Make a note of any questions you may wish to ask the nurse prior to your pre-op assessment.

How soon after the operation can I have sex?

Avoid sexual intercourse for at least 48 hours after the operation. Remember you will have to use other methods of contraception until your semen specimen has no sperm in it. You must wait until you receive your “all clear” letter, before stopping other forms of contraception.

When can I have unprotected sex?

You must produce a semen sample at least 12 weeks after your surgery for us to check that the operation has worked. You must wait until you receive a letter/ text with the results. You should carry on using additional contraception until you have received the “all clear” letter.

Will it affect my sex drive?

No. 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’ll be no sperm in your semen. Many couples say that they enjoy sex more after a vasectomy. This is because they can choose to have sex more spontaneously.

What if I change my mind? Can a vasectomy be reversed?

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 unlikely to be available on the NHS, so you may have to pay for this yourself. The longer the time period since the vasectomy, the lower the success rate.

Could being sterile affect me emotionally?

It’s a big decision to have a vasectomy, so you should think it over carefully. If you’re sure about your decision, you may feel relieved that you don’t need to think about contraception and the possibility of pregnancy again. If you feel anxious or uncomfortable about the procedure, or you think you would find it hard to accept being infertile, it may not be suitable for you.

Can I use IVF after a vasectomy?

If you have a vasectomy and later decide that you want a child, you may be able to use IVF. To do this, a surgeon would retrieve sperm from your testicles and use this to fertilise your partner’s egg. But IVF:

•  isn’t always successful
•  may not be available on the NHS
•  can be expensive if done privately

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

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

I have heard that there is an increase in the risk of prostate cancer after the vasectomy. Is this true?

No. Research suggests that vasectomy does not increase your risk of cancer.

Can I have the operation if I’m single?

Yes. But if you’re young, some surgeons are reluctant to do it in case your circumstances change and you regret it later.