How can I be sure I want a vasectomy?
Be absolutely sure you don’t want to father a child under any circumstances. Talk to your partner, it’s essential to make the decision together. Consider other kinds of birth control as well.
A vasectomy might not be right for you if you are very young, your current relationship is not stable, you are having the vasectomy just to please your partner, or if you are under a lot of stress.
What is different about non-scalpel vasectomy?
Non-scalpel vasectomy is different from a conventional vasectomy in the way the doctor accesses the tubes which carry sperm. In a no-scalpel vasectomy, the doctor feels for the tubes under the skin and holds them in place with a small clamp. This makes the procedure much less painful than the traditional operation method.
Instead of making two incisions, the doctor makes one tiny opening with a special instrument so the tubes can be reached. The tubes are then blocked and cut using a cautery method. There is very little bleeding with the no-scalpel technique and usually no stitches are needed to close the tiny opening, which heals quickly.
How does a vasectomy work?
Vasectomy is usually done under a local anaesthetic. The person having the vasectomy is awake but has an injection into the skin to make the area numb so that they do not feel pain. Local anaesthetic is injected into a small area of skin on either side of the scrotum above the testicles (testes).
A tiny cut or puncture hole is made in the numbed skin on each side of the scrotum. The vas deferens can be seen quite easily under the cut skin. It can be cut with a surgical knife (scalpel) or using diathermy. Diathermy is electrical current that cuts and seals the ends of the tubes. It stops the bleeding at the same time. Sometimes a small piece of the vas deferens is removed.
The hole is so small that often no stitches are needed. If stitches are required, either dissolvable stitches or a special surgical tape are used. The operation takes about 15 minutes.
There is usually some discomfort and bruising for a few days afterwards which 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 lifting or strenuous exercise for four weeks or so after the operation.
Will it hurt?
When the local anaesthetic is injected into the skin of the scrotum, you will feel some discomfort, but as soon as it takes effect, you should feel no pain.
Afterwards you may be sore for a couple of days, and you may want to take a mild painkiller. But the discomfort is usually much less with no-scalpel technique, as there is less injury to the tissues. Also, there are no stitches. You will be provided with complete instructions about what to do after surgery.
What are the risks?
You will have counselling before this procedure to discuss the risks and benefits of this procedure.
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 noticeable. However, it 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 weeks or months after the operation. This usually settles within three months.
A very small number of men develop a post-vasectomy pain which does not settle over time. This can be mild or severe. It may be in the scrotum, the penis, the testicles (testes) or the lower tummy. The most recent studies show that this only occurs in 0.2% of men.
How quickly does this make me sterile?
After a vasectomy there are always some active sperm remaining. It takes about 20 ejaculations to clear them. You and your partner should use another from of birth control until a sample of your semen has been tested 16 weeks after your operation and confirmed as free of sperm.
At the time of your appointment, we will provide you with a sample pot and information regarding obtaining a post-vasectomy semen test. It is very important that you take this test and that you wait for the results before you stop using other methods of birth control.
What are the advantages of vasectomy?
It is permanent, therefore reducing the risk of unplanned pregnancies. 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. Vasectomy does not protect from sexually transmitted infections.
Does a vasectomy affect sex drive?
No. The sex hormones made by the testicles (testes) – for example, testosterone – continue to be passed into the bloodstream as before so are not affected by a vasectomy. Also, vasectomy does not reduce the amount of semen ejaculated during sex. Sperm only contribute 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 is removed.
Is it reversible?
It is very important only to consider a vasectomy when you are certain that you (and any partner) do not want children or further children. It is important to consider all sorts of situations, including a tragedy in the family or a break-up of the relationship. A vasectomy should only be considered where there is certainty that you would not want more children even in those situations.
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 the relationship with your partner.
Remember there are reversible forms of long-term contraception which are very effective. Consider these as a couple before making your decision. These are all for women.
Ideally, both partners are happy with the decision before a vasectomy. However, it is not legally necessary to obtain your partner’s permission.
Vasectomies are considered permanent and reversal is never offered on the NHS. Private providers will offer vasectomy reversal and the success rates of this are quoted as:
75% will achieve pregnancy if the reversal is done within 3 years of the vasectomy.
50-55% if it has been 3 – 8 years since the vasectomy.
40-45% if it has been 9-14 years since the vasectomy.
30% if it has been 15-19 years since the vasectomy.
Less than 10% if it has been more than 20 years since the vasectomy.
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 never available on the NHS, so needs to be paid for privately.
Can I have the operation if I’m single?
Yes. But if you’re under 30, you’ll 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’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.
But 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.
See a GP or a professional at a contraception or sexual health clinic to talk about all of your options.
How soon after the operation can I have sex?
It is recommended to abstain from sex for between 2 to 7 days after the vasectomy. However, other methods of contraception will need to be used until the semen specimen has been confirmed as clear of sperm. Some sperm will survive upstream from the cut vas deferens for a few weeks.
Can I use IVF to father a child?
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
