Vasectomy

When you arrive at WISH at Aconbury North come in through the automatic doors, and follow the signs upstairs to Sexual Health – we are on the first floor. Please ring the bell on the Minor Ops Suite door and a member of staff will come to meet you as soon as possible.

You will need to come into the building alone – relatives/friends accompanying you to drive you home should wait in the car and be available to collect you promptly once you are ready to go home, and can collect you from the entrance doors  to Aconbury North.

Current hospital policy requires all patients to wear a mask or face covering upon entry to the building. If you don’t have one, we can provide a mask on your arrival. You will be in the clinic for approximately 45 minutes.

Vasectomy consent form.pdf [pdf] 373KB

Vasectomy diagram.pdf [pdf] 328KB

What is a vasectomy?

Vasectomy is a permanent method of contraception for men. It is the most effective method of contraception available.

A vasectomy is a minor surgical procedure that cuts through the tubes that carry a person’s sperm from their testicles, where semen produced, to their penis. This means when they ejaculate (cum), their semen will not contain any sperm and so cannot cause a pregnancy.

The procedure is carried out under a local anaesthetic injected into the skin of the scrotum (the ‘sack’ holding the testicles or ‘balls’). A small opening is made in the skin of the scrotum allowing the doctor to reach the sperm carrying tubes (vas deferens). The tubes are then cut, and the cut ends are sealed with a tie. The skin of the scrotum is sometimes stitched with dissolving stitches.

A person’s semen is made up of fluid produced by the prostate and other glands located near the base of the penis, to which sperm are added just before ejaculation. Sperm make up only about 5% of the total volume of the semen. The patient’s glands and fluids are not affected by the operation so, although there will no longer be sperm in the semen, its appearance and volume will be virtually unchanged.

• A vasectomy is almost 100% effective. Only around 1 in 2000 vasectomies fail, usually as a result of the cut ends of the tubes spontaneously joining up again.
• It is a permanent method of contraception, ideal for anyone who does not want (any more) children.
• A person’s partner does not have to use contraception.
• It does not affect the person or their partner’s ability to enjoy sexual intercourse. The vasectomy does not alter sex drive, arousal, orgasm or the volume or appearance of semen.
• It is safer than female sterilisation which involves more invasive surgery, usually under a general anaesthetic.
• Female sterilisation has a failure rate of 1 in 200
• Vasectomy is a minor surgical procedure carried out under local anaesthetic.
• Extensive research in the field has concluded that there is no evidence of long-term health risks for the person.

• It is important for individuals to be very sure that they don’t want (any more) children since vasectomy should be considered permanent and irreversible. Research shows that individuals are more likely to regret having a vasectomy if they were under 25, childless, or not in a relationship at the time of the operation.
• Vasectomy only protects against pregnancy, not against sexually transmitted infections and so condoms should be considered whenever there is a possibility of infection in either partner.
• Some individuals do not like the idea of a procedure on their scrotum even though the local anaesthetic helps to block any pain. Some people describe pressure and pulling sensations during the operation.
• There will be some discomfort/pain during the recovery period.

The procedure is not immediately effective since sperm already in the tubes will need to clear. This takes approximately 24 ejaculations and 3-4 months

The initial request should be made to your GP who will make a referral via the E-referral (Choose and Book) system to the Worcestershire Integrated Sexual Health Service (WISH), who are based at Aconbury North, Newtown Road, Worcester. You will be contacted by the clinic secretary in due notice, though due to Covid-19 delays there is a longer wait than usual. Please make sure your phone number is up to date with your GP as this is how we contact you to book your initial appointment and consultation. This will take place over the phone with a qualified Nurse, who will discuss your medical history and the procedure.

 If you wish to proceed to a vasectomy operation after this consultation, a date will be arranged during the consultation, usually within 8 weeks.

 If for any reason you do not wish to proceed within this time limit, you should wait until you are ready to proceed before asking to be referred.

On the day of the procedure, you will need to shave the hair from your scrotum. You may eat and drink as normal.

You will need to bring a clean pair of supportive tight-fitting underpants with you.

The procedure itself takes about 15-20 minutes and is performed by a specially trained surgeon supported by a nurse. You will be asked to lie on your back on the operating couch. The surgeon will wash the skin of the scrotum with antiseptic fluid before injecting local anaesthetic into the skin on one side of the scrotum.

When the anaesthetic has taken effect, the surgeon will make a small puncture wound in the skin over the tube, using the non-scalpel technique, which will allow them to lift a small section of the vas deferens through the skin opening. The vas deferens is then cut, the two ends firmly tied with a thread, and the vas is replaced in the scrotum. A second injection is given, and the same procedure is then carried out on the other side of the scrotum (on the other tube). There is only a small amount of bleeding during the operation, and it is unlikely that the skin will need stitches. A gauze pad will be placed over the wounds, and the tight underwear helps to keep it in place. The pad should be taken off and thrown away after 24 hours. The wounds should then be allowed to heal uncovered. After the procedure you will walk to the recovery room and rest for about 15-20 minutes until you are ready to be driven home. During this time a nurse will explain what you can expect during the recovery period and they will be able to answer any questions. Patients undergoing vasectomy procedures SHOULD NOT drive themselves home and will need to be collected from the clinic.

Most people will feel some discomfort and experience some bruising and swelling for the first few days. Painkillers such as Paracetamol and Ibuprofen should help. Wearing supportive tight-fitting underpants for a few days and nights after the vasectomy will help with discomfort.

It is advisable to avoid showering or bathing for the first 24 hours after the procedure. After that showers are preferable to baths for the first 7 days to avoid infection. The wound may ooze some fluid for the first few days, but as long as the wound is not becoming more inflamed or more painful with time, this is normal. If you have had stitches, there is no need to wear a dressing over them and they should dissolve within 3 weeks.

It is important that you relax at home for 2 days with your legs elevated to reduce the risk of complications following your operation, and if your job involves lifting heavy loads or a lot of physical activity you are advised to have a longer period off work. Exercise, heavy lifting or driving long distances for one or two weeks after the vasectomy should be avoided.

Sex or masturbation can be resumed after a week if you feel comfortable. It is important to use another method of contraception until you have had tests on your semen showing no more sperm are being ejaculated.

You will be asked to produce a semen sample for analysis – usually this is at 16 weeks after the procedure. You will be contacted with an appointment and all the relevant information and asked to submit a sample to Birmingham Women’s Hospital in Edgbaston, Birmingham.

If your semen analysis is delayed beyond the usual 16 weeks, it is important not to stop using contraception – only when you have received written notification of the result of your semen analysis can you assume that the vasectomy operation has been successful.

If sperm is detected in the first sample, you will be asked to provide a further sample. In a small number of individuals, non-motile sperm may persist and sometimes a ‘special clearance’ is given. Further information will be provided if this is the case for you.

Vasectomy is minor surgery and complications are rare. In fewer than 2% of cases a swelling called a haematoma develops as a result of bleeding within the scrotum. A haematoma generally clears up on its own with painkillers and bedrest.

In up to 8% of cases a mild infection develops at the wound site. In very rare cases a haematoma or infection may need hospital treatment.

A sperm granuloma may develop in about 5% of patients. This is a small lump under the skin near the site of the procedure caused by the leakage of sperm from the cut end of the vas deferens tube. These usually clear up without any treatment, but if they become painful, they can be removed under local anaesthetic.

It is fairly common for patients to experience brief pain in the testicles on ejaculation following their vasectomy; this will resolve itself in time. There is a condition known as Post Vasectomy Pain Syndrome which results in a few patients having constant pain in their testicles and treating this is difficult. This condition is RARE and there have not been any UK studies done on it therefore it is difficult to give accurate information other than to say it is rare and unlikely to happen, but this cannot be guaranteed.

Very rarely the cut ends of the vas deferens tube(s) can re-join and if this happens it could result in a partner’s pregnancy. This happens in fewer than 1 in 2000 cases.