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Your questions answered
WISH at Aconbury North
Worcestershire Integrated Sexual Health
Telephone: 01905 681650
If you or anyone in your household are experiencing any Covid 19 symptoms – high temperature or new and continuous cough, even if it’s mild, please contact us to rearrange your appointment, go to NHS.UK to check your symptoms and follow specialist medical advice, and everyone in your household must stay at home for 14 days and keep away from others.
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.
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 operation that cuts through the tubes that carry a man’s sperm from his testicles, where they are produced, to his penis. This means that when he ejaculates (cums), his semen will not contain any sperm and so cannot cause a pregnancy.
The operation 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 man’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 glands and their fluids are unaffected by the vasectomy operation so, although there will no longer be sperm in the semen, its appearance and volume will be virtually unchanged.
What are the advantages of vasectomy?
- 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 a man who does not want (any more) children.
- A man’s partner does not have to use any contraception, so avoiding side effects for her.
- It does not affect a man’s, or his partner’s, ability to enjoy sexual intercourse. The vasectomy will 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 operation carried out under local anaesthetic.
- Extensive research in the field has concluded that there is no evidence of long-term health risks for the man.
What are the disadvantages of vasectomy?
- It is important for a man to be very sure that he does not want (any more) children since vasectomy should be considered permanent and irreversible . Research shows that men are more likely to regret having a vasectomy if they were younger that 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 men do not like the idea of an operation on their scrotum even though the local anaesthetic helps to block any pain. Some men describe pressure and pulling sensations during the operation.
- There will be some discomfort /pain during the recovery period.
· The operation is not immediately effective since sperm already in the tubes will need to clear. This takes approximately 30 ejaculations and 3-4 months.
How do I request a vasectomy?
The initial request should be made to your GP who will make a referral via ’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, usually within the next 2-4 weeks, with written confirmation of the appointment your GP has arranged. Your initial appointment will be for a pre-operative assessment and consultation. This could take place at Smallwood House Clinic in Redditch if your GP is in Redditch and Bromsgrove, at WISH at Aconbury North, Newtown Road in Worcester if your GP is in South Worcester, and at The Health Centre, Bromsgrove Street in Kidderminster if your GP is in Wyre Forest.
If you wish to proceed to a vasectomy operation after this consultation, a date will be arranged before you leave the clinic. The operation is usually within 8 weeks after the consultation.
Our aim is that a man should have his vasectomy operation performed within 18 weeks from the time the GP refers him.
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.
What is the usual procedure for a vasectomy?
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 and if you have one please bring a dressing gown.
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 tube (or vas deferens) through the skin opening. The tube/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. Men undergoing vasectomy procedures SHOULD NOT drive themselves home and will need to be collected from the clinic.
How long does it take to recover from the operation?
Most men will feel some discomfort and experience some bruising and swelling for the first few days. Painkillers such as Paracetamol and Ibuprofen should help, but if the discomfort is more that you feel is acceptable, you should see your own GP. Wearing supportive underpants for a few days and nights after the vasectomy will help with any discomfort.
It is advisable to avoid showering or bathing for the first 24 hours after the operation. After that showers are preferable to baths for the first 7 days in order 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, they should dissolve within 3 weeks.
It is important that you relax at home for 2 days with your legs elevated as much as possible before returning to work to help reduce the risk of complications following your vasectomy. If your work involves lifting heavy loads or a lot of physical activity you may be advised to have a longer period off work. In any case it is better to avoid exercise, heavy lifting or driving long distances for one or two weeks after a vasectomy.
Sex or masturbation can be resumed after a week if you feel comfortable. It is important to use another method of contraception until tests on semen show no more sperm are being ejaculated
How will I know if the vasectomy was successful?
'You will be asked to produce a semen sample for analysis – usually this is at 16 weeks after the procedure but currently there are delays in this part of the service due to the coronavirus pandemic. As soon as the service allows, you will be contacted with an appointment and all the relevant information, and asked to submit a sample to Birmingham Women’s Hospital, 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 semen sample. It is important not to stop using contraception until you have received written notification that the vasectomy has been successful. In a small minority of men, non-motile sperm may persist and sometimes a ‘special clearance’ is given. Further information will be provided if this should be the case for you.
What are the possible complications?
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. If this happens the man should see his GP as soon as possible. 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. The man should see his GP to obtain antibiotic treatment. In very rare cases a haematoma or infection may need hospital treatment.
A sperm granuloma may develop in about 5% of men. 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 men 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 men 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.
There is ongoing research taking place, looking at possible links that having a vasectomy could increase the risk of developing cancer of the prostate or testicles in the future – to date there are no proven links.
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. If a man is worried this may have happened he can talk to his GP about having further semen samples tested.