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). These are then cut and the ends tied. 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 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 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 recommended that you relax at home for a couple of days before returning to work. 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 are asked to produce a semen sample for analysis at 16 weeks after the operation.
You will be contacted with an appointment and all the relevant information, to submit a sample to the hospital that is doing the test.
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.
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.