Male Sexual Health

Male Sterilisation (Vasectomy)

What is a vasectomy?

A vasectomy is a disconnecting the tubes coming from the testicles that carry the sperm form the testicles to the urethral from where it is ejaculated.

How is this done?

This is an operation that involves disconnection of these tubes (vas) at the level of the upper part of the scrotum. This is usually done under local anaesthetic and can also be done under general anaesthetic. Local anaesthetic means injection of a medication in the scrotum which will numb that area and the urologist or a trained doctor can do this operation. Two small cuts are usually made or a sharp (knifeless) instrument can be introduced through the skin to hook up the tubes by locating them by finger palpation at the start of the procedure.

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Once the tubes are brought outside the skin, they are tied and cut. This will permanently block the transport of sperm from the testicles to outside.

What are the implications of vasectomy?

This is a permanent procedure. At a later stage if you wanted to revert this procedure it can be surgically possible and that will involve a much longer, time consuming operation and it will be more expensive. Reversal of vasectomy is not available on the NHS in the United Kingdom and you would have to pay for this service. 6% of men who undergo vasectomy do regret the decision about having gone through the procedure. Therefore you are to be absolutely sure before considering this method of contraception.

Is vasectomy a completely reliable method of contraception?

Vasectomy is the most reliable form of contraception but this could fail. The initial success of the vasectomy will be confirmed by absence of sperms in your semen which you would check at three months and four months after the procedure. Even after the initial success the cut ends of the vas could join together at a later stage and the tubes may transfer the sperm outside and you may find yourself fathering a child. This is in the order of about 1 in 2000 men undergoing vasectomy. Therefore it is not a common problem and vasectomy is the most reliable method of contraception but again it cannot be considered 100% reliable for ever.

When can I stop using other methods of birth control?
You should continue your current birth control measures until your doctor or your urologist writes to you following the results of the semen tests you would undertake at three months and four months after the procedure. Until then you should continue your current methods of birth control measures. The sperms which are produced in the testicle can stay alive on the tubes for up to 90 days and therefore 90 days should elapse before you submit your first semen test. It is advisable that you ejaculate at least few times during this period to clear the sperms from the tubes.
What are complications of vasectomy?

The complications include the common complications of any surgery as well as those specific to vasectomy.

  • Bleeding
  • Haematoma formation (accumulation of blood) in the scrotum which may need further surgical evacuation.
  • Wound infection
  • Injury to other organs (blood vessels to the testes causing shrinking of testes)
  • About 5-15% of men who undergo vasectomy can develop longstanding testicular pain due to swelling and inflammation of the tubes coming from the testicles. These are supposedly caused by the irritation of the sperms that accumulate in these tubes. Such patients may require further treatment options using pain killers and in some cases even to undergo further surgery to remove the thickened tubes that come from the testicle (epididymectomy) or in extreme cases to resort to removal of testicles.
How long should I take time off work?
You may return to work after a few days unless you have any complications or if you work involves very heavy manual work and personal body contacts with lifting of heavy objects. Generally you can return back to work within a week.