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• You have decided to have a vasectomy and this factsheet provides some standard information and advice about the procedure. However, you should always follow the instructions of your own specialist.

  If you have any unanswered questions or concerns, please do not hesitate to ask your specialist or nurse for more information. It is natural to feel anxious, but knowing what to expect can often help.

  What is a vasectomy?

  A vasectomy is an operation to cut and seal off the tubes (called the vas deferens) that carry sperm from each of the testicles to the penis.  Having a vasectomy means you will not be able to conceive children. It is a permanent method of contraception that's sometimes called "male sterilisation". 

  A vasectomy will not affect your sex drive or ability to enjoy sex. You will still have erections and produce the same amount of fluid when you ejaculate. The only difference is that the fluid will not contain sperm. Your body will still produce sperm, but they can’t travel to your penis and are naturally reabsorbed. 

  Although there is an operation that can reverse a vasectomy, this is a difficult procedure that often fails.  Therefore, when you chose to have a vasectomy, it should be considered irreversible. 

  Research shows vasectomy is a very reliable form of contraception.  In a recent study of 1000 men, only 20 had positive semen tests (that contained sperm) during a three year follow up of their vasectomy.  Most of these positive results were at very low levels of sperm, and many men were negative when re-tested. There were no unwanted pregnancies in the couples studied.

  Vasectomy is routinely performed with a local anaesthetic as a day case, with no need for an overnight stay in hospital. Much less commonly, a general anaesthetic is given. Your specialist will advise which is the most suitable for you. For more information about anaesthesia, please see the separate  leaflets.

  Preparing for your operation

  Your specialist or hospital will give you some information about when and how to check into hospital.

  Before you come into hospital, you may be asked to:

  • Have a bath or shower at home on the day of your admission
  • Remove any bulky or sharp jewellery. Rings and earrings that youd prefer not to remove can usually be covered with sticky tape
  • Bring tight-fitting underpants to wear after surgery – these support your testicles and reduce swelling
  • There is no need to go without food and drink if you are having a local anaesthetic

  When you arrive at the hospital, a nurse will explain how you will be cared for during your treatment and may perform some simple tests such as checking your pulse and blood pressure, and testing your urine.  Your specialist may also visit you.  This is a good time to ask any outstanding questions about your treatment.

  You may need to shave part of your scrotum, to prevent hairs getting caught in the wound, and will be asked to change into a hospital gown.

  Consent

  Before going to the theatre, You will be given a consent form to sign. By doing this, you confirm that you understand what the procedure involves, including the benefits and risks, and give your permission for it to go ahead. 

  Please refer to further information below regarding the risks of this procedure. You need to know about these in order to give your informed consent.

  About the operation

  You will usually walk to the operating theatre. Once you are lying comfortably on the operating table, you will be given local anaesthetic injections in both sides of your scrotum. This may sting but the area will quickly go numb.

  The surgeon will feel your testicles to locate the vas deferens and make tiny cuts in both sides of the scrotum. The tubes are carefully pulled out through these incisions.  Each tube is cut, a small section is removed and the ends of the tubes are sealed off.

  The vas deferens are gently placed back into the scrotum and the cuts are closed using dissolvable stitches or adhesive strips.

  The sections of the tubes that are removed are routinely analysed in a lab to confirm they are the vas deferens.

  The operation lasts about 15-30 minutes.

  After your operation

  After the procedure, you will return to your room or the day care ward.  A nurse will assess the operation site and ensure you are as comfortable as possible.
  
  As the local anaesthetic wears off, your scrotum might feel a bit sore. A painkiller, such as paracetamol or ibuprofen, should help relieve any discomfort.

  Going home

  You will be offered light refreshments and, after getting dressed, you will be able to go home. It is sensible to have someone to drive you.

  Before you leave, your nurse will advise you about caring for your stitches, and taking a bath or shower. The nurse will also give you a contact telephone number for the hospital, in case you need to ask for any further advice.

  Before you can rely on your vasectomy for contraception, your semen will need to be tested. Sperm can remain in the tubes for several months, so you will need to take one semen sample to the hospital 8 -12 weeks after surgery and a second sample two weeks later. Your nurse will give you precise dates and two bottles to provide the samples.

  After you return home

  It's sensible to take it easy for the rest of the day. Most men feel fit enough to go back to work the day after vasectomy. Wearing tight-fitting underwear day and night for a week will help to ease discomfort and prevent swelling. Avoid heavy lifting or vigorous exercise in the first few days after the operation, as this can put a strain on the healing cuts.

  You can have a bath or shower as normal, but dry the area gently and thoroughly. Any dissolvable stitches will disappear on their own after about a week, and fabric strips can be peeled off after 7-10 days. 

  You will be able to have sex as soon as you are comfortable, but use contraception until you’ve had the results from your semen samples.

  Your wound should heal fairly quickly. However, if there is an increase in swelling, or the wound becomes red or hot, please contact the hospital.

  What are the risks?

  Having a vasectomy is generally a very safe procedure. However, like all surgery, there are some risks. These can be divided into the risk of side-effects and the risk of complications.

  Side-effects

  These are the unwanted, but usually mild and temporary, effects of a successfulprocedure. After a vasectomy, there will be numbness caused by the local anaesthetic. Your scrotum will also be a bit sore and bruising may develop.

  Complications

  This is when problems occur during or after the operation. Most men are not affected. The main possible complications of any surgery are excessive bleeding during or soon after the operation, or infection.  Complications may require further treatment such as returning to theatre to stop the bleeding, or antibiotics to treat an infection.

  Specific complications of vasectomy are rare. Bleeding can occur inside the scrotum, causing it to swell and become painful. This is called a haematoma.

  It is possible for sperm to leak out of the cut tubes and collect in surrounding tissues. If this happens, hard lumps, called sperm granulomas can form. This is rare but can be painful.

  Very occasionally, the cut tubes become inflamed and cause other tubes next to the testicles to swell. If this happens, you may feel a dull ache in your testicles that can last for several months. A small proportion of men experience pain for longer. This may be due to pinched nerves or scarring and might require further surgery.

  Very rarely, even when performed correctly, there is a very small risk the tubes can rejoin naturally and you will become fertile again. 

  Some research suggests that vasectomy increases your risk of developing kidney stones. You should ask your specialist to explain how these risks apply to you.

  This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

• Further information

  Engender Health
  http://www.engenderhealth.org/wh/fp/888/index.html
  http://www.engenderhealth.org/wh/fp/cvas2.html

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