Vasectomies

A vasectomy is one of the most effective methods of contraception (it is thought to be 99% successful), in which the tubes which carry sperm from the testicles to the outside world are interrupted, so sperm cannot leave the body to fertilise an egg. It should be considered a PERMANENT and IRREVERSIBLE procedure.

Attempts at reversal are possible privately but at significant cost and they may not be successful. Studies suggest that up to 7% of patients being sterilized later express regret so this decision needs careful thought and with consideration that personal circumstances can change, for instance a new partner in the future. Having said that, it is often an excellent option for men who feel certain they don’t want more children in the future or are certain they don’t want to be a father.

We would always recommend discussing a vasectomy with your partner first.

Make sure you have considered alternative options for contraception, which include barrier methods or your partner using hormonal contraception including the pill, the contraceptive implant, or the coil. Female sterilisation is another option although this is more invasive and has a higher failure rate.

Any man can have a vasectomy, however some medical conditions may make this more complicated, and need discussion prior to the procedure. These include – severe obesity, other medical conditions such as bleeding problems or blood thinning medication, previous operations around the genitals including hernia surgery or scrotal surgery. If you are diabetic you will need to have recent blood tests demonstrating good control of this in order to safely proceed. Allergies to anaesthetic or latex are also very important to discuss.

It is also important to think extra carefully if you are under 30 years old (see below), you do not have any children already, if you have a child less than one year old, or if your partner is pregnant, as rates of regret are higher in all these groups. You should also be cautious in making this decision if you have had recent difficulties in the relationship with your partner.

If your partner is in her 40s or older, it may be helpful to consider the potential impact of menopause when deciding on contraception. If she is experiencing symptoms such as less frequent periods or hot flushes, or is approaching the age her mother went through menopause, contraception may only be needed for a limited time. In these cases, the long-term benefits of a vasectomy may be outweighed by the short-term need.

That said, many couples are confident in their decision not to pursue pregnancy in their 40s and choose vasectomy as a reliable, hormone-free form of contraception. This can also help alleviate symptoms some women experience from hormonal birth control.

As a general guide, contraception is no longer needed if your partner is over 50 and has not had a period for one year, or between 40 and 50 with no period for two years.  Decisions such as these need to be made with your partner as there is an impact for both parties.

Also, keep in mind that a vasectomy is not immediately effective—you will need a post-vasectomy semen analysis to ensure that the vasectomy has worked, and must continue to use contraception during this time.

If you are less than 30 years old and you have had fewer than 2 children, especially if you are single (whatever your age), please consider the following points before having a vasectomy:

1. You may regret it. Men who have vasectomies when they are in their 20s, especially if they have had fewer than two children, to seek vasectomy reversal at a later date – it is thought around 1 in 7 men will decide it was a mistake. They may regret their vasectomy decision particularly if reversal is not successful.

2. You, and your partner,  may change your mind about wanting children. It’s not uncommon for people who thought they didn’t want children in their 20s to change their mind in their 30s or 40s.

3. Relationships end and you may wish to start a family with a new partner.

4. Vasectomy should be considered a permanent and non-reversible procedure because vasectomy reversals are not always successful. So before having a vasectomy, be aware of all of the other options and that reversal is expensive and not available on the NHS.

5. Young men may wish to consider sperm storage. It may well be worth the investment, (typically £300 for first sample, £150 subsequent samples, then £300 annually thereafter) but do bear in mind that there is quite a cost implication involved in using the sperm to create a pregnancy subsequently

A vasectomy is performed under local anaesthetic, so you’ll be awake during the procedure but should not feel any pain. It takes place in our day surgery theatre and typically lasts between 20 and 30 minutes.

A small incision is made in the scrotum, through which the tubes that carry sperm are gently brought out, sealed or disconnected, and then returned to their original position. The incision is minimal and typically does not require stitches.

A piece of gauze will be placed as a dressing, which should be worn inside snug-fitting underwear for a few days while healing begins.

You should not drive after the procedure so will need to arrange transport home.

We would recommend taking it easy for a few days, wear supportive underwear day and night, and use simple pain relief like paracetamol. It is best to avoid showering for 48hrs and soaking (e.g. baths/swimming) for 3-4 days. You should also avoid strenuous exercise and heavy lifting for 1-2 weeks afterwards. You may resume sexual intercourse when you feel comfortable, although you should continue to use contraception until the results of your post-vasectomy semen analysis have been seen.

You will need to have a semen sample 12 weeks after the procedure, and this must go directly to Poole Hospital – we will give you more information and the sample kit for this on the day. This is an essential part of the process to ensure that the procedure has been successful.

No assurance can be given that you have become infertile without these tests and no responsibility can be accepted for failure of the operation if the required sample is not submitted at the appropriate time. You will be given advice on the post-vasectomy semen analysis.

Complications from a vasectomy are rare but can include bruising, bleeding, swelling or infection.  It is thought around 1% of those who have had a vasectomy develop persistent pain, which although not severe, may interfere with your quality of life and may require further treatment.

Around 0.5% of men who have a vasectomy have a ‘failed vasectomy’, which means the tubes rejoin and they regain their fertility.  This can happen in future years, but it is rare.

• You won’t be able to get the area wet for 48 hours, so we advise having a shower or bath the morning of the vasectomy
• Please shave your scrotum area 3-4 days before the procedure.
• It is advisable to ‘clear your diary’ for a few days after the procedure and you shouldn’t life anything heavy for 1-2 weeks.
• You won’t be able to drive home, so please arrange transport for the day.
• Some people benefit from ice packs (wrapped in a clean towel) to help with any swelling after the procedure
• We would advise having a stock of pain medication for the days after the procedure
• It is fine to eat and drink before the procedure
• Freshly laundered, supportive, tight-fitting underwear is advised for the days following the vasectomy.