Vasectomy

What is a vasectomy?

A vasectomy is also known as male sterilisation; it is a procedure that prevents the sperm from reaching the semen when the man ejaculates, meaning the man’s semen does not contain any sperm and therefore cannot be used to fertilise an egg. It is generally regarded as a permanent measure but it can be reversed if necessary. Most men have a vasectomy to prevent them from having more children in the future; this procedure is one of the most effective forms of contraception available.

What does the procedure involve?

The vasectomy itself is a very easy and quick procedure; it normally only takes around 15-25 minutes. There are two types of vasectomy, including the conventional vasectomy and the no-scalpel vasectomy.

  • The conventional vasectomy involves making two small incisions in the scrotum, which allow the surgeon to gain access to the vas deferens (the small tubes that carry sperm from the testicles). The tubes are both cut at the end and a small amount of tissue is removed from each tube; the tubes are then closed and the incisions are stitched.
  • The no-scalpel vasectomy: the no-scalpel method eradicates the need for an incision; instead, the doctor will feel for the vas deferens and then clamp them in place. The doctor will then make a tiny hole in the scrotum and enlarge it using forceps (these are smaller than standard forceps); the tubes are then cut and sealed in the same way as the conventional vasectomy. This method is preferable because it carries less risk of infection and is less painful; there is also less bleeding and recovery will usually be faster.

Both types of procedure are usually carried out under local anaesthetic, although in rare cases general anaesthetic may be used (this is usually if the patient has an allergy to local anaesthetic or is prone to fainting). Local anaesthetic will be used to numb the scrotum and the testicles so that the patient will not experience any pain during the procedure.

Is the procedure available on the NHS?

Most vasectomies are carried out free of charge on the NHS, but there are often waiting lists as the demand is fairly high. Some areas may have longer waiting lists than other areas; your GP should be able to find out how long you would have to wait if you want to go ahead and have a vasectomy. If you don’t want to wait, you may consider having the operation done privately; this will often be much quicker but you will have to pay for the treatment.

How long does recovery take?

Most patients go home the same day as they have the operation but they may experience pain, swelling and tenderness for a while afterwards; most patients experience these symptoms for between 3 and 7 days after the procedure. Doctors recommend taking painkillers to ease pain and wearing tight fitting underwear to support the scrotum for a few days after the operation. Most patients will be able to return to work after a few days. It is advisable to avoid having sexual intercourse for a few days; if you do have sexual intercourse you need to carry on using contraception until you have had two semen tests that confirm no sperm is present.

Are there any risks?

The risk of complications is very low; however, many patients will experience mild symptoms including bruising, swelling and pain for a period of time after the operation. In rare cases, complications can occur; possible complications include:

  • Infection: infection can occur as a result of the incisions made in the scrotum
  • Haematoma: haematomas (collections of blood) can form in the scrotum; this can cause severe pain and swelling and should be treated as quickly as possible
  • Sperm granuloma: a granuloma is a hard lump that can develop when the sperm leaks out of the tubes when they are cut. The lumps are not painful but they may contribute to pain in the groin and scrotum
  • Testicular pain: chronic testicular pain may be caused by a vasectomy; this can vary between dull, long-term pain and acute bouts of more severe pain.

Is the procedure reversible?

A vasectomy is reversible but the results are not always positive and a vasectomy should really be seen as a permanent measure. If the reversal is carried out within ten years of the original operation there is around a 50 percent chance of success; the rate falls considerably after this period of time. The NHS does not carry out many vasectomies and private operations can be expensive.

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