Vasectomy

A vasectomy, also known as male sterilization, is a quick and virtually painless surgical procedure. The tubes that carry sperm from the testicles to the penis are sealed preventing pregnancy. The procedure is effective and permanent and you will be able to return home the same day.

In the male genitalia, there are two tubes, called vas deferens which carry sperm to the penis. A vasectomy disrupts each vas deferens preventing sperm entering and activating semen.

So, what happens to the sperm? Sperm cells stay in your testicles and are absorbed by your body. After 3 months of vasectomy, your semen won’t contain any sperm, so it can’t cause pregnancy. But this does not mean that you are not going to have semen. You can still ejaculate semen without the sperm.

Vasectomies at the Cadogan Clinic are carried out as a day case surgery under local anesthetic. This means that only your scrotum will be numbed, and you will be awake for the procedure. You will not feel any pain, although it may feel slightly uncomfortable.

Occasionally patients prefer a general anaesthetic, but it is still a day case procedure. At the Cadogan Clinic we use TIVA (Total IntraVenous Anaesthesia) which is light and allows you to go home early.

It's common to have some mild discomfort, swelling and bruising of your scrotum for a few days after the vasectomy. If you have pain or discomfort, you can take painkillers, such as paracetamol.

It's common to have blood in your semen in the first few ejaculations after a vasectomy. This isn't harmful.

It is advised that you wear close-fitting underwear, such as Y-fronts, to support your scrotum and help ease any discomfort or swelling. Make sure you change your underwear every day.

It is safe for you to have a bath or shower after your operation –make sure you dry your genital area gently and thoroughly.

Most men will be fit to return to work one or two days after their vasectomy, but you should avoid sport and heavy lifting for at least one week after the operation. This is to minimise the risk of developing complications.

You can have sex again as soon as it is comfortable to do so, although it is best to wait for a couple of days. However, you will still have sperm in your semen immediately after the operation, as it takes time to clear the remaining sperm in your tubes. It takes an average of 20-30 ejaculations to clear the tubes of sperm completely. You will need to use another method of contraception until you have had two clear semen tests.

Thus, don’t have sex immediately after the procedure; you should wait until you don’t feel any pain around the surgery site and comfortable to have sex. This may mean waiting a week or more after your procedure, it depends. Also, sex can hurt after vasectomy as it may cause mild pain, soreness and bruising around your scrotum, blood in your semen and other symptoms which can last from a few days to a few weeks.

Once the operation has been carried out successfully and semen tests have shown that there is no sperm present, long-term partners may not need to use other forms of contraception.

However, a vasectomy does not protect against HIV infection or any other STI's, so you should still use condoms with any new partner.

After the vasectomy, there will be some sperm left in the upper part of the vas deferens tubes. It can take more than 20 ejaculations to clear these sperm from the tubes so, during this time, there is still a risk of pregnancy. Until it has been confirmed that your semen is free of sperm, you should continue to use another form of contraception.

At least eight weeks after the procedure, you will need to produce a sample of semen, which will be tested for sperm. This will also help to identify the rare cases in which the tubes naturally re-join themselves. Once tests have confirmed that your semen is free of sperm, the vasectomy is considered successful and you can stop using additional contraception.

A few men continue to have small numbers of sperm in their system, but these sperm do not move (they are known as non-motile sperm). If you are one of these men, your doctor will discuss your options with you. The chances of making your partner pregnant may be low enough to consider the vasectomy successful, or you may be advised to have further tests or consider other options.

It is possible to have a vasectomy reversed. However, the procedure is not always successful. You have a better chance if it is done very soon after the vasectomy. But it is worth mentioning that this procedure is more complicated than vasectomy itself.

If a reversal is carried out within 10 years of your vasectomy, the success rate is about 90%. This falls your reversal is carried out more than 10 years after your vasectomy. As shown above, success rates are not perfect and there is no guarantee. Moreover, pregnancy still may not happen after a vasectomy reversal because your sperm may be less mobile than they were before.

 Even if a surgeon manages to join up the vas deferens tubes again, pregnancy may still not be possible. This is why you should be certain before going ahead with the vasectomy.

- The failure rate is only one in 2,000 – out of 2,000 men who have a vasectomy, only one will get a woman pregnant in the rest of his lifetime.
- There are rarely long-term effects on your health.
- Vasectomy does not affect your hormone levels or sex drive but rather it makes your sex better.
- It will not affect the spontaneity of sex or interfere with sex.
- Vasectomy may be chosen as a simpler, safer and more reliable alternative to female sterilization.
- Vasectomies are easier and less expensive than female sterilization.
- Vasectomies are permanent and the success rate reaches more than 99% effective at preventing pregnancy.
- Vasectomy doesn’t require hospitalization of the patient as the operation takes only 15-20 minutes.

The disadvantages of a vasectomy are:

+ You need to use contraception after the operation until tests show your semen is free of sperm.
+  If your semen contains sperm, you could make your partner pregnant.
+  As any surgery, complications can occur –risks are rare, but can include long-term testicle pain, haematoma, infection, bleeding, bruising, or swelling after the procedure.
+ Vasectomy doesn’t prevent the spread of sexually transmitted infections (STDs).
+ Vasectomy is not immediately effective as it may take 2-3 months to get tubes clear from sperm.
+ You need to keep using contraception for 2-3 months after surgery.
+ Vas deferens tubes could reconnect, but this is very rare.