Vasectomy
- Professor Raj Persad, Consultant Urological Surgeon
A vasectomy is a form of permanent contraception for people who have male sex organs, including a penis and testicles. It involves a minor procedure to block the tubes that carry sperm out of the testicles to produce semen.
How a vasectomy is carried out
The procedure | surgical techniques - watch in 2 minutes 24
A vasectomy is a surgical procedure to stop you being able to have children. This video looks at what happens during the operation.
About vasectomy
Having a vasectomy procedure involves sealing off a tube in your scrotum called the vas deferens. The vas deferens is the tube that carries sperm out of your testicles, where it’s made, to produce semen. This is the fluid that’s ejaculated out of your penis. You’ll still be able to have sex in the same way after a vasectomy, and you’ll still produce semen. Your levels of the hormone testosterone and your sex drive will be unaffected. But your semen won’t contain sperm. This means it won’t be able to fertilise an egg and cause a pregnancy.
When you should have a vasectomy
You may decide to have a vasectomy if you don’t want any more children. A vasectomy is a very effective, permanent type of contraception and it’s rare for it not to work. It has a higher success rate and is a simpler procedure with a lower risk of serious complications than female sterilisation procedures.
If your vasectomy is successful, you won’t need to use contraception again to prevent pregnancy. But it’s important to know that a vasectomy can fail. For more information, see our section on complications. Vasectomy doesn’t protect against sexually transmitted infections (STIs). So if you need protection from STIs, you’ll need to use an additional contraceptive.
When you shouldn’t have a vasectomy
You shouldn’t have a vasectomy if there’s any possibility that you may want to have children in the future. Don’t forget that your circumstances may change and you may come to regret your decision.
It’s better not to make the decision to have a vasectomy when you’re under stress or going through any major life changes. Such changes include immediately after having a baby, miscarriage or abortion. It’s also best to wait if you’re having any family or relationship difficulties. You may be more likely to regret a vasectomy if you’re under 30, single or have no children. In these cases, your doctor will want to be sure you’ve thought through your decision carefully.
Although it’s possible to have a vasectomy reversal, this doesn't always work and your fertility may not return. Vasectomy reversal isn’t usually covered on the NHS, so you would need to pay to have this done privately.
How to get a vasectomy
If you’re thinking about having a vasectomy, you’ll need to book an appointment for an assessment first. This can be with your GP or at a contraceptive or sexual health clinic. If you have a current partner, it’s best if they can go with you. Your doctor will want to know about your (and your partner’s) medical history because they will want to discuss all your contraceptive options.
Your doctor will examine you to check if you have any medical problems that might make a vasectomy more difficult. These can include:
- previous surgery involving your genitals or scrotum
- an enlarged vein (varicocele) or swelling (hydrocele) in your scrotum, which makes it difficult to reach your vas deferens
- long-term pain in your testicles
- testicular cancer
You can usually have a vasectomy if you have any of these problems but you may need general anaesthesia rather than local anaesthesia. Your doctor may also suggest general anaesthesia if they have difficulty finding your vas deferens tube when they examine your scrotum. For more information, see our section on preparation.
Your doctor will talk to you about all your contraceptive options, and the benefits and risks of having a vasectomy including possible complications. For more information, see our section on complications. Your doctor will explain exactly what will happen before, during and after the procedure. They will usually give you some written information to take away too.
Take your time in making the decision, and talk things through with your partner if you have one. Be sure to ask your doctor if you have any questions. You’ll be asked to sign a consent form before the procedure, so it’s important that you feel fully informed.
Preparing for a vasectomy
Your doctor will explain how to prepare for your procedure. For example, if you smoke, it’s a good idea to quit before any operation. Smoking can increase your risk of infection and other complications after surgery. It can also slow down your recovery.
Vasectomy is usually done as a day-case procedure at a clinic or hospital or sometimes at your GP practice. This means you’ll be able to go home on the same day. You usually have a vasectomy under local anaesthesia. This means your groin area will be numb, but you’ll stay awake during the operation. Your doctor may recommend that you have a general anaesthetic if your surgery is likely to be more difficult. This means you’ll be asleep during the procedure.
It’s a good idea to take some close-fitting, supportive underwear or an athletic/scrotal support with you to the hospital or clinic. These will help to ease any discomfort and swelling in your scrotum after your procedure.
The hospital or clinic may ask you to clean and shave your scrotum before you come in for the procedure. If so, they will give you instructions on how and when to do this. When you arrive for your procedure, a member of the hospital team will check that you’re still happy to go ahead.
What happens during a vasectomy?
A vasectomy procedure usually takes around 10 to 15 minutes.
If you’re having a local anaesthetic, your doctor will give this as an injection into the skin and tissue around your scrotum. You’ll need an injection on each side. The injection can be a bit painful, but once the anaesthetic has taken effect, your skin here will be numb. If you do continue to feel any pain, tell your doctor and they may be able to give you a painkiller or more anaesthetic.
There are two main ways you can receive a general anaesthetic. You might breathe in an anaesthetic gas through a face mask, or it can be injected into your vein through a cannula. Having a general anaesthetic means you’ll be unconscious for the entire procedure.
To reach your vas deferens tubes, your doctor may make one or two small cuts in the skin of your scrotum. Or, they may use a minimally invasive technique called ‘no scalpel vasectomy’. This means they will just make small puncture holes instead. They’ll cut each vas deferens then seal the tubes shut by tying or stitching them, inserting plugs, or heating the tissues. Sometimes a small part of each vas deferens is removed.
The puncture holes in your skin may be small enough to not need stitches. But if you do need them, your doctor will use dissolvable stitches or adhesive strips.
What to expect afterwards
You’ll have some dressings covering the wound and will need to wear a support to protect and compress the area. You may need to stay at the hospital or clinic for a short time while the staff make sure you’re feeling OK.
It will take several hours for the local anaesthetic to wear off and the feeling to come back in your scrotum. Take care not to bump or knock yourself. You may want to start taking over-the-counter painkillers such as paracetamol before the anaesthetic wears off.
You’ll be able to go home as soon as you feel ready. It’s a good idea to have a friend or family member drive you home as you’re likely to be in some discomfort. Before you leave, your doctor or nurse will give you some advice about your recovery. They’ll also give you information about follow-up appointments.
Recovering from a vasectomy
You may continue to feel some discomfort for several days after your vasectomy procedure. Vasectomy side-effects include swelling, bruising and pain around your scrotum. You may have some clear, yellow fluid coming from your wound a few days after the procedure, and it may bleed a little. This should improve within a couple of days. Take it easy for the first few days – get plenty of rest and don’t lift anything heavy or do any strenuous exercise. Arrange to take some time off work if you need to.
If you need something to help with the pain, take a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen. You may find ice packs helpful too, but don’t apply them directly to your skin. Wear close-fitting, supportive underwear such as tight pants or a scrotal or athletic support for the first few days – both day and night. This will support your scrotum and help to ease any discomfort and swelling.
You can shower as soon as you want to after a vasectomy. But don’t submerge your wound – either by having a bath or going swimming – for at least five to seven days. Dry your genital area gently and thoroughly afterwards by dabbing it.
You should wait for between two and seven days before having sex. Make sure that you use contraception until your doctor has confirmed you’re sterile. You might have some blood in your semen the first few times you ejaculate.
If you have stitches, they’ll usually dissolve within two to three weeks.
Post-vasectomy tests
It can take several weeks to become sterile after having a vasectomy. This is because after the procedure, some sperm will remain in the tubes past the area where they have been blocked. These sperm will be cleared during normal ejaculation. How long it takes can vary but on average, you’ll need between 20 and 30 ejaculations. For this reason, it’s important to continue with regular, protected sex to flush the remaining sperm out of your system.
Your doctor will test a sample of your semen around 12 weeks after your operation to see if your tubes are clear of sperm. They’ll be able to tell you whether you’re sterile or need to repeat the test again later. Around 8 in 10 people will be clear of active sperm at this point. Don’t stop using other forms of contraception until your doctor confirms you are sterile.
Complications of vasectomy
Complications are problems that happen during or after a procedure. Most men don’t have any long-term problems following vasectomy. But it’s important to be aware of the potential risks before you have the procedure. Possible complications of a vasectomy include the following.
- An infection. This is estimated to affect fewer than two in 100 men. Seek medical attention if your scrotum becomes red, tender or swollen and you have a fever. You may need antibiotics.
- Damage to small blood vessels, causing bleeding inside your scrotum. This is called a haematoma and will need further treatment. Contact the hospital or your GP if you notice a large swelling.
- Long-term pain in your testicles, scrotum, penis or lower abdomen. This isn’t a problem for most men but if you are affected, medicines or, rarely, surgery can usually help to relieve it.
- Hard lumps in your testicles formed from sperm and called sperm granulomas. You might need another procedure to remove these if they’re uncomfortable.
- Pain or swelling in the tubes (epididymis) at the back of your testicles, where sperm are stored. This is called epididymitis. It can happen if the epididymis become backed up with stored sperm.
- Failure of the vasectomy. It’s possible that the vasectomy may not work. This can happen early on and you may find out when you go for your post-vasectomy sperm counts. Rarely (in around 1 in 2000 people), the tubes rejoin after you’ve had a negative sperm count (a ‘late failure’). This means that you’ll be fertile again. It can happen years after your vasectomy.
There’s no evidence that blocking the tubes that transport your sperm causes any long-term health risk.
Vasectomy reversal
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- Pippa Coulter, Freelance Health Editor
