Vasectomy

A vasectomy procedure, also known as ‘the snip’, is a form of permanent contraception (sterilisation) that stops sperm being ejaculated from the penis during sex. It involves a minor procedure to block the tubes that carry sperm out of the testicles to produce semen.

Preparation 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 the skin over your scrotum will be numb, but you’ll stay awake during the operation. Your doctor may sometimes recommend that you have a general anaesthetic, and they’ll explain why if this is necessary. This means you’ll be asleep during the procedure.

It’s a good idea to take some close-fitting, supportive underwear, or an athletic or 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.

Vasectomy procedure

A vasectomy procedure usually takes less than 30 minutes.

If you’re having local anaesthesia, your doctor will inject the anaesthetic 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 more anaesthetic.

There are two main ways you can have a general anaesthetic. You might breathe in an anaesthetic gas through a face mask, or your anaesthetist can inject it 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 make small puncture holes instead. They’ll cut each vas deferens then seal the tubes shut by tying or stitching them or by using heat. Sometimes your doctor will remove a small part of each vas deferens.

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.

Aftercare following vasectomy

Your doctor will put some dressings over the wound and you’ll 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. It may help to take 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. Ask a friend or family member to drive you home because 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.

Recovery following a vasectomy

You may continue to feel some discomfort for several days after your vasectomy procedure. 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 a couple of days 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 put them directly on your skin. Wear close-fitting, supportive underwear such as tight pants or a scrotal or athletic support for the first couple of 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 patting it.

Wait for between two and seven days before you have sex. Make sure that you use contraception until your doctor has confirmed you’re sterile (see the section on post-vasectomy tests below). Although rare, 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 because 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 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 if you’re sterile or need to repeat the test again later. Don’t stop using other forms of contraception until your doctor confirms you’re sterile.

Complications of vasectomy

Complications are problems that happen during or after a 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. Contact the hospital or your GP if you notice a large swelling.
• Hard lumps in your testicles formed from sperm and called sperm granulomas. You might need another procedure to remove these if they’re uncomfortable.
• Inflammation of your testicle. This is called epididymo-orchitis.
• Long-term pain in your testicles, scrotum, penis or lower tummy (abdomen). This isn’t a problem for most men but if you’re affected, medicines or (rarely) surgery can usually help to relieve it.
• 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.