Reading Urology : Vasectomy Information

A vasectomy is meant to be a permanent method of male contraception. It involves interrupting the tubes (vas) that carry the sperm from your testicles. This prevents the sperm from mixing with the semen and reaching your penis. So a vasectomy should stop your partner getting pregnant.

What are the benefits of surgery?

As a vasectomy is meant to be permanent, you and your partner should no longer need to use any other form of contraception. However, until you are told by us or your doctor that you are sperm-free, you should use another method of contraception.

What does a vasectomy under local anaesthetic involve?

The procedure will take 30-40 minutes and you will be booked into one of our out-patient clinics if you are having your vasectomy under a local anaesthetic. You will spend about 5-10 minutes with the consultant prior to having the procedure in the minor operations room.

Before leaving home we would advise you to take (if you do not suffer from any reactions to) an anti-inflammatory such as Ibuprofen or Nurofen. You are not required to stop eating or drinking prior to this procedure.

Before the operation, the front of your scrotum, at least, needs to be shaved. You may prefer to do this at home. Make sure your scrotum is clean.

The anaesthetic is injected by the consultant alongside each vas tube at the top of your scrotum.

In the no-scalpel technique we use, the consultant feels for the tubes under the skin and holds them in place with a small clamp. Instead of an incision, he makes a tiny puncture with a special instrument which is then used to gently stretch the opening so that the tubes can be reached. The tubes are then cut and blocked. No stitches are needed to close the opening, and it should heal quickly.

Medication

You should continue your normal medication unless you are told otherwise. If you are on warfarin you will need to stop taking it before the operation. Make sure your surgeon is aware you are on warfarin and follow his advice about stopping it.

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What complications can happen?

We will try to make your operation as safe as possible. However, complications can happen. You should ask your doctor, or talk to us, about anything which you do not understand. Any numbers which relate to risk are from studies of patients having this operation. Your GP should be able to tell you if the risk of a complication is higher or lower for you.

Pain It is normal to get some mild discomfort and tenderness in your scrotum. We recommend that you continue to take your anti-inflammatory medication for 48 hours to make yourself comfortable.
Bleeding after surgery (risk: 1 in 100). It is common to get bruising of the scrotum after a vasectomy and this should settle over a few days. If bleeding is heavy please contact us during office hours (generally Mon-Fri 8-5 0118 902 8094) or your GP for further help.
Infection in the scrotum (risk: 1 in 100). If this happens you may need treatment with antibiotics.
Becoming fertile again (risk: 1 in 3,000 over a lifetime). If the tubes rejoin sperm will mix with your semen and you will become fertile again. There is no way of knowing this has happened other than by testing your semen, as it looks the same whether you are fertile or not.
Long-term pain in the testicles (risk: 1 in 25). This pain is probably caused by scar tissue forming and the tubes swelling. Although the pain is not usually severe, it can last for some months and sometimes painkillers are needed.
Congestive epididymitis (risk: 1 in 20). The tube-like structure that stores sperm may get blocked causing pressure and pain. However, it usually settles on its own.
Sperm granuloma (risk: 1 in 50). This is where sperm leaks and causes small painful swellings on the end of the vas tube that has been cut. This usually settles but may sometimes need further surgery.

If any discomfort persists or appears to be getting worse, please contact your GP.

How soon will I recover?

The procedure takes about 30 minutes and you are always welcome to rest in our recovery area or in reception if necessary. You should be accompanied by someone who can drive you home. It is also advisable for you to spend a few days quietly at home following the procedure and not to take part in any strenuous activity or exercise (including sex) during that time. You may possibly want to arrange a few more days away from work if you are in a strenuous or manual occupation.

The future

At about three and again at four months after the operation you should arrange to provide samples of your semen. These will be tested to find out if there are any sperm left. The testing can be done at Berkshire Independent Hospital pathology department at a cost of £17.50 per sample, or your GP may be able to arrange this for you.

Until you are told by us or your GP that you are sperm free you should use another method of contraception.

A vasectomy is meant to be a permanent method of contraception. Although it is possible to have an operation to rejoin the tubes (vasectomy reversal), this does not work for everyone. You should assume that you will not be able to have children again.

If you have any questions please contact us, or your GP.

Are there any alternatives to surgery?

There are two common methods of contraception for women which have a similarly low failure rate compared to a vasectomy:

A coil or IUCD, failure rate - less than 2 in 1,000 over one year
Hormone implants, failure rate - less than 3 in 1,000 over one year

Other methods of contraception include the oral contraceptive pill and female sterilisation, with a failure rate of 1 in 200.

For men the only safe form of contraception, other than a vasectomy, is using a condom. However, the failure rate of 1 in 7 over the course of a year, is substantially higher.

If you think any of these methods may be more suitable for you, please discuss it with your GP.