A vasectomy or 'male sterilisation' is a simple and reliable method of contraception. It is usually considered a permanent form of contraception, although in some cases the procedure can be reversed, if necessary, e.g. if you decide to have children later on in life.
How does a vasectomy work?
It works by preventing sperm from reaching the semen that is ejaculated from the man's penis during sex. It is a quick and painless surgical procedure, usually carried out under local anaesthetic. In most cases, you will be able to return home the same day as your procedure.
A vasectomy has no effect on your sex drive or ability to enjoy sex. You will still have erections and ejaculate normally. The only difference is that the semen you ejaculate will not contain sperm.
What are the benefits?
A vasectomy may be appropriate when a couple do not want any more children, or have decided not to have any at all. It may be chosen as a simpler and more reliable alternative to female sterilisation.
A vasectomy is normally permanent, so once it has been carried out successfully and semen tests have shown 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 sexually transmitted infection (STI), so you should continue to protect yourself by using condoms with any new partner.
Is it right for me
In almost all cases vasectomy is permanent, so be sure you don't want any more children
When should I say no?
If you are thinking about reversal, using a sperm bank or the option of IVF in the future, having a vasectomy isn't the right contraceptive choice for you at the moment.
Having a vasectomy should always be viewed as permanent sterilisation. This is because, although reversal is sometimes possible, it takes delicate micro-surgery to join the tubes together again. Even when a surgeon successfully joins them, conception isn't always possible.
You might find the following points helpful in making your decision : -
Vasectomy is most suited to men in a stable relationship who have decided, with their partner, not to have any children or not to have any more.
If you enter a new relationship at a later point in your life you may not be able to father a child.
Some doctors are reluctant to perform the operation on younger men (under the age of 30), especially if they have no children. This is because some men change their minds about having children later in life.
It's a simple procedure which is more reliable than permanent sterilisation in a woman and has fewer complications.
What other contraception is available for men?
Apart from vasectomy, the other main choice for men is condoms. As you are probably aware, there are several choices available for women, which your GP or a family planning expert can advise on.
Can I use IVF to father a child?
If you have a vasectomy, and then decide at a later date that you want a child, there may be the option of doing so by IVF. To do this, sperm would be retrieved from your testicles by a trained surgeon and used to fertilise your partner's egg. This may not be available on the NHS. It also tends to be an expensive procedure. As IVF isn't always successful, you can't rely on it as a type of 'fertility insurance policy'.
Can I store sperm in a sperm bank, just in case?
You could do this but, as with IVF, sperm stored in a sperm bank can't be relied on to bring about a pregnancy. It can also be expensive.
Can I have the operation if I am single?
Yes, you can, but if you're under 30 you'll find that many surgeons are reluctant to do it in case your circumstances change and you regret it later.
Could being sterile affect me emotionally?
It's a big decision to end the part of your life where you could father a child - another reason to think it over carefully.
However, studies show that when men who have a vasectomy are sure about their decision, the vast majority don't suffer from any psychological effects. In fact, most feel relieved that the worry of possible pregnancy is over and they don't need to think about contraception again.
If you feel very anxious or uncomfortable about the procedure, or if you think you would suffer mentally from being sterile, then it's not the best type of contraception for you. You can discuss alternatives with your GP or with a professional at a family planning clinic.
When it should be done ?
You should only have a vasectomy if you are certain that you do not want to have any more children. If you have any doubts, you should consider an alternative method of contraception until you are completely sure.
It is not advisable to make your decision about having a vasectomy following a crisis, or a big change in your life - for example, if your partner has just had a baby, or if they have just terminated their pregnancy.
If you have a partner, you should discuss it with them before deciding to have a vasectomy. If possible, you should both agree to the procedure before you proceed. Some doctors prefer both partners to agree to the procedure after providing information and counselling. However, it is not a legal requirement to get your partner's permission in order to have a vasectomy.
A vasectomy can be performed at any stage of adult life. However, many GPs are reluctant to carry out the procedure on young men, particularly if they do not have any children. Research has shown that men under 30 years of age are most likely to regret having a vasectomy later on in life.
If you are a young male wishing to have a vasectomy, your GP does have the right to refuse to carry out the procedure or refuse to refer you for the procedure if they do not believe it is in your best interests. If this is the case, you may have to pay to have a vasectomy carried out privately.
How vasectomy is performed ?
[ Illustration of vasectomy ]
Bladder
Pelvic bone
Spermatic cord cut
Testical
Seminal vesicle
A vasectomy is a quick and simple procedure that can be performed at : -
your General Surgery hospital in India
a hospital as a day-patient appointment
a private clinic
There are two types of vasectomy. The 'conventional' and most widely used type of vasectomy involves making two small incisions in the scrotum (the pouch of skin that surrounds your testicles). The other type uses a newer 'no scalpel' technique. Your GP will discuss with you what type of vasectomy is best for you.
Conventional vasectomy
During a conventional vasectomy, the skin of your scrotum will first be numbed with local anaesthetic. Two small incisions, about 1cm long, are made on each side of your scrotum.
The incisions in your scrotum allow your surgeon to access the vas deferens (the tubes that carry sperm out of your testicles). Each tube will be cut and a small section removed. The ends of the tubes are then closed, either by tying them or sealing them using a diathermy (an instrument which heats to a very high temperature).
The incisions are stitched up, usually using dissolvable stitches, which will disappear naturally within about a week.
No-scalpel vasectomy
A no-scalpel vasectomy is more commonly available through private clinics, but many GPs are now being trained to carry out the procedure. During this procedure, your surgeon will feel the vas deferens underneath the skin of your scrotum and then hold it in place using a small clamp.
A special instrument is then used to make a tiny puncture hole in the skin of the scrotum. A small pair of forceps is used to open up the hole, allowing the surgeon to gain access to the vas deferens without the need for an incision. The tubes are then closed in the same way as with a conventional vasectomy, either by being tied or sealed.
During a no-scalpel vasectomy, there will be very little bleeding and no stitches. The procedure is also thought to be less painful, and less likely to cause complications.
Anaesthetic
The majority of vasectomies are carried out under local anaesthetic. This means that only your scrotum and testicles will be numbed and you'll be awake for the procedure. A local anaesthetic will mean you'll not feel any pain during the surgery, although it may feel slightly uncomfortable.
In rare cases, a general anaesthetic may be required. This means you will be unconscious during the procedure. A general anaesthetic may be used if you are allergic to local anaesthetic, or if you have a history of fainting easily. However, most people will only require a local anaesthetic.
How long will it take?
A vasectomy usually takes between 15 and 30 minutes to perform. You should be allowed to go home the same day.
Can I choose to see a male doctor for the operation?
Yes, you can request a male doctor if this is what you prefer, but in some cases this may mean you have to wait longer. Your GP may be able to offer you some choices in where you can have it done. The operation is also available privately.
Recovering from a vasectomy
Following a vasectomy, you will normally experience some mild discomfort, swelling and bruising of your scrotum. This will usually last for a few days.
If you are experiencing pain or discomfort, you can take paracetamol or ibuprofen. However, ibuprofen is not suitable if you have asthma, a history of stomach ulcers, or kidney or liver problems. Contact your doctor for advice if you are still experiencing considerable pain after taking painkillers.
Wearing close-fitting underwear, such as double Y fronts, during the day and at night will help to support your scrotum and will also ease any discomfort or swelling. Make sure that you change your underwear every day.
When can I resume my daily activities?
Most men will be fit to return to work one or two days after their vasectomy, but should avoid sport and heavy lifting for at least one week after the operation. This will help minimise the risk of developing complications (see the 'complications' section). If any of your symptoms continue after a few days, you should consult your doctor.
It is safe for you to bathe or shower after your operation, but make sure you dry your genital area gently and thoroughly.
When can I have sex again?
You can have sex again as soon as it's comfortable to do so, though it's best to wait for a couple of days. However, you are not sterile immediately after the operation as it takes time to clear the remaining sperm in your tubes. Until you have had two clear semen tests, you will still have to use another method of contraception.
Vasectomy Results
How will I know if my vasectomy has been a success?
After a vasectomy has been performed, some sperm will survive in the upper part of the vas deferens tubes. Until it has been confirmed that your semen is free of sperm, there is still a risk of pregnancy and you should continue to use another form of contraception.
At least eight weeks after the procedure you'll need to produce a semen test, which will be checked for sperm. This will also help to identify the rare cases in which the tubes naturally rejoin themselves. Once the tests have confirmed that your semen is free of sperm, the vasectomy has been successful and further contraception can be stopped.
Is reversal possible?
It is possible to have a vasectomy reversed, but the procedure is often unsuccessful. You have a better chance of a successful reversal if it's done soon after the vasectomy.
Even if a surgeon manages to join up the vas deferens again, pregnancy may still not be possible. This is why you should be as sure as you can be before going ahead. Your doctor should help you in making your decision. Reversal is only rarely available on the NHS and can be expensive.
When can I ditch the condoms?
You should remember that, although a successful vasectomy is a completely effective method of contraception, it does not protect you against sexually transmitted infections. You should continue to protect yourself with condoms if you're at risk.
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