Vasectomy or male sterilisation at Oxford, The Manor Hospital

What is a vasectomy?

A vasectomy involves cutting both tubes that carry sperm from your testicles. This stops the sperm made in the testes from reaching the semen. Your body can still produce sperm, but the testicles reabsorb it naturally.

Is a vasectomy right for me?

If you are a man and have reached a certain point in your life, you may be considering vasectomy surgery as a permanent method of male contraception. Our experienced urology consultants specialise in male sterilisation and can provide you with rapid access to a consultation and treatment.

Choosing to have a vasectomy is a serious decision, but there is an option to reverse the procedure through vasectomy reversal surgery if your personal circumstances change. However, the success of a vasectomy reversal isn't guaranteed, so your decision to have a vasectomy is very important.

You should only consider a vasectomy if you're certain you don't want any, or any further, children. If you have a partner, it's important to discuss your thoughts with them. If you do have any doubts, it’s best to wait until you've made a definite decision.

Will my sex life be affected?

A vasectomy won't affect your sex drive, or your ability to enjoy sex, ejaculate or have an erection. Semen is still produced, there is simply no sperm in the semen.

However, you should use another form of contraception until we've confirmed that the operation is a success.

You should also remember that a vasectomy protects against causing pregnancy, but it does not protect against sexually transmitted infections.

What happens during a vasectomy?

The procedure usually takes about 15–20 minutes. The surgery can be performed under local anaesthetic or general anaesthetic. If you have local anaesthetic, this will be injected alongside each tube at the top of your scrotum and in your skin where the cuts will be made.

Before the procedure

There are a few things you can do in the lead up to the procedure to make sure everything goes as smoothly as possible:

• Let your doctor know about any medication you take and follow their instructions
• If you smoke, stop smoking several weeks before the operation
• Try to maintain a healthy weight
• Exercise regularly
• Don't drink alcohol in the week leading up to the procedure
• If you're diabetic, keep your blood sugar levels under control around the time of your procedure
• Have a bath or shower on the day of the operation and make sure your scrotum is clean
• Shave your scrotum beforehand, or the healthcare team will do it for you.

When you arrive in hospital, you’ll meet your surgeon, anaesthetist and nurse. You'll be able to ask any more questions you may have.

During the procedure

1. Once you're under anaesthetic, your surgeon will make one small cut on each side of your scrotum – or they may make a single cut in the middle of your scrotum
2. They'll cut the tubes that carry sperm and close the ends with stitches, clips or an electric current 
3. Finally, they'll close the cuts with dissolvable stiches.

After the procedure

Afterwards you'll be taken to the recovery room. If you have general anaesthetic, you'll wake up here. You shouldn’t feel any pain, but you might be groggy and slightly uncomfortable as you come around.

When you’re ready, you’ll be taken to your room, where the healthcare team will look after you.

Recovery after a vasectomy

Your scrotum may be sore for 1–3 weeks, but you should be able to return to normal activities about about 2–3 days.

Short-term recovery

Back in your room, you may feel some pain as the anaesthetic wears off, which you can take painkillers for.

To ease discomfort and reduce swelling and bruising, you can:

• hold an ice pack against your scrotum
• wear a scrotal support or firm underwear.

You should be able to go home the same day. If so, for the first 24 hours:

• you’ll need someone to take you home and stay with you overnight
• don’t drive, operate machinery, or do any potentially dangerous activities (like cooking) until you’ve fully recovered feeling, movement and co-ordination
• you shouldn’t sign legal documents or drink alcohol.

Managing your recovery at home

You should get plenty of rest for the first 24 hours, but then it’s important to stay active to avoid any complications like blood clots. You should also follow the instructions from our healthcare team on medication or special compression stockings.

Your testicles will probably ache for a few days, so take over-the-counter painkillers if you have any discomfort. Your scrotum may also be bruised and swollen, but this will go down after about a week.

Here are a few things you can do to make sure you recover well:

• Don't ejaculate or do any strenuous exercise including running or cycling for 5–7 days
• If you have sexual intercourse, use another form of birth control until your doctor confirms that sperm are no longer present in your semen
• Gradually increase your activity with low-impact exercises like walking.

You should call your doctor if:

• the swelling doesn't go down
• you have discharge from your wounds
• you’re still in pain after 4 weeks.

Driving after a vasectomy

Don’t drive until you’re confident you can control your vehicle and always check your insurance policy and with your doctor first.

Time off work

You should be able to return to work after about 2 days, or a week if your work involves strenuous exercise.

Follow-up appointments

It can take around 20 ejaculations to clear out any sperm that may be left, so your doctor will ask you to give one or two samples of your semen after your 20th ejaculation. The samples will be tested to make sure there are no sperm left, which can take up to 12 weeks. You should use alternative contraception until your doctor says you are sperm-free.

Complications

As with any operation, there is a small chance of complications, such as:

• bleeding
• infection
• reaction to anaesthetic.

Specific complications of vasectomy can include:

• becoming fertile again, if the tubes rejoin
• sperm granuloma, where sperm leaks and causes painful swellings on the end of the tube that has been cut
• long-term pain in your testicles
• congestive epididymitis, where the tube that stores sperm gets blocked, causing pressure and pain.

The healthcare team will do their best to minimise any risks. Make sure you discuss any concerns you have about these complications with your consultant.

Alternative treatment options

You may also want to consider the following forms of contraception:

• Condoms – this is the only other method of male contraception, but the risk of pregnancy is higher
• Female sterilisation – this a permanent method of female contraception, which involves blocking both falopian tubes
• Hormonal implants – a non-permanent female contraception where a small plastic rod is placed under the skin in the upper arm, which releases progestogen to prevent ovulation
• Hormonal coil– a small, plastic T-shaped device that releases progesterone to prevent pregnancy as well as make your periods lighter and less painful
• Oral contraceptive pill – a tablet that you take daily for either 21 days with a 7-day break, or every day, which releases oestrogen and progesterone, or just progesterone, to suppress ovulation.