A vasectomy is a form of permanent contraception for men. Sometimes referred to as ‘the snip’, it’s a surgical procedure where the tubes that carry sperm from the testicles – the vas deferens – are cut or sealed. This prevents any sperm from getting into the semen, so it won’t fertilise a woman’s egg.
It’s thought to be more than 99% effective and it’s permanent, so you’ll never have to worry about contraception once it's done.1
Emma Cronin, a nurse and midwife for AXA Health’s 24/7 health support line for members, explores what you should consider before getting it done, how it works and answers some frequently asked questions.
Things to consider before having a vasectomy
You should only consider getting a vasectomy if you're absolutely sure you won't want to have any children in the future. Although you may have heard of a vasectomy reversal, they aren’t always possible or successful, so it should always be treated as a permanent form of contraception.
Vasectomies can be carried out on the NHS, but a doctor will need to sign off before it can be carried out. They’ll ask you about your personal circumstances, outline all the facts and answer any questions.
If you’re single and under the age of 30, a doctor might feel as though your circumstances could change. If they believe there’s any chance you’ll regret your decision, they may advise against the surgery or refuse to perform it.
How does the procedure work?
While choosing to have a vasectomy is a big decision, it’s a relatively fast and simple procedure. The operation is usually done using local anaesthetic, so you're awake throughout but won't feel anything. It should only take around 15 minutes and, in most cases, you’ll be able to return home on the same day.
There are two different types of vasectomy procedure:
1) Conventional
A conventional vasectomy is where a scalpel is used to make two small cuts in the scrotum, after the area has been numbed using a local anaesthetic, of course. This allows the doctor to reach the vas deferens tubes, which are cut and then tied off or sealed using heat. Finally, the incisions in the scrotum will be stitched up, usually with dissolvable stitches that disappear on their own.
2) No-scalpel
This procedure isn’t too different to the conventional method, but the tubes are reached via a tiny puncture hole that’s made in the skin of the scrotum. This means there’s no need to cut the skin with a scalpel and no need for any stitches after the tubes are tied or sealed. It’s said to be less painful than a conventional vasectomy and there’s less chance of infection.
What happens after the operation?
In most cases, you’ll be able to go home on the day of your operation. The area will be covered with a dressing, and it’s advisable to wear supportive underwear to keep everything compressed and stable.
It’s common to have some mild discomfort for a few days after the operation. The level and location of any pain will depend on the type of procedure you’ve had, but it can include swelling and bruising around the scrotum.
You can take painkillers, such as paracetamol, to ease your discomfort and you’ll also want to take care not to bump or knock the area at all as it’ll be very tender for a few days.
As with any kind of surgery, there’s a chance of infection and, as this is in an intimate area, it’s particularly important to keep it as clean and dry as you can. You’ll be given instructions on how to look after your dressing, and your doctor will confirm if / when you can bathe or shower after your operation.
Frequently asked questions
While it may sound like a relatively simple, quick operation, we know this is a very sensitive area (literally!), so you’re bound to have a lot of questions.
Here are some of the most common queries and concerns people have when they’re thinking about a vasectomy.
How long until I’m up and about?
You’ll likely need to wait at the hospital for a while after your operation to make sure you’re okay, and for the local anaesthetic to wear off. After that, as mentioned before, you should be able to go home. You’ll be able to walk around, but it’ll be quite tender so you should rest as much as possible.
Depending on what you do, you could be able to return to work in as little as one or two days, but you should avoid any heavy lifting or sport for at least seven days after your procedure.
How long will I be ‘out of action’?
You should speak to your doctor but, as a general rule, it’s advisable to avoid any sexual activity for at least a week following a vasectomy. It’s also important to be aware of the fact that you'll need to use contraception for eight to 12 weeks after the operation. This is because your tubes will still contain some sperm and it can take a while to fully clear them out.
How can I tell if the vasectomy has been successful?
After around 12 weeks, you'll need to have a semen test. Your doctor will take a semen sample to see if it contains any sperm. In some cases, this test might be repeated to confirm that all the remaining sperm has gone. It’s advisable to continue using contraception until you’ve received the results of these tests and confirmed that your semen is sperm-free.
Will having a vasectomy affect my sex drive or performance?
The simple answer to this is no. A vasectomy won’t change your sex drive or your ability to have and enjoy sexual intercourse. Your testicles will keep producing testosterone – the male sex hormone – after a successful vasectomy, so your sex drive and ability to get an erection won't be affected.
Your body will also continue to produce semen, so you’ll ejaculate as you did before. The only difference now is that there won’t be any sperm present in the semen. The testicles will keep producing sperm, but with nowhere to go, it’ll get harmlessly absorbed back into your body.
Does a vasectomy make me more or less likely to get cancer?
If you’ve had a vasectomy, this won’t prevent you from getting prostate cancer or testicular cancer. However, there isn’t evidence to suggest that it increases your risk either. A vasectomy also won't protect you against getting an STI, so there may be times that you need to consider using a condom.
Are there any other unusual symptoms or side-effects?
It’s possible for a vasectomy to cause long-term pain in the testicles, which could need follow up surgery. It can also cause blood to collect within the scrotum (haematoma) and, as with any surgery, the area can become infected.
In some cases, inflammation can occur as a result of sperm escaping from the tubes, and this can cause a small mass or lump (sperm granuloma) on the testicles. And finally, in some very rare cases, it’s possible for the tubes to naturally repair and reconnect.
Can a vasectomy be reversed?
While it is possible to have a vasectomy reversed, it doesn’t always work. That’s why a vasectomy is considered as a permanent procedure and should never be entered into lightly.
However, if your circumstances have changed or you’re experiencing ongoing pain or discomfort, you may want to look into getting the procedure reversed. While the vasectomy involves cutting or sealing the tubes that deliver sperm to the semen, a reversal operation is a more complex procedure where those tubes need to be reconstructed so they can transfer sperm again.
How can I get a vasectomy reversal?
A vasectomy reversal isn’t usually available on the NHS, or through private healthcare cover. There may be rare exceptions, if there’s been a complication for example, but you’re likely to have to cover the cost yourself.
So, you’ll need to contact a private clinic and arrange an initial consultation, in which a doctor will discuss your circumstances and answer any queries you may have. They’ll also do some tests and examinations, as well as talk you through the potential risks and the chances of success.
What happens during a vasectomy reversal operation?
A vasectomy reversal is more complex than a vasectomy. It’s usually done under general anaesthetic, so you’ll be asleep throughout the procedure. It can take between one and three hours depending on how complex the operation is, and you may be kept in overnight afterwards.
The operation involves a small cut being made in the scrotum and then removing the parts of the vas deferens that were previously tied or sealed before rejoining the tubes with dissolvable stitches. The complexity of the operation and the time it could take will depend on whether there are any blockages within the tubes. Once the operation is finished, the site is closed up, again with dissolvable stitches, and you’ll have to wait and rest until the anaesthetic has worn off.
After a successful operation, it can then take a number of months for the amount of sperm within your semen to return to a good level. You’ll need to have your semen tested with the doctor around three months after surgery and, if it shows lower levels of sperm or the test is inconclusive, you may need a number of follow up tests.
What’s the success rate for vasectomy reversal?
A vasectomy reversal operation is deemed successful if, after testing, there’s sperm in your semen again. The chances of the operation being successful will depend on your individual circumstances, including how long it’s been since the original vasectomy.
It’s also important to note that a successful reversal still doesn’t guarantee that you and your partner will be able to conceive. This depends on various factors, including the length of time since your vasectomy.
It's thought that the chances of conceiving after a reversal are as follows:
- 75% if your vasectomy reversal is within three years of the original vasectomy2
- up to 55% for a vasectomy reversal between three and eight years after the vasectomy2
- around 30% to 40% if the reversal is after nine years, up to 19 years2 (after which it becomes increasingly unlikely).
Age will also play a part in these statistics, as we become less fertile as we get older. And there are plenty of other factors that can also affect your fertility, which should be considered when deciding whether or not to get a vasectomy or have reversal surgery.
For more information, check out our article where we’ve answered common questions about male fertility.
References
- Vasectomy (male sterilisation) - NHS
- Sterilisation reversal - NHS Inform