Vasectomy (male sterilisation)

Sterilisation is a permanent form of contraception that involves an operation that stops eggs and sperm coming into contact.

A vasectomy involves cutting and sealing or tying the tube that carries sperm from the testicles to the penis. Though a person can still ejaculate after a vasectomy, their semen will not contain sperm.

Once you are sterilised it is very difficult to reverse the process, so it's important to consider the other options available before making your decision. Sterilisation reversal is not usually available on the NHS.

In recent years, many more couples in their 30s and 40s are opting for efficient and long lasting contraceptives instead of sterilisation, as more couples are choosing to have families later in life.

Sterilisation is over 99% effective at preventing pregnancy.

Pros and Cons

Pros

Sterilisation is over 99% effective at preventing pregnancy.
Once sterilisation has been confirmed as working you won’t need to use contraception to prevent pregnancy again.
It's a quick and relatively painless procedure.

Cons

Although it isn’t common, the tubes can rejoin meaning that you will be fertile again.
Sterilisation cannot be easily reversed, and reversals are rarely funded on the NHS.
Sterilisation does not protect you against STIs.
You’ll need to continue using contraception until the sterilisation has been confirmed as working.
LARC methods of contraception can be as effective as sterilisation.
There are some common short term side effects from the operation, such as blood in the semen for first few ejaculations after operation (this is not harmful) and a bruised, swollen and/or painful scrotum for a few days.

How does a vasectomy work?

The tubes that carry sperm from the testicles to the penis are cut, blocked or sealed with heat. There are two types of vasectomy procedure:

Conventional

The skin of your scrotum is numbed with local anaesthetic. The doctor makes two small cuts, about 1cm long, on each side of your scrotum to access the tubes that carry sperm from your testicles. Each tube is cut and a small section removed. The ends of the tubes are then closed, either by tying them or sealing them using heat.

The incisions are stitched, usually using dissolvable stitches, which will disappear naturally within about a week.

No-scalpel vasectomy

This procedure is usually carried out under local anaesthetic. The doctor will feel for the vas deferens tubes (the tubes that carry sperm) underneath the skin of your scrotum and then hold them 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 access the vas deferens without needing to cut the skin with a scalpel. The tubes are then closed in the same way as in a conventional vasectomy, either by being tied or sealed.

During a no-scalpel vasectomy, there will be little bleeding and no stitches. The procedure is also thought to be less painful and less likely to cause complications than a conventional vasectomy.

Questions

What are the possible long term side effects?

These are very rare, however:

There is a risk that sterilisation will not work.
The tubes that carry the sperm can re-join after sterilisation. This can happen immediately or some years after the operation has been carried out.
Some people get haematomas. A haematoma is when blood collects and clots in the tissue surrounding a broken blood vessel. Haematomas are mostly small (pea-sized), but can occasionally be large. In severe cases, you may need further surgery to treat the blood clot.
Leaked sperm from the cuts can collect in the surrounding tissue, forming hard lumps that are known as sperm granulomas. The lumps are not usually painful and can often be treated using anti-inflammatory medication, which your GP will prescribe. If the granulomas are particularly large or painful, they may have to be surgically removed.
Some people get pain in one or both of their testicles after a vasectomy. It can happen immediately, a few months or a few years after the operation. It may be occasional or quite frequent, and vary from a constant dull ache to episodes of sharp, intense pain. Any such feelings should pass naturally within a few weeks. However, speak to your GP if you are still experiencing a dull ache 3 weeks after the procedure.

Is a vasectomy available on the NHS?

Yes, vasectomy is available on the NHS.

What is the recovery after a vasectomy like?

Wearing close-fitting clean underwear, such as Y-fronts, during the day and at night will help to support your scrotum and will also help ease any discomfort or swelling.

Most people will be fit to return to work one or two days after their vasectomy, but you should avoid sport and heavy lifting for at least one week after the operation.

Who should I talk to if I am considering getting a vasectomy?

You should speak to your GP or local sexual health clinic.

Could being sterile affect me emotionally?

It is a big decision to end the part of your life where you could have a biological child. If you feel anxious or uncomfortable about the procedure, or if you think you would suffer mentally from being infertile, then it is not the best type of contraception for you.

You can discuss alternatives with your GP or with a professional at a contraception clinic (sometimes called a family planning clinic).

Vasectomy does not affect your hormone levels or sex drive.

Is there any risk of vasectomy causing cancer?

Although prostate cancer and testicular cancer can occur in people who have had a vasectomy, research suggests that vasectomy does not increase your risk of cancer.

How will I know which method of vasectomy is best for me, conventional or no scalpel?

The surgeon will discuss the risks and benefits of both methods with you.

Is a vasectomy reversible?

It is considered permanent. It can be reversed but is not always successful and is not usually available on the NHS.

Is my partner protected against pregnancy straight away after a vasectomy?

After vasectomy it will take up to 20 ejaculations to clear the sperm from the tubes and during this time there is still a risk of pregnancy. At least 8 weeks after the procedure you will need to produce a semen sample which will be checked for sperm. You will need to use another method of contraception until you have two clear semen tests.