Vasectomy (male sterilisation)

Benefits

  • You don’t have to think about contraception again
  • Quick and relatively painless procedure
  • No effect on sex drive or ability to enjoy sex
  • You will still have an erection and ejaculate normally
  • A simpler, safer and more reliable option than female sterilisation.

Vasectomy involves cutting and sealing or tying the tube that carries sperm from the testicles to the penis. Though you will still ejaculate, your semen will not contain sperm. Vasectomy is becoming less common amongst men in the UK as more couples are choosing to have families later in life.

How it works

Most vasectomies are carried out under local anaesthetic, and you can usually go home the same day. You will not feel any pain, though it may be slightly uncomfortable. You will need to use contraception for up to 8 weeks after the operation, and will have to return to the doctor for up to two semen tests to check that all the sperm have gone.

The tubes that carry sperm from a man's testicles to the penis are cut, blocked or sealed with heat. Your semen will not contain sperm, so your semen cannot fertilise your partner’s egg.

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Things to consider

Vasectomy does not protect against STIs, so you may need to use condoms if you think you are at risk of infection.

What if?

You’re not sure about whether you want to have children or not:

Once you have a vasectomy it is very difficult to reverse the process, so it's important to consider the other options available before making your decision. Some men choose to start or have a second family in their 30s or 40s. Vasectomy reversal is not usually available on the NHS.

Suitability

You can have a vasectomy at any age. However, if you are under 30, particularly if you do not have children, your doctor may be reluctant to perform the procedure.

Clinicians do have the right to refuse to carry out the procedure or refuse to refer you for the procedure if they do not believe that it is in your best interests.

Side effects & risks

Common Rare
Short term:

Blood in semen for first few ejaculations after operation – this is not harmful.

Bruised, swollen or painful scrotum for a few days.

Any surgery has slight risk of infection.
Long term:

Small risk that sterilisation will not work, or that tubes that carry sperm will re-join.

Small risk of blood clots, pain in testicles or non-harmful lumps.

Questions?

How does the operation work?
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The tubes that carry sperm from a man's 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

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.

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What is the recovery after a vasectomy like?
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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 men 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.

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What are the possible long term side effects?
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These are very rare.

  • 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.
  • 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.
  • Sperm granulomas, when 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 men 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.

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Who should I talk to if I am considering getting a vasectomy?
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Your GP or local sexual health clinic.

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Is a vasectomy available on the NHS?
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Yes, vasectomy is available on the NHS.

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Is a vasectomy reversible?
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It is considered permanent. It can be reversed but is not always successful and is not usually available on the NHS.

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How will I know which method of vasectomy is best for me, conventional or no scalpel?
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The surgeon will discuss the risks and benefits of both methods with you.

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

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Could being sterile affect me emotionally?
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It is a big decision to end the part of your life where you could father a 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.

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Is there any risk of vasectomy causing cancer?
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Although prostate cancer and testicular cancer can occur in men who have had a vasectomy, research suggests that vasectomy does not increase your risk of cancer.

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Where can I get it?

Your sexual health clinic or GP will ask about your circumstances and provide information and counselling before agreeing to refer you for the procedure. In some areas, waiting list for vasectomy on the NHS can be quite long. You can pay to have the operation done privately.

You should only be sterilised if you are certain that you do not want to have any, or any more, children. If you have any doubts, consider another method of contraception until you are completely sure.