A vasectomy involves cutting the tubes (the ‘vas’) that carry sperm from the testes to the penis. It is a highly reliable form of contraception, successful for more than 99 out of every 100 men. However, it cannot absolutely guarantee sterility.

Before Your Operation

• Medication: Take all your usual medications on the day of the operation, except for blood thinners (warfarin, aspirin, clopidogrel, persantin, rivaroxaban, or similar). If you take warfarin, attend 30 minutes early for an INR check.
• Shaving: It would be helpful if you could shave the scrotum prior to attending for your procedure. This reduces the risk of wound infection and makes surgery easier for the clinician.
• No need to shave yourself otherwise.
• Transport: Arrange for someone to drive you home. You must not drive or use public transport after your procedure or for the rest of that day. Failure to arrange this could result in your operation being postponed.

What to Expect on Admission

• The procedure is usually performed under local anaesthetic and takes 20 – 30 minutes. If the surgeon cannot feel the vas properly, you may be referred for a general anaesthetic.
• You will be treated as a day case and allowed home soon after the procedure.

What to Expect During the Procedure

• The skin of the scrotum and the vas will be numbed with a local anaesthetic injection. This may be uncomfortable, but you should feel no pain during the procedure. If you do, tell the surgeon.
• You may feel a pulling sensation as the vas is tied—this is normal but can make some men feel slightly sick, sweaty, or light-headed.
• The wounds are closed with one or two dissolving stitches, which do not need to be removed.

What to Expect After the Procedure

• The local anaesthetic will wear off after a few hours. You may experience aching for 24 – 72 hours, which can usually be relieved with simple painkillers such as paracetamol or ibuprofen.
• Some swelling or bruising at the operation site is normal and usually lasts several days. Wearing tighter, supportive underpants or swimming trunks can help minimise this and ease discomfort.
• You may also notice a small amount of fluid seeping from the wound.
• Keep the area dry for 24 hours after surgery. After this, showering is recommended (avoid hot baths, as they can encourage bleeding or swelling).
• With most jobs, you can return to work the next day. If your work involves heavy lifting, you may need more time off. Avoid sports for two weeks.

Intercourse and Contraception

• You may resume intercourse with appropriate contraceptive precautions as soon as you are comfortable.
• Vasectomy only prevents pregnancy—it does not protect against sexually transmitted infections.
• You are advised to have intercourse as often as possible to help clear any remaining sperm before your semen test.

Providing a Semen Specimen

• You should provide a semen specimen for analysis 16 weeks from the Monday after your operation (and after at least 10 ejaculations).
• You will be given a pot and form before leaving the hospital.
• The sample should be produced by masturbation (not using a condom), as fresh as possible, and delivered to the hospital within two hours of production.
• Bring samples to: Area 4, Outpatients Department, Forth Valley Royal Hospital on a Monday morning (time stated on your sample form).
• You will receive a letter confirming whether your operation has been successful about three weeks after submitting your sample. Do not presume you are sterile until you have received this confirmation. Continue using contraception until advised it is safe to stop.
• Occasionally, sterility may not be confirmed on the first sample, and further specimens may be required.

Complications Following Vasectomy

Problems are rare but possible:

• Bruising: A small amount is normal; severe bruising is rare.
• Infection: Possible at the wound or testis; may require antibiotics or rarely surgery.
• Pain: Some discomfort is normal; rarely, chronic scrotal pain can occur.
• Failure: Early failure rates are less than 1%. Late failure (where the vas ends rejoin) can occur, restoring fertility and possibly resulting in pregnancy (risk: about 1 in 3,000 cases).
• Irreversibility: Vasectomy must be regarded as irreversible. Reversal is not available on the NHS and is not guaranteed to succeed if done privately.
• No significant health risks are associated with vasectomy.

Follow-Up and Contacts

• You will not routinely be seen back in clinic. Your GP will be informed.
• If you experience problems, contact the Urology Department on 01324 567623 (Monday – Friday, 8.30am – 5.00pm). Outside these hours, contact NHS 24 on 111.
• For general queries: Urology Outpatients Department 01324 567535.
• For alternative formats or languages, call 01324 590886 (9am – 5pm) or email fv.disabilitydepartment@nhs.scot.