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.

Important: Some sperm are stored above the point where the vas is divided, so the procedure is not immediately effective. It can take up to 20 to 30 ejaculations before these sperm are cleared. Continue using another form of contraception until you have received confirmation from the hospital that it is safe to stop. Do not assume the procedure has been successful until you have been contacted. In some cases, further samples may be required.

Before your operation

• Medication: Take all your usual medications on the day of the operation, except for blood thinners (such as warfarin, aspirin, clopidogrel, persantin, rivaroxaban or similar). If you take warfarin, attend 30 minutes early for an INR check.
• Shaving: You do not need to shave yourself before attending for the procedure.
• Transport: Arrange for someone to drive you home. Failure to do so could result in your operation being postponed.

What to expect on admission

• The procedure is usually performed under local anaesthetic and takes 20 to 30 minutes. If the clinician 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 clinician.
• 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 to 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 supportive underpants or swimming trunks can help minimise this and ease discomfort.
• You may 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.
• Many people return to work quickly, but it is often advisable to take one or two days off, especially if your job involves heavy work.
• Avoid sports for two weeks.

When to seek medical advice

• Contact your GP if you develop a temperature, increasing redness, throbbing pain, or discharge from the wound.

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 regularly 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. 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; this may require antibiotics or rarely surgery.
• Pain: Some discomfort is normal; rarely, long-term scrotal pain can occur.
• Failure: Early failure rates are less than 1%. Late failure, where the ends of the vas join again, can occur and may restore fertility. This happens in 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 carried out privately.
• No significant health risks are associated with vasectomy.

Follow-up and contacts

• You will not routinely be seen again in clinic. Your GP will be informed.
• If you experience problems, contact the Urology Department on 01324 567623 (Monday to Friday, 8.30am to 5.00pm). Outside these hours, contact NHS 24 on 111.
• For general queries, contact the Urology Outpatients Department on 01324 567535.