How a vasectomy is performed

A vasectomy is a quick and simple procedure that can be performed at your doctor surgery, clinic or hospital. It usually takes 15-30 minutes to perform and you should be able to go home the same day.

There are two types of vasectomy. The ‘conventional’ and most widely used type of vasectomy involves making two small incisions in the scrotum (the pouch of skin that surrounds your testicles). The other type uses a newer ‘no scalpel’ technique. Your doctor will discuss with you which is best for you.

Conventional vasectomy

During a conventional vasectomy, the skin of your scrotum will first be numbed with local anaesthetic. Two small incisions, about 1cm long, are made on each side of your scrotum. The incisions allow your surgeon to access tubes that carry sperm out of your testicles, known as vas deferens. Each tube will be cut and a small section removed. The ends of the tubes are then closed, either by tying them or sealing them using a diathermy (an instrument that heats to a very high temperature). The incisions are stitched, usually using dissolvable stitches, which will disappear naturally within about a week.

No-scalpel vasectomy

A no-scalpel vasectomy is more commonly available through private clinics, but many doctors are now being trained to carry out the procedure. During this procedure, your surgeon will feel the vas deferens 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 the need for an incision. 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.

Anaesthetic

Most vasectomies are carried out under local anaesthetic. This means only your scrotum and testicles will be numbed and you will be awake for the procedure. You will not feel any pain, although it may feel slightly uncomfortable. In rare cases, a general anaesthetic may be required. This means you will be asleep during the procedure. A general anaesthetic may be used if you are allergic to local anaesthetic or have a history of fainting easily. However, most people will only need a local anaesthetic.

Recovering from a vasectomy

You will normally experience some mild discomfort, swelling and bruising of your scrotum for a few days after the vasectomy. If you’re still in pain a few days after your operation, consult your doctor.

Painkillers

If you have pain or discomfort, you can take paracetamol or ibuprofen. However, ibuprofen is not suitable if you have asthma, a history of stomach ulcers or kidney or liver problems. Contact your doctor for advice if you are still experiencing considerable pain after taking painkillers.

Underwear

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

Hygiene

It is safe for you to bathe or shower after your operation, but make sure you dry your genital area gently and thoroughly.

Going back to work

Most men will be fit to return to work one or two days after their vasectomy, but should avoid sport and heavy lifting for at least one week after the operation, to minimise the risk of developing complications. If any symptoms continue after a few days, consult your doctor.

Having sex

You can have sex again as soon as it is comfortable to do so, although it is best to wait for a couple of days. However, you are not sterile immediately after the operation, as it takes time to clear the remaining sperm in your tubes. Until you have had two clear semen tests, you will still need another method of contraception.

Signs that the vasectomy has been a success

After a vasectomy has been performed, some sperm will survive in the upper part of the vas deferens tubes. This is because sperm are left in the system beyond the point of the cut. It takes more than 20 ejaculations to clear these sperm, although the rate can vary among men.

Until it has been confirmed that your semen is free of sperm, there is still a risk of pregnancy and you should continue to use another form of contraception. At least eight weeks after the procedure you will need to produce a semen test, which will be checked for sperm. This will also help to identify the rare cases in which the tubes naturally rejoin themselves. Once tests have confirmed your semen is free of sperm, the vasectomy is considered successful and further contraception can be stopped.

A few men continue to have small numbers of sperm in their system, but these sperm do not move (they are known as ‘non-motile’ sperm). It is not always clear whether this means you could make your partner pregnant. If you are one of these men, your doctor will discuss your options with you.

Reversing a vasectomy

It is possible to have a vasectomy reversed, but the procedure is often unsuccessful. You have a better chance if it is done soon after the vasectomy. If a reversal is carried out within 10 years of your vasectomy, the success rate is estimated to be 55%. This falls to 25% if your reversal is carried out more than 10 years after your vasectomy. Even if a surgeon manages to join up the vas deferens again, pregnancy may still not be possible. This is why you should be as sure as you can be before going ahead. Your doctor should help you in making your decision.

When can I stop using condoms?

Although a successful vasectomy is a completely effective method of contraception, it does not protect you against sexually transmitted infections (STIs). You should continue to protect yourself with condoms if you are at risk of catching an STI.

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