A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this happening by keeping the egg and sperm apart or by stopping egg production. One method of contraception is vasectomy (male sterilisation).
Vasectomy – what is it?
During a minor operation, the tubes that carry sperm from a man’s testicles to the penis are cut, blocked or sealed.
This prevents sperm from reaching the seminal fluid (semen), which is ejaculated from the penis during sex. There will be no sperm in the semen, so a woman’s egg can’t be fertilised.
Vasectomy is usually carried out under local anaesthetic, and takes about 15 minutes.
Vasectomy services in Bromley
If you are considering a vasectomy and you live in Bromley, contact your GP. You will need a GP appointment before you are referred for the procedure. Vasectomy services are provided by the Bromley GP Alliance.
If you are a GP referring into the service and have any queries please contact the GP Alliance on 01689 866531 or email: admin
At a glance: facts about vasectomy
- In most cases, vasectomy is more than 99% effective. Out of 2,000 men who are sterilised, one will get a woman pregnant during the rest of his lifetime.
- Male sterilisation is considered permanent – once it’s done, you don’t have to think about contraception again.
- You need to use contraception for at least eight weeks after the operation, because sperm stay in the tubes leading to the penis.
- Up to two semen tests are done after the operation, to ensure that all the sperm have gone.
- Your scrotum (ball sack) may become bruised, swollen or painful – some men have ongoing pain in their testicles.
- As with any surgery, there’s a slight risk of infection.
- Reversing the operation isn’t easy, and is rarely available on the NHS.
- Vasectomy doesn’t protect against sexually transmitted infections (STIs). By using a condom, you’ll protect yourself and your partner against STIs.
How vasectomy works
Vasectomy works by stopping sperm from getting into a man’s semen. This means that when a man ejaculates, the semen has no sperm and a woman’s egg cannot be fertilised.
How vasectomy is carried out
Vasectomy is a quick and relatively painless surgical procedure. The tubes that carry sperm from a man’s testicles to the penis are cut, blocked or sealed with heat. In most cases, you will be able to return home the same day.
Most vasectomies are carried out under local anaesthetic. This means that 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 that 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.
A vasectomy has no effect on sex drive or ability to enjoy sex. You will still have erections and ejaculate normally. The only difference is that your semen will not contain sperm.
A vasectomy can be performed at:
- GP Hub (via the Bromley GP Alliance)
- your local GP surgery
- a hospital as a day-patient appointment
- a sexual health clinic
- a private clinic
There are two types of vasectomy. The traditional technique, called conventional vasectomy, involves making two small incisions in the scrotum (the pouch of skin that surrounds your testicles) using a scalpel (surgical knife).
The other type, called a no-scalpel vasectomy, is a newer technique now in common use. The doctor doing your vasectomy will discuss with you which is best.
Conventional vasectomy
During a conventional vasectomy, the skin of your scrotum is numbed with local anaesthetic. The doctor makes two small cuts, about one centimetre long, on each side of your scrotum.
The incisions allow your surgeon to access the tubes that carry sperm out of your testicles. These tubes are known as “vas deferens”. 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 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
No-scalpel vasectomy is usually carried out under local anaesthetic. During a no-scalpel vasectomy, the doctor 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 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.
Before you decide to have a vasectomy
Your doctor will ask about your circumstances and provide information and counselling before agreeing to the procedure.
You should only have a vasectomy 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.
You shouldn’t make the decision about having a vasectomy after a crisis or a big change in your life – for example, if your partner has just had a baby, or has just terminated a pregnancy.
If you have a partner, discuss it with them before deciding to have a vasectomy. If possible, you should both agree to the procedure, but it is not a legal requirement to get your partner’s permission.
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.
Your GP does 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. If this is the case, you may have to pay to have a vasectomy privately.
How long will I have to wait for the operation?
In most parts of the UK, a vasectomy is available free of charge from the NHS. However, waiting lists can be several months, depending on where you live.
Speak to your GP about vasectomies in your area. As waiting lists for vasectomies can be long, some men choose to pay to have the procedure carried out privately.
You can request a male doctor, but in some cases this may mean having to wait longer. Your GP may be able to offer you options of where the vasectomy can be carried out.
Recovering after the operation
It’s common to have some mild discomfort, swelling and bruising of your scrotum for a few days after the vasectomy. If you have pain or discomfort, you can take painkillers, such as paracetamol. Contact your GP for advice if you are still experiencing considerable pain after taking painkillers.
It’s common to have blood in your semen in the first few ejaculations after a vasectomy. This isn’t harmful.
Some other common questions about recovery are outlined below.
Underwear
Wearing close-fitting 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. Make sure you change your underwear every day.
Hygiene
It is usually safe for you to have a bath or shower after your operation – check with your doctor what is suitable for you. Make sure you dry your genital area gently and thoroughly.
Returning to work
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. This is to minimise the risk of developing complications (see below). 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 will still have sperm in your semen immediately after the operation, as it takes time to clear the remaining sperm in your tubes. It takes an average of 20 to 30 ejaculations to clear the tubes of sperm. You will need to use another method of contraception until you have had two clear semen tests.
Once the operation has been carried out successfully and semen tests have shown that there is no sperm present, long-term partners may not need to use other forms of contraception.
However, a vasectomy does not protect against HIV infection or any other STIs, so you should still use condoms with any new partner.
How will I know if my vasectomy has worked?
After the vasectomy, there will be some sperm left in the upper part of the vas deferens tubes. It can take 20 to 30 ejaculations to clear these sperm from the tubes so, during this time, there is still a risk of pregnancy.
Until it has been confirmed that your semen is free of sperm, you should continue to use another form of contraception.
At least eight weeks after the procedure, you will need to produce a sample of semen, which will be tested for sperm. This will also help to identify the rare cases in which the tubes naturally rejoin themselves. Once tests have confirmed that your semen is free of sperm, the vasectomy is considered successful and you can stop using additional contraception.
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). If you are one of these men, your doctor will discuss your options with you. The chances of making your partner pregnant may be low enough to consider the vasectomy successful, or you may be advised to have further tests or consider other options.
Is reversal possible?
It is possible to have a vasectomy reversed. However, the procedure is not always successful. 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 about 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 tubes again, pregnancy may still not be possible. This is why you should be certain before going ahead with the vasectomy. Your doctor can help you to make your decision.
Reversal is rarely available on the NHS and the operation can be expensive if done privately.
Who can have a vasectomy
Having a vasectomy should always be viewed as permanent sterilisation. This is because, although reversal is sometimes possible, it may not be successful. A reversal operation requires delicate microsurgery to join the tubes together again. Even with a successful operation, it still may not be possible to father a child.
Advantages
- The failure rate is only one in 2,000 – out of 2,000 men who have a vasectomy, only one will get a woman pregnant in the rest of his lifetime.
- There are rarely long-term effects on your health.
- Vasectomy does not affect your hormone levels or sex drive.
- It will not affect the spontaneity of sex or interfere with sex.
- Vasectomy may be chosen as a simpler, safer and more reliable alternative to female sterilisation.
Disadvantages
- Vasectomy doesn’t protect against STIs
- It’s difficult to reverse, and reversal may not be available on the NHS.
- You need to use contraception after the operation until tests show your semen is free of sperm – if your semen contains sperm, you could make your partner pregnant.
- Complications can occur – the risks are listed below.
Risks
Soreness and bruising
Most men feel sore and tender for a few days after the operation, and will usually experience some bruising and swelling on or around their scrotum.
Haematoma
A haematoma is when blood collects and clots in the tissue surrounding a broken blood vessel. Following a vasectomy, you may develop a haematoma inside your scrotum.
Haematomas are mostly small (pea-sized), but can occasionally be large (filling the scrotum) and, rarely, they can be very large. This can cause your scrotum to become very swollen and painful. In severe cases, you may need further surgery to treat the blood clot.
Sperm granulomas
When the tubes that carry sperm from your testicles are cut, sperm can sometimes leak from them. In rare cases, sperm can collect in the surrounding tissue, forming hard lumps that are known as sperm granulomas.
Your groin or scrotum may become painful and swollen either immediately or a few months after the procedure. 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.
Infection
After a vasectomy, you may be at risk of developing an infection as a result of bacteria entering through the cuts made in your scrotum. Therefore, after the operation, it is important to keep your genital area clean and dry to keep the risk of infection as low as you can.
Long-term testicle pain
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. For most men, however, any pain is quite mild and they do not need further help for it.
Long-term testicular pain affects around one in 10 men after vasectomy. The pain is usually the result of a pinched nerve or scarring that occurred during the operation. You may be advised to undergo further surgery to repair the damage and to help minimise further pain.
Testicles feeling full
After a vasectomy, some men may develop the sensation that their testicles are “fuller” than normal. This is usually caused by the epididymis becoming filled with stored sperm. The epididymis is the long, coiled tube that rests on the back of each testicle. It helps to transport and store sperm.
Any such feelings should pass naturally within a few weeks. However, speak to your GP if you are still experiencing fullness after this time.
Fertility
In a very small number of vasectomy cases, the vas deferens reconnects over a period of time. This means that the vasectomy will no longer be an effective form of contraception. However, it is rare for this to happen.
Common questions about vasectomy
Can I have the operation if I am single?
Yes, but if you are under 30 you will find that many surgeons are reluctant to do it, in case your circumstances change and you regret it later.
Will it affect my sex drive?
No. After a successful vasectomy, your testicles will continue to produce the male hormone (testosterone) just as they did before the procedure. Your sex drive, sensation and ability to have an erection won’t be affected. The only difference is that there will be no sperm in your semen. Your body still produces sperm, but they are absorbed without harm.
Could being sterile affect me emotionally?
It is a big decision to end the part of your life where you could father a child. This is another reason to think it over carefully.
If you are sure about your decision to have a vasectomy, you may feel relieved that the worry of possible pregnancy is over and you do not need to think about contraception again.
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.
Is there any risk of vasectomy causing cancer?
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.
Can I use IVF to father a child?
If you have a vasectomy, and then decide later that you want a child, there may be the option of doing so by IVF (in vitro fertilisation). To do this, a surgeon would retrieve sperm from your testicles and use this to fertilise your partner’s egg. However:
- IVF may not be available on the NHS
- IVF done privately can be expensive
- IVF is not always successful
Can I store sperm in a sperm bank, just in case?
You could but, as with IVF, sperm stored in a sperm bank cannot be relied on to bring about a pregnancy. It can also be expensive.
Where to get contraception
Contraception is free to everyone through the NHS. Places where you can get contraception include:
- some GP surgeries – talk to your GP or practice nurse
- contraception clinics
- some young people’s services - call 0300 123 7123 for more information
If you’re under 16 years old
Contraception services are free and confidential, including for people under the age of 16.
If you’re under 16 and want contraception, the doctor, nurse or pharmacist won’t tell your parents (or carer) as long as they believe you fully understand the information you’re given, and your decisions.
Doctors and nurses work under strict guidelines when dealing with people under 16. They’ll encourage you to consider telling your parents, but they won’t make you.
The only time that a professional might want to tell someone else is if they believe you’re at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first.