Vasectomy

Vasectomy is an operation that is frequently asked for by men who feel that they no longer wish to have children, usually because their family is complete. It is carried out under local anaesthetic, and usually only takes about 20 minutes to perform. Most men will get a certain amount of bruising and swelling afterwards, and this will be accompanied by some discomfort, but it usually only takes a few days to settle down. It is impossible to advise exactly how long you should take off work afterwards, but a week will almost certainly be enough for most men, except possibly those in very physically demanding occupations. It is unlikely that you would wish to start sexual activity much before 2 weeks after the operation.

The body is good at healing, and in some cases the cut ends of the tube that is divided during the operation will find each other, rendering the operation a failure - it is therefore mandatory that you have 2 sperm counts after about 3 months, to make sure the operation has worked, as unexpected failure of the operation can have very significant ramifications.

Once you have been given the "all clear" after these tests have been done, you can then consider yourself permanently sterile, and you and your partner can abandon other forms of contraception. If you do indulge in sexual activity with anyone other than you regular partner, you should still use a condom. Occasionally, men who have been successfully sterilised by vasectomy do regain their fertility spontaneously, but this is very rare. Vasectomy does not carry a lifetime guarantee.

After a vasectomy, the sperm cells that are made within the testicle cannot get out, and so the ejaculated fluid contains none of these cells, but you will not notice any change in your sexual performance. Sometimes, the sperm cells can build up in the testicles, and cause occasional episodes of discomfort and swelling, but these are not usually serious, and should not cause any concern, even if the symptoms develop several years after the operation. There does not appear to be any increased likelihood of developing testicular cancer after this operation.

Sadly, some men who have a vasectomy find that their circumstances subsequently change, whether it be by bereavement, divorce or simply a change of mind. In these circumstances, a request to attempt to reverse the vasectomy is made. Whilst this may be successful, it is extremely unlikely that fertility will be as reliable as it previously was, and vasectomy reversal is not a uniformly successful procedure. Please read the notes on this procedure for further information.

Vasectomy is never the only form of contraception available to a couple, and we will not carry out the procedure if you are under 30, if you have not already had children, or are not in a stable relationship, except in very particular circumstances. It may also be very difficult to carry out the operation if you have had previous scrotal surgery, so please discuss the merits of the procedure with your general practitioner before asking for a referral.

Reversal of vasectomy

If you had a vasectomy before, and are now regretting the decision, the situation is not completely hopeless, but it is not possible to guarantee a successful outcome by which is meant being able to achieve a pregnancy in your partner. The time since your vasectomy is the most important factor, and if this is more than 10 years, then it is less likely to be successful.

Vasectomy reversal is carried out under general anaesthetic (usually), and is likely to keep you off work for up to 2 weeks, maybe longer if you are in a very physically demanding occupation. It is not available on the NHS, and may require staying overnight in hospital, and is likely to result in a little more bruising, swelling and discomfort than experienced after the original vasectomy.

It is the only technique that will make it possible for you to father a child in the usual way, so if you cannot face the prospect of surgery, then it will be necessary to either accept your sterility, to adopt, or to undergo infertility treatment (test tube baby techniques), which carries a higher success rate, but is likely to be more expensive.