What is a vasectomy for?

Vasectomy is form of permanent birth control – also know as 'sterilisation'. It is a minor medical procedure that involves the surgical cutting, blocking, or sealing of the ducts known as ‘vas deferens’.

The ‘vas deferens’ are the two ducts or tubes that carry sperm from the testicles to the penis. By cutting both tubes, vasectomies prevent sperm from reaching the semen (ejaculate). Sperm is needed to fertilise an egg (ovum) to cause pregnancy.

The main use of vasectomy is to prevent pregnancy – for many sexual couples, there is a high chance of pregnancy if no form of contraception is used: 

• Vasectomy is a long-term solution for people who do not wish to become pregnant. The procedure is usually permanent. It can be reversed in certain situations, but this is a difficult procedure

• It’s an increasingly popular form of birth control, which doesn’t affect sexual desire

• You will still be able to ejaculate when you orgasm – the only difference is that your semen will no longer contain any sperm, so it cannot fertilise an egg to produce a pregnancy

The vasectomy is a very simple procedure: 

• It takes around 15 minutes

• It’s carried out under local anaesthetic

• It shouldn’t hurt at the time, but the area may be sore for a few days afterwards, while the cuts heal

• Over-the-counter painkillers will help you manage any pain after the procedure

What happens during a Vasectomy?

• The traditional procedure:

• Your doctor will make a small cut on each side of the scrotum 

• These will allow them to access the tubes that carry the sperm from the testicles to the penis (the vas deferens) 

• They will then cut and seal the tubes, in order to stop the sperm from leaving the testicles

• There is also a new technique, called ‘no-scalpel vasectomy’: 

• This is done using keyhole surgery

• This is usually less invasive, and your nurse or GP can tell you whether this is an option

• After either type of vasectomy, you will still be able to ejaculate as usual, but your semen won’t contain any sperm. 

It's an effective procedure – vasectomies are over 99% effective at preventing future pregnancies. Only 1 out of 2,000 men who are sterilised will get a woman pregnant during the rest of their lifetime. 

According to NHS Digital, there were 14,039 vasectomies carried out in NHS hospitals during 2015/16. The total number of vasectomies is higher, including vasectomies carried out privately or at dedicated sexual health clinics. However, the total number of vasectomies has fallen by 41% since 2005/06.

How do I get a vasectomy?

You can get the vasectomy procedure done in several different places: 

• At some GP surgeries

• At hospital, with a day-patient appointment

• At most sexual health or GUM clinics

• At private clinics

Having a vasectomy carried out is free of charge on the NHS in most parts of the UK. However, the waiting list can take several months. You can also choose to have the procedure done privately, which will cost around £400. 

Before you decide to have a vasectomy carried out on the NHS – you will have to have a consultation with your doctor. They will be able to provide you with information, and will ask you some basic questions about your reasons for wanting the procedure, and your current lifestyle choices. 

A doctor has the right to refuse to perform vasectomy – or they can refuse to refer you for one if they don’t believe that it will be in your best interests. The reasons for this could be, for example, that they think you are too young, or that it is too soon after a big change or crisis in your life. If this happens, you can always seek a second opinion, or choose to pay for it to be done privately.

Before they agree you should have a vasectomy, your doctor they will:

• Check you understand the advantages and disadvantages

• Check you have considered the alternatives

• Check whether you might regret the decision later

• Want to give you extra counselling to make the decision if:

• You’re younger than 30

• You don’t have any children

• Your decision is related to a partner currently going through pregnancy

• Your decision is related to ending a relationship with a partner

• You are being encourage to get your vasectomy by someone else

Who can get a vasectomy? – if you are fertile and have a penis you could get vasectomy. Any doctor on the NHS has the right to refuse to carry it out, but you can always choose to pay for the procedure privately. 

You shouldn’t have vasectomy if you intend to have children in the future, or would like the option of doing so. Some people choose not to have the procedure for religious reasons. 

You might not be able to get a vasectomy if:

• You are recovering from an injury to your scrotum

• You have a whole-body infection or a diarrhoea from an infection

• You have enlarged veins in your testicles

• You have any unusual growths around your testicles

What will it be like after the procedure?

It’s perfectly common to experience the following symptoms after vasectomy:

• Swelling

• Bruising

• Mild pain of the scrotum

This discomfort should only ever be mild – it will usually last just a few days after the procedure. It’s also common to see some blood in your semen in the first few ejaculations after vasectomy, which isn’t anything to worry about. If you have any pain, you can take over-the-counter painkillers, like ibuprofen (which will also help ease any swelling).

To help ease discomfort – you should wear close-fitting underwear (day and night) to support the area. Make sure you change your underwear every day, wash regularly (if your doctor says it is safe for you to do so), and dry the area gently afterwards.

You should be fine to return to work 1-2 days afterwards – but try to avoid sports or heavy lifting for one week after the operation. It’s best to wait for a couple of days before having sex, but you should only do so when it is comfortable for you to do so.

You may not be protected until 8 weeks after your vasectomy – immediately after vasectomy, your ejaculate will still contain some sperm, because it takes time for the tubes to clear (about 20-30 ejaculations). You will have to use another method of contraception to prevent pregnancy until you have had two clear semen tests (usually after about 8 weeks).

How will a vasectomy affect my sex life?

For most people:

• You will no longer need to use contraceptive to avoid pregnancy

• You will still need to use protection from STIs

• Overall your sex drive and function will be the same

You won't need contraceptives to avoid pregnancy – once it has been confirmed that your semen is free of sperm, the biggest change in your sex life will be that you won’t have to use any other form of contraception with your partner. This can be incredibly liberating for many people, and especially for women who have regular sex with men, as women often bear the responsibility for birth control.

You can still get STIs – it’s important to remember that vasectomies do not protect you against getting STIs, like chlamydia. Only condoms will do this, so you should continue to use these with new partners.   

It shouldn't affect your sex drive – having vasectomy won’t affect your testosterone (hormone) levels, or cause low libido (low sex drive). It doesn’t interfere with sex, sensation, and there's no physical link between vasectomy and erectile dysfunction. It rarely causes complications, or has any long-term effect on your health.

Can anything go wrong with a vasectomy?

Yes – like any medical procedure, there is always a small chance that thingsl won’t go perfectly to plan. However, the risk with vasectomies is very small, because it is such a common and simple operation. Having a vasectomy procedure is one of the safest forms of birth control available.

Some of side effects of vasectomy that occur rarely, include:

• Blood clots in the scrotum (haematoma)

• Hard lumps of sperm (known as granulomas) forming in the scrotum

• Infection

• Long-term pain (from a pinched nerve or scarring), which affects less than 1 in 10

• Testicles feeling ‘fuller than normal’, which should pass within a few weeks

Ask your nurse or GP for further reassurance about these complications, which are all treatable with medication, or in rarer cases, further surgery.

The failure rate for vasectomy is tiny – just 1 in 2,000 people will make a partner pregnant after sterilisation. Getting a reversal of vasectomy isn’t an easy procedure, and isn’t usually available on the NHS. 

Should I get a vasectomy or try something else?

Sources

Concise Medical Dictionary (8 ed.) (2010) Oxford University Press [accessed 4 August 2020]

Does a vasectomy hurt? (2016) The Guardian [accessed 1 April 2020]

Sexual and Reproductive Health Services (2017) NHS [accessed 4 August 2020]

Vasectomy (male sterilisation) (2015) NHS [accessed 1 April 2020]