Vasectomy

• If you have had any operations of the scrotum/testes even as a child, please call us. You may require an assessment first before we can book in for our one stop clinic.

• Please trim or shave the hair around the scrotum (under the penis) on the morning of the operation.

• You should not eat heavily beforehand, nor drink alcohol on the day of the procedure.

• You will need to wear well-fitting and supportive underpants or swimming trunks (ie not boxers) after the procedure for several days.

• Your appointment will include an examination of the scrotum, counselling and consent, followed immediately by your operation and the postoperative advice. Your overall visit at the centre is about 45 minutes.

• Occasionally it may not be possible to perform the procedure under local anaesthetic. This may be because it is not possible for mobilise the tubes (vas deferens) to the surface of the skin or a medical concern. You might then be offered referral to a hospital to have the operation done under general anaesthetic if you wish.

• We would prefer you have someone drive you home after the procedure.

A small amount of local anaesthetic is used to numb an area in the scrotal skin using a very fine needle, and once numb, more anaesthetic is infiltrated deeper around the vas (tube carrying the sperm).

The operation consists of removing a piece of the vas through a tiny incision in the scrotal skin and cauterizing the ends using diathermy.

The procedure is then repeated on the other side.

In most cases, only one incision is required. We prefer to use a couple of dissolvable stitches to close the wound, although this is not always necessary. It takes about 2 weeks for the stitches to dissolve.

The nurse will spend a few minutes with you and give you after care advice and answer any questions you may have. You may also be asked to fill in a satisfaction questionnaire about your experience at the Surgical Centre. Thank you in advance, as this helps us to improve our service. You can leave when you feel ready.

COMMON Qs & As

Do I still need to use contraception?
Yes. Please be aware that you must not abandon contraception until we have informed you in writing that your semen sample is negative for sperm.

Can the operation fail?
Yes. The procedure occasionally fails to render the patient sterile due to early re-joining of one or both tubes. This happens in about 1:100 cases. Your semen analysis at 16 weeks will pick this up. Late re-joining can also occur but is rare, believed to occur in 1:2000 vasectomies. Because it is very rare, further semen tests are not routinely done. Unfortunately, it is usually picked up if your partner becomes pregnant. You should contact us if this happens.

How and when do I do my sperm test?
Post- op semen test- This is essential to check that your operation has been successful. You will be provided with a small container and a request form after the operation for you to use to do your sperm test. Please produce one semen specimen by masturbation no sooner than 16 weeks after your operation. Please put that date in your diary, as no reminder will be sent. Condoms should not be used for that purpose. Please wash/shower before the test. It is estimated that men need to ejaculate at least 24 times during those 16 weeks before the test to clear the sperm that are already present in the tubes. It is also advised you have a period of abstinence between 2-7 days before doing the test.

As soon as possible after your procedure please telephone the Haematology Laboratory at RCHT (01872 252502) to book an appointment for Post vasectomy semen analysis at 16 weeks. This analysis is carried by appointment only and cannot be accommodated without booking an appointment.

At your prebooked appointment time, please deliver to the Haematology Laboratory reception (located in the link corridor via the Trelawney entrance), Royal Cornwall Hospital, Truro, TR1 3LJ. Your sample should be less than 2 hours old at delivery. Your partner may deliver your sample for you if you are unable to do so yourself. You will be informed of the result in writing about a fortnight later. Most men are cleared on their first sample. However, about 20% of men will have a positive first test.

What if the tests are still positive?
Semen analysis- If several of the post op semen tests still show presence of sperm, we will request a fresh semen analysis. This looks at specific numbers and whether the sperm is motile or not (like a fertility test). You will be sent an appointment directly from the hospital with specific instructions on how to do your sample.

When can I resume intercourse?
One week after. This allows time for the tubes to remain sealed.

Do I need to take painkillers?
We recommend you take regular ‘over the counter’ painkillers as soon as you get home and do so for a few days. Keep the wound dry for 48 hours if at all possible.

When can get back to work or exercise?
It is advisable that you make arrangements for light work for up to 2 weeks after your operation. No sports, heavy exercise or swimming is advised during that time.

Can the operation be reversed in the future?
This is possible to do but the results are not good. It is best to regard a vasectomy as a permanent procedure. Vasectomy reversal is not available under the NHS.

Will my sex life be affected?
Sexuality and virility- This is not affected. You will continue to have normal ejaculates but without sperm.

What do I do when I get home?
Relax with your feet up. Do as much as you feel comfortable to do but it is perhaps better to avoid long periods of standing or walking for the first couple of days.

When can I resume sports?
Avoid swimming, surfing, cycling for at least 2 weeks. Avoid rugby, football and squash for at least 4 weeks.

How do I care for my wound?
Keep the wound dry for 48 hours. After that time, soak the dressing off in shower, avoid soap or shower gel. Dry the area thoroughly and apply a clean (Melolin) dressing, as supplied by the Surgery, with the shiny side against the skin. You will be supplied with 5 dressings.

How long does it take for the wound to heal?
This will take 7 to 14 days to heal completely. If you have stitches, these are dissolvable so will not need to be removed and will dissolve within 7 to 14 days. It is very important to keep the wound site clean and dry. Please don’t use creams and talcum powder on the area until it has completely healed.

Will I get any swelling and bruising?
Some swelling and bruising will occur after the operation. Therefore, it is best to wear supportive underpants or briefs for at least 7 to 14 days. If the area is swollen, bruised and uncomfortable, apply a pack of ice wrapped in a towel to the scrotal area for a few minutes at a time whilst lying down. This helps to reduce swelling. Some men can have some bruising around the testicles and it can occasionally spread to the penis and groin area. This should resolve within a week.

Will I need pain killers?
The local anaesthetic used will gradually wear off in 1-2 hours. We advise that you take some pain killers as soon as you get home.

You can take Paracetamol or Ibuprofen, providing you are not allergic to them. Please don’t take aspirin or any medication containing aspirin, e.g. Dispirin, as these can cause bleeding.

When can I return to work?
Most men are fit to return to work after a couple of days, unless you have a physically demanding job, in which case we recommend that you do light duties for 2 weeks. If you are unsure, check with the surgeon.

When can I resume sexual intercourse?
You can resume sexual intercourse after 1 week. On the first or subsequent ejaculations, it is possible that you may experience some blood staining which is usually brown, stale blood. This is perfectly normal as the tubes are clearing themselves after the operation. Please use an alternative form of contraception until you have been advised otherwise by the Clinic.

What are the possible immediate complications following a vasectomy?

• Infection: If you experience excessive pain, swelling, the wound site is hot to touch or you have flu-like symptoms with or without a temperature, then it is possible that you may have an infection. Please contact us as we can advise you about treatment which may involve a course of antibiotics.

• Haematoma: If you experience some bleeding from the wound site, apply a clean dressing and pinch the edges of the wound together with some pressure for about 20 minutes, by which time the bleeding should have stopped. If it doesn’t stop then please contact us. In very occasional cases, a small blood vessel inside the scrotal area can start to bleed, causing localised swelling and pain (haematoma). If you develop a large painful swelling, please contact us as soon as possible.

When is my semen sample due for testing?
Your sample is due 16 weeks after the operation, by appointment only, it might be an idea to mark this on your calendar as you will not be sent a reminder. Please fill in all the details on the form provided and affix a label on the sample bottle provided. To clear the store of sperm, approximately 24 ejaculations are required. You need to ejaculate (by masturbation) straight into the container (Do not use a condom). It is also advised you have a period of abstinence between 2-7 days before doing the test, which should be done in the morning after a wash/shower. You will be notified in writing once we have received the results of this sample. If we receive a positive result a further sample will be required.

Until we send you a clearance letter, you must use an alternative form of contraception.

Where do I take the sample?
As soon as possible after your procedure please telephone the Haematology Laboratory at RCHT (01872 252502) to book an appointment for Post vasectomy semen analysis at 16 weeks. This analysis is carried by appointment only and cannot be accommodated without booking an appointment.

At your prebooked appointment time, please deliver your sample to the Haematology Laboratory at the Royal Cornwall Hospital (close to the drop off zone at the entrance of the hospital), Royal Cornwall Hospital, Truro, TR1 3LJ. Your sample should be less than 2 hours old at delivery. Your partner may deliver your sample for you if you are unable to do so yourself.

What if I move house after the operation?
Please let us know of any changes to your address as we will not be able to advise you of the final outcome of your operation.

Please contact us in the first instance, rather than your own surgery, on 01726 885104 if you have any queries or problems. Phone lines are open Monday to Friday 08:30am – 4:30pm only.

If outside of these hours, then please contact NHS 111 on 111. Please note that NHS 111 may refer you on elsewhere if necessary.

Any surgical procedure has an element of risk attached to it and occasionally things do not turn out as well as expected. Fortunately, the complications are uncommon.

• A little soreness and bruising are usual.

• Wound haematoma: (discrete painful collection of blood) or infection (painful red, hot wound +- a fever) do occasionally occur and may necessitate further treatment with drainage of the blood collection or antibiotics. These complications can occur in up to 5% of cases. Therefore you should report excessive discomfort or wound problem to your doctor.

• Granuloma: This is uncommon and consists of a tender lump at the end of the vas and is usually noticed several months after the operation. This is caused by a leak of sperm. It normally settles spontaneously. If persistent, it can be removed surgically.

• Slight swelling of the testis may occur. This resolves spontaneously but may take several weeks.

• Positive test at 7 months: Some men can have persistent but very small number of sperm, which are not motile. This is determined through a fresh semen analysis. In this case, we will issue you with a letter of ‘special clearance’. Although pregnancy is not known to occur, the risk is not zero.

• Post vasectomy pain syndrome: A rare complication, pain may be experienced continually or intermittently for months or even years after. It may be very troublesome and occasionally require a further surgical procedure or vasectomy reversal. It is not possible to predict who might get it.