Vasectomy (sterilisation for men)
Written by Dr David Delvin, GP and family planning specialist
What is vasectomy?
Vasectomy is a simple and straightforward operation that stops sperm entering semen. It is a permanent form of contraception, but it shouldn't interfere with your sex life because you will still have erections and produce semen.
It is a routine operation these days, with about 18 per cent of British males of reproductive age having had a vasectomy.
Who can have a vasectomy?
Provided you have thought it over carefully, any man can choose to be sterilised by having a vasectomy - though doctors are generally unwilling to do the operation on very young males, especially those without children.
Vasectomy is a much simpler procedure than the sterilisation of women and is almost always done on an outpatient basis – in other words, without having to stay in hospital. You can usually go home a couple of hours after the operation.
Can you get a vasectomy on the NHS?
In some parts of the UK vasectomy is available free under the NHS, although in recent years getting funding has become more difficult.
Even where NHS vasectomy is available, going private will almost certainly get you operated on much more quickly.
- In remoter country areas of Britain, there is often one GP who does private vasectomies at his or her surgery.
- In large cities, there are many clinics that will perform the operation for you, at a cost of anything between £350 and £700. The excellent Marie Stopes chain of charitable clinics charges a flat fee of £395.
Who should you contact?
You can talk to your GP, a family planning clinic or any reputable clinic that advertises vasectomy. They should tell you how the sterilisation procedure works and discuss the small risk of unwanted effects.
You should talk over any worries with them - especially about sex. It's then a good idea to have at least a few days to think things over and discuss the procedure with your partner.
I suggest you steer clear of any clinic that doesn't give you time to think about whether you want to go ahead. A vasectomy is a big step in a man's life, and you shouldn't let yourself be rushed into it.
Does your partner need to know?
It is folly to have a vasectomy without your wife or partner's consent.
Taking such a unilateral decision can lead to marital discord.
In addition, it is technically possible that your spouse could sue you for depriving her of the chance of having further children.
A good clinic will want to discuss alternative types of contraception with you, and to make sure that you and your partner are really happy with the idea of vasectomy - and that you understand that you are taking this decision for life.
What happens in a vasectomy?
The actual surgical procedure is a bit alarming for most men, but there is usually very little pain and the operation is short.
These days, it is nearly always done under a local anaesthetic.
A few surgeons – mainly in private practice – like to do it while the patient is under a general anaesthetic. . (Inevitably, this pushes the cost up quite a lot, because you have to pay for the anaesthetist and all his equipment and drugs.)
Did you know?
The tube that carries sperm to semen is called the vas.
Vasectomy means 'cutting out a piece of vas'.
Will you have any problems afterwards?
Most men are just a bit sore and bruised afterwards. But a few develop bleeding, marked swelling or an infection (symptoms: pain and a temperature). If any of these things happen, contact a doctor.
Heavy bleeding is uncommon, but if it happens it could put you off work for several weeks.
You should wear an athletic support (a jock strap) for a week or so after the vasectomy to ease the discomfort. Getting into a warm bath is also very soothing.
Do not attempt any strenuous physical activity for at least a month after the op. Lifting a heavy weight could make a stitch slip and so cause bleeding, but this is uncommon.
Did you know?
In the last year or so, a few men have tried to sue surgeons after developing sperm granulomas.
They claim they weren't told of the possibility of developing a granuloma.
When can you have sex again?
You can have sex as soon as you feel like it after the operation (some men have sex within hours), but you'll need to use an additional contraceptive method for a while.
Yes – you will produce semen. It will look just the same as before and the volume should be the same.
Does sterilisation work immediately?
After the operation, you will still have some sperm left in the tubes that lead to the penis. This means that you must use another contraceptive method for the time being.
About two to three months after your surgery, you'll need to have a semen test to see if all the sperm have gone. Many surgeons like to make really sure by doing two tests.
Once you have been reassured that no sperm can be seen in your ejaculate - under a microscope - then you can rely on your vasectomy without using any back-up contraception.
But there is still a tiny failure rate.
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