Vasectomy
Vasectomy Information and Counselling
This booklet has been prepared to give you information about male sterilisation (vasectomy), and to answer most of the questions you may have about the operation and its effects.
We normally offer a brief counselling session followed immediately by the vasectomy. This is because we believe that the decision to have a vasectomy is one that only you and your partner can make - often after discussion with your GP and sometimes a range of experienced friends and colleagues.
Should you however wish to make a separate appointment to discuss vasectomy, please call the clinic to arrange an appointment via telephone. There is no charge and we will be pleased to help.
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General Information
Vasectomy in one of the safest, simplest and most effective methods of contraception but because it should also be considered permanent it is important you be fully informed before deciding to proceed.
In the United Kingdom and across the world vasectomy is now relied upon by many millions of couples.
We rarely have a waiting list of more than a few weeks and the technique used can normally be completed in under 30 minutes. The service is designed to take up as little of your time as possible. Because we are able to arrange consultation, which includes a short counselling session and operation under local anaesthetic on the same day, the whole appointment should take no longer than 30 minutes. No further visits to the clinic are needed (unless you particularly want follow up advice) since the semen tests are posted to the laboratory and there are no stitches to be removed.
Suitability for Vasectomy
We will consider any man for vasectomy who has seriously thought about the implications of his decision and is positive he has had all the children he will ever want. This applies equally to men who are married, single, divorced, widowed, childless or with families, regardless of age. However, if you are in your early twenties or under, you might consider coming for an initial consultation and counselling, with a view to having the operation at a later date. We would not refuse to perform the operation on the grounds of age but feel it is important to give you the opportunity to discuss your decision whilst allowing time for further consideration. In addition we strongly advise you not to undergo vasectomy if you have any sexual or personal problems as this is not a good time to make such an irrevocable decision.
The vasectomy procedure must be seen as permanent. If reversal is a concern while you are considering vasectomy, or if you think there is a chance you will change your mind in later life as a result of changed circumstances, we strongly advise you to postpone the decision until you are 100% sure that you want no more children under any circumstances. Studies show 6% of men who had undergone vasectomy regreted their decision to have had vasectomy. 5-10% men do suffer from long term testicular pain and a small percentage may need reversal or other surgical procedures for the pain.
Though vasectomy is the most reliable method of contraception, there is a chance of failure due to the cut ends join together and spontaneously re-establish the continuity (recanalisation) and render the return of fertility.
For these reasons we give you (and if you wish, your partner) the opportunity to discuss with the doctor prior to the operation all the implications of the procedure and its permanency.
How Vasectomy Works
Vasectomy means removal of part of the vas. The vas (vas deferens to be medically correct) is the tube that carries sperm from the testis up into the groin and back towards the base of the penis. There the sperms are mixed with transport fluid from the prostate gland and enter the storage vessels (call seminal vesicles) where more fluid is added. This fluid (semen) is ready for ejaculation. Only 3% of the fluid ejaculated comes up the vas from the testis so after vasectomy there is no difference in the volume, colour or any other feature of the semen.
After vasectomy, sperms continue to be produced as normal in the testis but they remain trapped in the tubes where they are harmlessly absorbed by the body. Many millions of sperm are left in the reservoirs of the seminal vesicles and these are gradually washed away with every ejaculation. We arrange semen tests at the laboratory at 12 and 14 weeks after vasectomy to ensure that the semen contains fluid only and no sperms. It is recommended that couples have intercourse 3 times per week until submitting the first semen sample to ensure complete emptying of the store of sperms.
The ‘No-Scalpel’ Vasectomy Operation
Pre-med. This is a simple injection into an arm vein of a fast acting relaxant (called Hypnovel). This is widely used by dentists and doctors before out-patient tests such as gastroscopy. The effect is pleasing, even essential for some anxious men. Having this does mean that you must be driven or accompanied home. You may drive again the next day. If however you are calm and relaxed at the thought of vasectomy then there will be no need to take this.
No-scalpel vasectomy (NSV). This technique is keyhole surgery. The skin of the scrotum and the vas are frozen with local anaesthetic until completely numb. (A common fear among men is that vasectomy involves an injection into the testis. This is not true). Next the skin is punctured and a small gap opened trough which the vas is brought up and all sensitive tissues gently cleared. Next a 1cm segment of vas is removed and the tubes are heat sealed. Finally a Titanium clip is applied for permanent closure of the vas. The tube is allowed to return into place and the skin wound closed without needing any stitches. The procedure is repeated on the second side. The whole operation takes usually 10 - 15 minutes.
NSV - a better vasectomy. NSV was devised in China in 1975 by Dr Li. The operation technique spread across the USA where more than 60% of vasectomies are by this method. Patients and doctors prefer NSV because it virtually halves the operation time and brings the recovery time down to 1 - 2 days rather than 2 - 4 days for conventional vasectomy. Infection and wound problems are only 1/10th of conventional vasectomy. The reason for this is that a minimum of tissues are disturbed leading to an easier and faster recovery - like the best key hole surgery.
After the Operation
Full instructions on what to expect after the operation will be given to you before you leave the clinic. You must bring someone to accompany you home and must not drive until the next day. You should remember that the area operated on needs to heal internally, so do not be tempted to exert yourself too soon. We recommend the following recovery times:
- Operation day (usually Thursday or Friday) - Home to rest
- Days 1 - 3 (usually Friday to Sunday) - No exertion, pottering.
- Days 4 - 7 - May return to work but no heavy lifting or exertion.
- Day 7 onwards - Back to normal, resume work, sport etc.
- Fortunately it is safe to resume a normal sex life after 7 days.
Will there be any long term effects?
There have been reports in the press over the last few years of a possible link between vasectomy and various cancers. We are pleased to confirm that there is no proof of a link with any cancer. Indeed there is a report from the USA that vasectomised men live longer!
Semen Tests
These are timed for approximately 12 and 14 weeks after vasectomy. Semen samples may be collected by masturbation directly into the container or by collection in a condom and snipping a hole in the teat end to drain the contents into the container. You may seek help from your GP for arranging the semen analysis. If you prefer us to arrnage the test through a local priate fertility clinic, that can be arranged. You will have to pay the fee of GBP 100 to that clinic directly.
We send out the ‘all clear’ certificate when we receive the second semen test report from the lab. More than 9/10 men are clear with the first two tests but do not be surprised if we ask you to submit a third or fourth test.
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