General Surgery Vasectomy

The operation is a minor surgical procedure which is carried out as a day case at the London Day Surgery Centre, during which the tubes (called the vas deferens) that carry sperm are sealed to prevent sperm getting into the ejaculated fluid.  It is a safe, simple and effective procedure which has been carried out on almost one fifth of UK men reproductive age.

The Operation

 

The operation therefore produces sterility and is irreversible.  It can be carried out under general or local anaesthesia and local is preferred by most men.  The vas deferens tubes, one on each side, which carry the sperm are cut and tied back.  It is a safe, simple and effective procedure which is commonly carried out.

 

After a small needle prick to insert the local a small incision is made in the middle of the scrotum just below the penis.  The vas deferens on each side is divided, a one centimetre portion excised and the ends turned back and ligated.  An absorbable suture is used, hidden under the skin, so there are no stitches to remove.  The operation takes about half an hour and you will be able to go home straight afterwards; or stay with us for a cup of tea or coffee or a soft drink and a biscuit.

 

Recovery

 

Usually you will only need simple adhesive plaster type dressings for a few days and full instructions will be given. Normal washing, showering, bathing is encouraged after 12 hours.  Complications are rare but you will be given a 24 hour telephone number in case of need.  Follow up appointments are not usually needed but you will be contacted by telephone after a few days to check all is well and at about four weeks after the operation you will be reminded that you need a sperm count to check it has been successful.  This can be carried out at any medical laboratory or hospital you wish.

 

Pain and tenderness is to be expected for the first day or so, gradually subsiding over a week or two.  There may be some swelling and bruising to see but this, too, will soon go. 

 

Normal exercise and sexual relations should be resumed as soon as it is comfortable to do so; there is no reason to delay if you feel all right.  But you must continue using contraception until the remaining sperm 'downstream' from the vasectomy site have been ejaculated or have died; this can take a month or more.

 

You will require a semen sample test at about one month after the vasectomy and this will be repeated if there are still sperms remaining.  You are not sterile until azoospermia (the complete absence of sperms) has been confirmed by the laboratory.

 

Potential risks of vasectomy

 

There are some risks which you should know about.  They are given in the table which is from a study of many thousands of vasectomies (NS Awsare et al “Complications of vasectomy” Annals of the Royal College of Surgeons of England 2005;87:406-410) and you can see that they are not common.  Testicular cancer, prostate cancer, kidney stones and hardening of the arteries (atheroma) never occur due to vasectomy.

 

infection	3.5% (treated with antibiotics but can take a few weeks to clear)
haematoma	2% (a large bruise which can take a few weeks to clear)
orchalgia	2 - 15% (a continuing testis pain)
fistula	case reports only (i.e. very very rare)
sperm granuloma	10% (a small, sometimes tender, lump where the vas has been cut)
anti-sperm antibodies	60% (this is why reversing operations are so often unsuccessful)
recanalisation	0.05% (a failure rate of 5 in 10,000 operations)
failure rate	2% if a negative sperm count test has not been done