Contraception guide

Vasectomy (male sterilisation)

A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this happening by keeping the egg and sperm apart or by stopping egg production. One method of contraception is vasectomy (male sterilisation).

During a minor operation, the tubes that carry sperm from a man's testicles to the penis are cut, blocked or sealed.

This prevents sperm from reaching the seminal fluid (semen), which is ejaculated from the penis during sex. There will be no sperm in the semen, so a woman's egg can't be fertilised.

 

Vasectomy is usually carried out under local anaesthetic, and takes about 15 minutes.

At a glance: facts about vasectomy

  • In most cases, vasectomy is more than 99% effective. Out of 2,000 men who are sterilised, one will get a woman pregnant during the rest of his lifetime.
  • Male sterilisation is considered permanent – once it's done, you don't have to think about contraception again.
  • You need to use contraception for at least eight weeks after the operation because sperm stay in the tubes leading to the penis.
  • Up to two semen tests are done after the operation to ensure that all the sperm have gone. 
  • Your scrotum (ball sack) may become bruised, swollen or painful – some men have ongoing pain in their testicles.
  • As with any surgery, there's a slight risk of infection. 
  • Reversing the operation isn't easy, and is rarely available on the NHS.
  • Vasectomy doesn't protect against sexually transmitted infections (STIs). By using a condom you’ll protect yourself and your partner against STIs. 

How vasectomy works

Vasectomy works by stopping sperm from getting into a man’s semen. This means that when a man ejaculates, the semen has no sperm and a woman’s egg cannot be fertilised.

How vasectomy is carried out 

Conventional vasectomy

No-scalpel vasectomy

Before you decide to have a vasectomy

How long will I have to wait for the operation?

Recovering after the operation

How will I know if the vasectomy has worked?

Is reversal possible?

How vasectomy is carried out

Vasectomy is a quick and relatively painless surgical procedure. The tubes that carry sperm from a man's testicles to the penis are cut, blocked or sealed with heat. In most cases, you will be able to return home the same day.

Most vasectomies are carried out under local anaesthetic. This means only your scrotum and testicles will be numbed, and you will be awake for the procedure. You will not feel any pain, although it may feel slightly uncomfortable.

In rare cases, a general anaesthetic may be required. This means you will be asleep during the procedure. A general anaesthetic may be used if you are allergic to local anaesthetic or have a history of fainting easily. However, most people will only need a local anaesthetic.

A vasectomy has no effect on sex drive or ability to enjoy sex. You will still have erections and ejaculate normally. The only difference is that your semen will not contain sperm. 

A vasectomy can be performed at:

  • your local GP surgery
  • a hospital as a day-patient appointment
  • a sexual health clinic
  • a private clinic  

There are two types of vasectomy. The traditional technique, called conventional vasectomy, involves making two small incisions in the scrotum (the pouch of skin that surrounds your testicles) using a scalpel (surgical knife).

The other type, called a no-scalpel vasectomy, is a newer technique now in common use. The doctor doing your vasectomy will discuss with you which is best for you.

Conventional vasectomy

During a conventional vasectomy, the skin of your scrotum is numbed with local anaesthetic. The doctor makes two small incisions (cuts), about 1cm long, on each side of your scrotum.

The incisions allow your surgeon to access the tubes that carry sperm out of your testicles. These tubes are known as vas deferens. Each tube is cut and a small section removed. The ends of the tubes are then closed, either by tying them or sealing them using diathermy (an instrument that heats to a very high temperature).

The incisions are stitched, usually using dissolvable stitches, which will disappear naturally within about a week.

No-scalpel vasectomy

You can get contraception at:

  • most GP surgeries
  • community contraception clinics
  • some GUM clinics
  • sexual health clinics
  • some young people's services

Find a clinic near you

No-scalpel vasectomy is usually carried out under local anaesthetic. During a no-scalpel vasectomy, the doctor will feel the vas deferens underneath the skin of your scrotum and then hold them in place using a small clamp.

A special instrument is then used to make a tiny puncture hole in the skin of the scrotum. A small pair of forceps is used to open up the hole, allowing the surgeon to access the vas deferens without the need to cut the skin with a scalpel. The tubes are then closed in the same way as in a conventional vasectomy, either by being tied or sealed.

During a no-scalpel vasectomy, there will be little bleeding and no stitches. The procedure is also thought to be less painful, and less likely to cause complications than a conventional vasectomy.

Before you decide to have a vasectomy

Your doctor will ask about your circumstances and provide information and counselling before agreeing to the procedure.

You should only have a vasectomy if you are certain that you do not want to have any, or any more, children. If you have any doubts, consider another method of contraception until you are completely sure.

You shouldn't make the decision about having a vasectomy after a crisis or a big change in your life – for example, if your partner has just had a baby, or has just terminated a pregnancy.

If you have a partner, discuss it with them before deciding to have a vasectomy. If possible, you should both agree to the procedure but it is not a legal requirement to get your partner's permission.

You can have a vasectomy at any age. However, if you are under 30, particularly if you do not have children, your doctor may be reluctant to perform the procedure.

Your GP does have the right to refuse to carry out the procedure or refuse to refer you for the procedure if they do not believe it is in your best interests. If this is the case, you may have to pay to have a vasectomy privately.

How long will I have to wait for the operation?

In most parts of the UK, a vasectomy is available free of charge from the NHS. However, waiting lists can be several months, depending on where you live.

Speak to your GP or ask at your local contraception clinic about vasectomies in your area. As waiting lists for vasectomies can be long, some men choose to pay to have the procedure carried out privately.

You can request a male doctor, but in some cases this may mean you have to wait longer. Your GP may be able to offer you options of where the vasectomy can be carried out.

Recovering after the operation

It’s common to have some mild discomfort, swelling and bruising of your scrotum for a few days after the vasectomy. If you have pain or discomfort, you can take painkillers, such as paracetamol. Contact your GP for advice if you are still experiencing considerable pain after taking painkillers.

It’s common to have blood in your semen in the first few ejaculations after a vasectomy. This isn’t harmful.

Some other common questions about recovery are outlined below.

Underwear

Wearing close-fitting underwear, such as Y-fronts, during the day and at night will help to support your scrotum and will also help ease any discomfort or swelling. Make sure you change your underwear every day.

Hygiene

It is safe for you to have a bath or shower after your operation, but make sure you dry your genital area gently and thoroughly.

Returning to work

Most men will be fit to return to work one or two days after their vasectomy, but you should avoid sport and heavy lifting for at least one week after the operation. This is to minimise the risk of developing complications (see below). If any symptoms continue after a few days, consult your GP.

Having sex

You can have sex again as soon as it is comfortable to do so, although it is best to wait for a couple of days. However, you will still have sperm in your semen immediately after the operation, as it takes time to clear the remaining sperm in your tubes. It takes an average of 20-30 ejaculations to clear the tubes of sperm. You will need to use another method of contraception until you have had two clear semen tests.

Once the operation has been carried out successfully and semen tests have shown there is no sperm present, long-term partners may not need to use other forms of contraception.

However, a vasectomy does not protect against HIV infection or any other sexually transmitted infections, so you should still use condoms with any new partner.

How will I know if my vasectomy has worked?

After the vasectomy, there will be some sperm left in the upper part of the vas deferens tubes. It can take more than 20 ejaculations to clear these sperm from the tubes so, during this time, there is still a risk of pregnancy.

Until it has been confirmed that your semen is free of sperm, you should continue to use another form of contraception.

At least eight weeks after the procedure you will need to produce a sample of semen which will be tested for sperm. This will also help to identify the rare cases in which the tubes naturally rejoin themselves. Once tests have confirmed that your semen is free of sperm, the vasectomy is considered successful and you can stop using additional contraception.

A few men continue to have small numbers of sperm in their system, but these sperm do not move (they are known as non-motile sperm). If you are one of these men, your doctor will discuss your options with you. The chances of making your partner pregnant may be low enough to consider the vasectomy successful, or you may be advised to have further tests or consider other options.

Is reversal possible?

It is possible to have a vasectomy reversed. However, the procedure is not always successful. You have a better chance if it is done soon after the vasectomy.

If a reversal is carried out within 10 years of your vasectomy, the success rate is about 55%. This falls to 25% if your reversal is carried out more than 10 years after your vasectomy.

Even if a surgeon manages to join up the vas deferens tubes again, pregnancy may still not be possible. This is why you should be certain before going ahead with the vasectomy. Your doctor can help you to make your decision.

Reversal is rarely available on the NHS and the operation can be expensive if done privately.

Who can have a vasectomy

Having a vasectomy should always be viewed as permanent sterilisation. This is because, although reversal is sometimes possible, it may not be successful. A reversal operation requires delicate microsurgery to join the tubes together again. Even with a successful operation, it still may not be possible to father a child.

Advantages and disadvantages of vasectomy

Advantages

  • the failure rate is only one in 2,000 – out of 2,000 men who have a vasectomy, only one will get a woman pregnant in the rest of his lifetime
  • there are rarely long-term effects on your health
  • vasectomy does not affect your hormone levels or sex drive
  • it will not affect the spontaneity of sex or interfere with sex
  • vasectomy may be chosen as a simpler, safer and more reliable alternative to female sterilisation

Disadvantages

  • vasectomy doesn’t protect against sexually transmitted infections
  • it’s difficult to reverse, and reversal may not be available on the NHS
  • you need to use contraception after the operation until tests show your semen is free of sperm – if your semen contains sperm, you could make your partner pregnant
  • complications can occur – the risks are listed below

Risks

Most men feel sore and tender for a few days after the operation, and will usually experience some bruising and swelling on or around their scrotum.

However, in some cases, a vasectomy can cause more serious problems, some of which are outlined below.

Haematoma

A haematoma is when blood collects and clots in the tissue surrounding a broken blood vessel. Following a vasectomy, you may develop a haematoma inside your scrotum.

Haematomas are mostly small (pea-sized), but can occasionally be large (filling the scrotum) and, rarely, they can be very large. This can cause your scrotum to become very swollen and painful. In severe cases, you may need further surgery to treat the blood clot.

Sperm granulomas

When the tubes that carry sperm from your testicles are cut, sperm can sometimes leak from them. In rare cases, sperm can collect in the surrounding tissue, forming hard lumps that are known as sperm granulomas.

Your groin or scrotum may become painful and swollen either immediately or a few months after the procedure. The lumps are not usually painful and can often be treated using anti-inflammatory medication, which your GP will prescribe. If the granulomas are particularly large or painful, they may have to be removed surgically.

Infection

After a vasectomy you may be at risk of developing an infection as a result of bacteria entering through the cuts made in your scrotum. Therefore, after the operation, it is important to keep your genital area clean and dry to keep the risk of infection as low as you can.

Long-term testicle pain

Some men get pain in one or both of their testicles after a vasectomy. It can happen immediately, a few months or a few years after the operation. It may be occasional or quite frequent and vary from a constant dull ache to episodes of sharp, intense pain. For most men, however, any pain is quite mild and they do not need further help for it.

Long-term testicular pain affects around one in 10 men after vasectomy. The pain is usually the result of a pinched nerve or scarring that occurred during the operation. You may be advised to undergo further surgery to repair the damage and to help minimise further pain.

Testicles feeling full

After a vasectomy, some men may develop the sensation that their testicles are 'fuller' than normal. This is usually caused by the epididymis becoming filled with stored sperm. The epididymis is the long, coiled tube that rests on the back of each testicle. It helps to transport and store sperm.

Any such feelings should pass naturally within a few weeks. However, speak to your GP if you are still experiencing fullness after this time.

Fertility

In a very small number of vasectomy cases, the vas deferens reconnects over a period of time. This means that the vasectomy will no longer be an effective form of contraception. However, it is rare for this to happen.

Common questions about vasectomy

Can I have the operation if I am single?

Yes, but if you are under 30 you will find many surgeons are reluctant to do it in case your circumstances change and you regret it later.

Will it affect my sex drive?

No. After a successful vasectomy your testicles will continue to produce the male hormone (testosterone) just as they did before the procedure. Your sex drive, sensation and ability to have an erection won’t be affected. The only difference is that there will be no sperm in your semen. Your body still produces sperm, but they are absorbed without harm.

Could being sterile affect me emotionally?

It is a big decision to end the part of your life where you could father a child. This is another reason to think it over carefully.

If you are sure about your decision to have a vasectomy, you may feel relieved that the worry of possible pregnancy is over and you do not need to think about contraception again.

If you feel anxious or uncomfortable about the procedure, or if you think you would suffer mentally from being infertile, then it is not the best type of contraception for you. You can discuss alternatives with your GP or with a professional at a contraception clinic (sometimes called a family planning clinic).

Is there any risk of vasectomy causing cancer?

Although prostate cancer and testicular cancer can occur in men who have had a vasectomy, research suggests that vasectomy does not increase your risk of cancer.

Can I use IVF to father a child?

If you have a vasectomy, and then decide later that you want a child, there may be the option of doing so by IVF (in vitro fertilisation). To do this, a surgeon would retrieve sperm from your testicles and use this to fertilise your partner’s egg. However:

  • IVF may not be available on the NHS
  • IVF done privately can be expensive 
  • IVF is not always successful

Can I store sperm in a sperm bank, just in case?

You could but, as with IVF, sperm stored in a sperm bank cannot be relied on to bring about a pregnancy. It can also be expensive.

Where to get contraception

Most types of contraception are available free in the UK. Contraception is free to all women and men through the NHS. You can get contraception, and information and advice about contraception, at:

  • most GP surgeries – talk to your GP or practice nurse 
  • community contraception clinics 
  • some genitourinary medicine (GUM) clinics 
  • sexual health clinics – they also offer contraception and STI testing services 
  • some young people’s services (call 0300 123 7123 for more information)

Find your nearest sexual health clinic.

Contraception services are free and confidential, including for people under the age of 16.

If you're under 16 and want contraception, the doctor, nurse or pharmacist won't tell your parents (or carer) as long as they believe you fully understand the information you're given, and your decisions. Doctors and nurses work under strict guidelines when dealing with people under 16.

They'll encourage you to consider telling your parents, but they won't make you. The only time that a professional might want to tell someone else is if they believe you're at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first. 

Page last reviewed: 15/01/2013

Next review due: 15/01/2015

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Comments

The 62 comments posted are personal views. Any information they give has not been checked and may not be accurate.

abbi1987 said on 25 September 2014

Ocra Bride said on 08 June 2014
Can my husband choose the gender of the surgical team?

Really?? Is that question yours or your partners??
No, a surgical team is assembled out of whos working that day and sorry to say every operating theater ive been in has had females in it.
If this is your question and not his I really dont think a female nurse will get giddy over your mans man hood as its been operated on.
If its your fella he dont need to worry bout getting stiff, hel be more worried about whether it will be usuable afterwards.

Guys..... Thankyou..... for both of our sakes we will not be opting for this. My man will probably be the 1 out of 10.

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YouHaveBeenWarned said on 10 September 2014

Bilateral Epididymectomy performed to alleviate chronic pain I have experienced after vasectomy. It has made things much worse.

It has now become a severe restriction on normal everyday activities.

It has become apparent that the worldwide medical community is unsure about the statistics associated with the complications of this procedure, which is often referred to as safe and effective. Effective because the man is likely to be sterile. Safe because the man is probably going to be okay (but no guarantees).

The NHS has to be careful when providing you with the details to avoid litigation, especially on the consent form. Make sure this is discussed with the surgeon before signing.

This website at the time of my vasectomy (Mar 2012) had the likelihood as rare, but now it is 1 in 10 which under the NHS classification is 'common'. This still differs from BAUS (up to 30%).

Something to bear in mind when being encouraged to go ahead with this simple, safe and effective operation.

YouHaveBeenWarned

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SIgNora said on 10 August 2014

Hubby is regular pain 3 years after vasectomy.

He had to give 6 samples of sperm, some 'just produced' at hospital cubicle to finally be given the all clear.

Pain has stabilised in last 12 months and he manages with over the counter pain killers.

The surgeon who cut in to his sack has said there is nothing more she can do to ease pain.

A disaster for both of us.

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Wormtongue said on 06 August 2014

Lots of differing opinions on here, and I have to say that i'm one of those who would say, that with the benefit of hindsight, I wouldn't set out for a vasectomy if you're still undecided. In the spirit of fairness, as follows:

Pros:
Got 'processed' very quickly from talk with GP (3 minutes) to booking in with Surgeon at local clinic. Spent no more than 5 minutes discussing why or why I should not have a Vas, but then I have four kids, so I guess I seemed like my mind was set.
Operation was painful. Macho BS from a lot of friends says it wasn't, but needles in your testicles will hurt. Sorry, but it will.
Recovery was straight forward, bruising etc. No majors.

Cons:
Post vas Semen samples - had the op in Dec 2013 - still giving up samples now - July 2014. On number 5 to be exact. 50 miles round trip from my nearest Pathology, costs are mounting. All very cattle handled, not one department seems to know who is the best to speak to. Now have to produce a live sample in a hospital cubicle - called the number provided by my clinic, explained my story no less than 9 times to 9 separate depts, before being booked in for the right one.

If i'm honest, its all a bit shabby - the whole process, the lack of 'care' - I do have to ask, would a woman be treated like this over a sexual health issue? My wife agrees not...

So it goes on - might have to have another vasectomy. Not having that again...

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WeidPund said on 20 July 2014

I had a vasectomy at easysnip clinic in Uttoxeter 6 months ago. I found the procedure simple but I was left exposed longer than I needed to be and I was required to trim hairs over a wide area of my groin and this wasn't considered full enough. I felt I was undergoing treatment for the benefit and ease of the doctor and his nurse who was assisting rather than for my benefit and choice. I had a no scalpel method but still needed stitches.

I too have had post vasectomy pain. I find it comes and goes but is no longer improving. I am now considering options to relieve this dull ache.

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MacKeenly said on 15 July 2014

One in ten left in long term pain ! ... and this is still offered as an option ?

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Lucky Number Slevin said on 13 July 2014

Officialmidget has summed up my feelings. My vasectomy was completed in 2011 at the age of 32 when I knew I did not want any more children. Despite being single and having to force the issue with my GP and consultant I eventually had a vasectomy. Unfortunately all the time in preparation was spent in my decision process and decision making and there was no time discussing the potential problems.

I was left in pain after two weeks. This became intense during physical and sporting activity and seemed to resolve itself when I rested. I was told to take pain relief tablets from the chemist to help. The pain remains. There appears no solution to remedy the problem and I have gone back to my GP on four occasions only to be told to rest or stop when it begins to hurt. I feel I have ruined parts of my life and regret not finding out more about the problems with this operation.

With advances in long term contraception it seems this operation should continue to decline in take up which is a good thing.

Interestingly, I have spoken to friends who have had pain after vasectomy in a way that does not happen for female sterilisation or long term acting contraception.

The dangers of vasectomy should be clearly explained before commencing the operation.

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Officialmidget said on 03 July 2014

Wished I never had this done 11 months ago been in pain since
Ruined sex life. NHS does not explain full facts should be banned.

When I had operation you could hear me outside in the waiting room. crying with pain. this has destroyed my Trust in the NHS.

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nasty operation said on 02 July 2014

I do not understand that the risk says:

Long-term testicular pain affects around one in 10 men after vasectomy

Why NHS still offer this risky operation.

Completely a modern medicine nightmare.

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nasty operation said on 13 June 2014

I suffered badly on this so called "simple, safe procedure", it is very drastic and nasty. Please do not, do not do it as you will regret it for many years to come. Mentally and physically, it will harm you, your partner and your family, especially when they are young and need your care.

Very nasty indeed, it is a completely joke of modern medicine.
As health professionals are pretending, why they do not operate themselves first?

How do they understand the consequences and advice patient without going through this themselves?

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Ocra Bride said on 08 June 2014

Can my husband choose the gender of the surgical team?

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Mirinaba said on 06 June 2014

I also suffer with Post-Vasectomy Pain which was diagnosed as congestive epididymitis. I have pain in my groin when I am physically active such as playing sports and also when engaging in sex. It is not continuous but I am aware it occurs often and the only advice I have received is to take pain-killers.
The risks of pain were not mentioned to me but appeared on the third page of the leaflet I was handed. I regret my decision and would encourage men to think carefully about the risks. Female sterlisation may be a more suitable option for some couples.

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The Cake Is A Lie said on 18 February 2014

Ouchy,

Obviously I'm not a doc so please take this all with a pinch of salt.

From my reading, if they can give you a nerve block in the spermatic cord, that will show if denervation or injected permanent chemical neurolysis would be effective for your post vasectomy and surgical pain.

There are risks of bad outcomes with all these procedures, with chemical neurolysis of too much numbing & long term loss of groin sensation, or for surgical denervation, loss of blood supply and necrosis of the testicles.

If you cannot have this done locally, I'd ask to be escalated to an NHS Urology practice who can offer the option.

I know you may have good reasons not to undergo reversal, but there are plenty of alternative contraception methods available if you do, and you can combine them between you and your partner to take the failure rates even lower, avoid systemic hormone use etc. If Mrs Cake was having this much chronic pain from a contraception method, I would be begging her to do whatever was needed to get her out of pain.

There is a post vasectomy pain discussion group here:

http://vasectomypain.crankycoder.com/

I've never posted, only lurked, but they may be able to offer some guidance, there are at least two americas based urologists with a specialism in post vasectomy pain syndrome who are posting on there.

If I was in your position I'd take a private appointment for about £100 to £200 with the guys in Hartlepool or Nottingham (can't name them here, I went with Nottingham) who have good experience addressing PVPS through reversal.

They may well say you are a bad candidate for that procedure, but then at least you would know and you would have their advice to inform and guide any further local NHS side urology conversations.

Good luck with getting a resolution.

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Rafa7 said on 11 February 2014

Hello all,I had a vasectomy on the 17/10/2013 and it was no problem at all,infact I could of probably driven myself home.Im not saying that its that way for everyone but I can only comment on my experience.The procedure lasted 30 mins at Dumfries day surgery unit.The only real pain was the initial injections and after that just a little tugging sensation.I had no pain or swelling just the usual bruising.I was back to work 4 days later as if nothing had happened.Staff were excellent and I was well looked after.Plenty of salt baths so no infections.

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Ouchy said on 11 February 2014

I am afraid the Epididymectomy has left me in pretty bad pain in the left testicle. Some 4 months on now, and the internal and external scar tissue is painful. I still have PVPS as well, and that a sharp stabbing pain most mornings.

The scar tissue on the 'operated on testicle' is quite extensive and 'to be expected' according to my surgeon. As a cyclist this is particularly troublesome to say the least.

I have another review soon, and I need to decide whether to have the testicle removed or not. It's not getting any better given the time that has elapsed. The pain is much worse.

I don't want to be firing live rounds again on the other testicle, so a reversal is out.

Denervation hasn't been mentioned, and my 'next' solution looks to be removal.

Oh and solicitors don't want to know. It seems that you are really up the creek with this if you don't choose reversal.

What a flipping mess. These lies have to stop !

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The Cake Is A Lie said on 11 February 2014

I'm going to stop posting endlessly on here.
I'm almost a month on from a reversal and thus far it seems to have paid off as I am very largely pain free. I'm still kind of in shock it has worked out so well in my case.

It could still scar closed and I'd be back close to to square one with opiate pain killers & doc's suggesting that I start on scary heavy stuff for relief like amitriptyline, gabapentin etc. I would undergo a second reversal if I had to, given this initial positive experience though.

Some papers which I'd read on the success of epididymectomy for chronic scrotal pain that led me to select reversal:

Does surgery have a role in management of chronic intrascrotal pain?
Sweeney CA, Oades GM, Fraser M, Palmer M.
Urology. 2008 Jun;71(6):1099-102. doi: 10.1016/j.urology.2008.02.036. Epub 2008 Apr 24. - 32% resolution rate

Epididymectomy for post-vasectomy pain: histological review. Chen TF, Ball RY.
Br J Urol. 1991 Oct;68(4):407-13. - 50% resolution rate

Long-term outcome of epididymectomy for the management of chronic epididymal pain.
Hori S, Sengupta A, Shukla CJ, Ingall E, McLoughlin J.J Urol. 2009 Oct;182(4):1407-12. doi: 10.1016/j.juro.2009.06.020. Epub 2009 Aug 15. - 93% had less or no pain postoperatively

Epididymectomy is an effective treatment for scrotal pain after vasectomy.
West AF, Leung HY, Powell PH.
BJU Int. 2000 Jun;85(9):1097-9. - Of the 16 patients, 14 had excellent initial symptomatic benefit from epididymectomy


PubMed is useful to get a good view of all related literature.

http://www.ncbi.nlm.nih.gov/pubmed/

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The Cake Is A Lie said on 26 January 2014

YouHaveBeenWarned,

Have you considered dropping a few hundred pounds on a couple off private urology consultations with senior urology guys from large hospitals to cross correlate the cause of your pvps pain using multiple opinions? The first guy I saw at my local NHS andrology clinic suggested I walk around a bit more during the day!!! I paid for 2x separate consults myself within 10 day of that depressing experience and got real and valuable information from them.

Paying to go to a superspecialist may well prove to be worth the money vs. the rest of your life in pain, or a surgery that does not produce the best possible result either through sub-optimal surgical technique or selection.

That's what I did, and it took me down the private reversal route in the end, even though my local hospital had offered the same. Everyone's situation is individual of course.

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YouHaveBeenWarned said on 23 January 2014

My advice is to gather as much info as you can from different resources. Quantifying the risk of long term pain associated with this procedure appears to be difficult for the medical community. Pretty much from non-existent up to a 30% chance, check out the British Association for Urological Surgeons website’s advice on vasectomy, last updated December 2012.

I don’t know if it because most men who suffer do not, or will not, complain so there is no true record. Even the targeted studies are not consistent. The consultant I am now seeing informed me it is ‘quite common’. Pain can occur immediately, weeks, months or years after the op.

If I was told long term pain was ‘quite common’ during the consultations before the op I would have had second thoughts. This website was updated to acknowledge long term pain after I had the op (notice how the statistic given is 1 in 10 yet the consultant in the video rates all complications, not just long term pain, between 3 and 5 percent).

My pain now has an indeterminate cause. I have completed triathlons and associated training without pain, yet I can be watching telly in agony. I have been waiting over 12 months for a bilateral epididyectomy.

There is no guarantee of success.

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The Cake Is A Lie said on 22 January 2014

The American Urology Association figures for pain with adverse impact on quality of life are here:
www.auanet.org/education/vasectomy.cfm
Search for "chronic scrotal pain", 2nd found on the page.

Denervation for pain success
The incidence of post-vasectomy chronic testicular pain and the role of nerve stripping (denervation) of the spermatic cord in its management.AHMED,I., RASHEED, S., WHITE, C., & SHAIKH, N. (1997). British Journal of Urology, (79), 269–270. - 83% relief

I didn't undergo denervation as its difficult to find a surgeon with audited results, and there are a number of reversal experts publishing figures.

Denervation carries risk of testis necrosis, plus I suspected I'd had some systemic reaction from my initial surgery, so reversal seemed the most rational approach.

I rejected epididymectomy as 1st option as success rates stated are variable and I didn't fancy having any more removed, again there is a greater atrophy risk.

My health had been off all year since my vas (see prior posts) and I thought "system reset" to a prior known state through reversal was most logical. Also I'd come to hate my vasectomy through such a bad year of health.

The surgeon who carried out my vasectomy offered reversal to me, but I paid and went to a ultraspecialist to get the highest sucess rate I could.

It emerged that I had a v rare tissue inflamation response which was most likely from the vasectomy. This could have been irritant or autoimmune but it's unclear. Is it part of my other health problems? I suspect a connection, but it's unproveable.
I am having a few healing problems, but otherwise my enlarged balls have deflated and the hellish pain is gone.

I've noticed that people try to debunk those highlighting bad vasectomy experiences as motivated by theism. That led me to dismiss some stuff I'd read pre op.There are websites of that nature about, but for the record I'm 100% atheist in my un beliefs.

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The Cake Is A Lie said on 21 January 2014

Selected pain rate references which indicate 15% +

The incidence of chronic scrotal pain after vasectomy: a prospective audit. Leslie TA, Illing RO, Cranston DW, Guillebaud J. BJU Int. 2007;100:1330–3. - 15% paper

Questionnaire-based outcomes study of nononcological post-vasectomy complications. Choe, J. M., & Kirkemo, A. K. (1996). The Journal of Urology, 155, 1284–1286. - 18.7% paper

An algorithm for the treatmentof chronic testicular pain. Heidelbaugh, J. J., Llanes, M., & Weadock, W. J. (2010). The Journal of Family Practice, 59(6), 330–336. - 5% - 43% paper

The incidence of post-vasectomy chronic testicular pain and the role of nerve stripping (denervation) of the spermatic cord in its management. AHMED,I., RASHEED, S., WHITE, C., & SHAIKH, N. (1997). British Journal of Urology, (79), 269–270. - 19% pain at >3 months

Early and late morbidity after vasectomy: a comparison of chronic scrotal pain at 1 and 10 years. Manikandan R, Srirangam SJ, Pearson E, Collins GN. BJU Int. 2004;93:571–4 - 15% paper


Reversal sucess rate references:

Vasectomy reversal provides long-term pain relief for men with the post-vasectomy pain syndrome. J Urol. 2012 Feb;187(2):613-7. Horovitz D, Tjong V, Domes T, Lo K, Grober ED, Jarvi K. - improvement of pain occurred in 93% and 50% were rendered pain-free

Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation. J Urol. 2000;164:1939–42. Nangia AK, Myles JL, Thomas AJ., Jr - 69% experienced full pain relief

Vasectomy reversal for treatment of the post-vasectomy pain syndrome. J Urol. 1997;157:518–20. Myers SA, Mershon CE, Fuchs EF. - 27 of 32 men had resolution of pain (84%)

Vasectomy Reversal For Post-Vasectomy Pain Syndrome: a Ten-Year Experience. volume 183, issue 4 of the Journal of Urology. Werthman P - 75% experienced full pain relief.

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The Cake Is A Lie said on 17 January 2014

Ouchy, mrcon.

This threatens to be men discussing their health. The fact men don't is the reason pvp is little known about. I read 50% of men do not discuss vas beyond close family.

From my reading "Life effecting pain" runs at 2%, so every 50th vasectomy would produce that outcome. The American Urology Association seems conservative and use 2%, so 1:50 is a solid figure.

15% (1:8) seems to be a safe figure for "troublesome pain" across many studies, so you're not crippled but it's pretty flipping unpleasant. Studies show that men 10 years after a vas also have a 15% figure, so its long term.

In a vas you are sealing a system that evolved to be able to vent to the seminal vessel by the deferens. I didn't know prior to my op that it continuously does this, not just in intercourse, thus congestion, inflammation & pain.

Hot baths give relief as heating the testes stops sperm production & drops pressure.

Ouchy, it sounds like you are badly off. If you can stretch to it, or take finance, reversal for the 2nd side is 70% + effective according to a number of studies, and if it fails denervation and then maybe epididymectomy, as you would have done. I know you have had an epi on one side already, but with a bad reversal result there are more options.

I have had a reversal a few days ago, so am currently healing along with my visa card. The pvp pain was gone when I woke from the op. I have post operative pain and an odd tweak but am still healing, other than that I am largely out of pain for the 1st time in 11 months. I can feel the vas muscle working & its what the cramp pains seem to have been.

Essure looks to be well out mrcon! & I’d never start that discussion myself now following my ordeal.

I'm going back to 12x Extra Safe's. We may also use a backup non systemic & non hormonal method, I'd really like to avoid the pill and similar risks.

Good luck to you both.

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Ouchy said on 16 January 2014

You are not mis-informed, the PVPS incidence is at least 1 in 20. That comes direct from my urology surgeon. Also the nursing staff when I had my epididymectomy said it's common, they see lots of men come in for further surgery after the vasectomy was performed at a GP practice.

As to stopping the surgery, well they need to inform couples about the risk and not lie.

PVPS is horrible. Mine is not cured and the epididymectomy has left me with a significant amount of painful scar tissue.

An epididymectomy is a nasty operation, where the scrotum is cut open and the testicle removed for the epididymis to be cut off. The testicle is then stitched back in place along the incision, which is over an inch long. The testicle can no longer move like the other one can.

Something needs to be done as there is so much mis-information being given. If you are in the 90% then it's fine, but a 10% risk rate is huge, and very life damaging.

I've been on a cocktail of pain killers, but the side effects are as bad, if not worse than constant pain.

The 'more damaged' testicle is still under review and I may yet have to have it removed, but my surgeon is reluctant as the pain will be likely to remain.

As for the post below about dementia, then this is just rubbish, and just detracts from the information here.

The main issue with Vasectomy is the high incidence of PVPS. Anything else is a tiny risk. As for what PVPS is like, it's the same as being kicked in your privates constantly. It's the same pain you get after the initial impact.

It will ruin your sex life is you end up with this Syndrome. The sad fact is if you get it, it is very difficult to cure.

PVPS is common, believe you me !

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mrcon said on 15 January 2014

Thanks for the advice. I do sympathise. It's hard to believe that with effects this severe on an elective procedure, the NHS would still perform it. If the complication rate of 10% or 5% is true, then shouldn't the operation be stopped? Is this really the true figure for severe long-term pain, or am I misinformed?

What are the alternatives? I did have a quick look at Essure, but it appears to have complications of its own - essureprocedure.net.

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TheGnu said on 04 January 2014

I had a vasectomy in 1982 and have found it very effective and great improvement to my and wife's sex life.
However like others have reported, I occasionally have had a dull ache and occasional "pulling up" of the right testicle during sex. I had a scan very recently and nothing was found.
Latterly I have been doing some deep emotional release work having accepted the notion that we store all emotional activity especially negative, trauma and abuse somewhere inside ourselves. For me this seems to be my groin and latterly the "pulling up" has lessened.
This may sound a bit fanciful but we are complex beings and I will continue to explore this area in the light of the recent scan as well as being mindful when having sex (66).

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patsy5 said on 18 December 2013

Before you consider having a vasectomy just google the words vasectomy and frontal lobe dementia together, there seems to be a proven link between the two that the nhs doesn't tell you about, there are several articles on it on the internet.

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footballmad55 said on 15 December 2013

mrcon. Having read my comments on the 13th I probably have not answered your enquiry with regards to what is it like to have "long term pain" ( PVPS ) well you would not like it that is certain. For me I have not been able to sit in comfort since my dreadful "snip" I have been not to bad while being active but as soon as I want to relax then I`m in pain. I loose several hours sleep every night, the testicles are in a very venerable place with regard getting trapped and then pain. One other problem with the snip is that horrible feeling of the testicles hanging what seems miles away and always getting trapped. Has your doctor had the snip? If not how do they know what it`s like!!

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The Cake Is A Lie said on 14 December 2013

The 1:1000 number is an old number most modern publications are abandoning.

I may have bias however as someone suffering testicular pain 10 months on.

My pain levels are variable, and seem to be caused by congestion of the epididymis which is unable to break down and absorb the sperm quickly enough which can no longer exit. In some men this happens and chronic pain seems to ensue. Some men suffer neuroleptic pain through a nerve being damaged in the op.

Most days I am continually on max dose over the counter pain killers combined, as things ramp to more unpleasant levels I add in perscription pain relief of variable levels to allow me to function / work / sleep. At it's worst I am pretty much going off somewhere quiet where I can cry out in pain privately. Hot baths are very helpful to relax things out at peak pain levels.

It has certainly impacted my quality of life, I don't like to even think of anything erotic as arousal and sex increase pain.

Search online for the "Cranky Coder Blog" (not for those offended by profanity) this chap has been back reading the literature for the old 1:1000 figure and found it was one very credible core urology text making an erronious circular reference via an accademic paper back to itself.

He got so mad with his testicular pain levels that he has spent a year chasing the urology texts to try to get the 1:1000 number out of circulation. An interesting read which I wish I had encountered before proceeding with my op.

Most medical sources seem to advertise Vasectomy as "risk free" read that blog and you'll be exposed the peer reviewed data that those many may be ignorant of, or believe not to be credible. Also go and reseach the physiological changes to the testicles and epididymis to understand the long term physical changes your testicles may undergo following the procedure.

If you feel pressure for a vasectomy due to "simplicity", also look into Essure.

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footballmad55 said on 13 December 2013

Hi mrcon, yes I`ve had the op and also had all of the listed problems I am still alive but my whole life has been compromised by this so called "simple snip". This operation might be simple for the surgeon, but for me it has been a disaster. Sex is supposed to be just as good, but when you are in pain with your personal parts it`s not. Type in vasectomy pains on the web and you will soon discover thousands of very disgruntled men. The British association of Urologists list 1 in 110 men getting MRSA with this op and between 10% to 30% with testicular pain, have a look for other complications. My own thoughts are that the problems with the snip have been well covered up, a few years ago NHS were giving much less problems than now. With widespread internet use the genie is well and truly out of the bottle. Just after I had my op I learnt of someone who had his blood vessel snipped as well and needed life support in a major city hospital. I also know of someone who`s wife got pregnant three years after the snip, so it isn't even 100% Do your research and then decide, for some it seems it`s OK but what a dreadful ruined life ahead if it all goes wrong. I wish like hell that I had never heard of a vasectomy.

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Ouchy said on 11 December 2013

The 10% comes from a number of studies and some of it is upto 20%. If you don't get it immediately it's possible to develop it some time later.

The GP I am afraid is lying. Once you start to talk to the local Hospital's Urology team, even they say it's common. 1 in 20 was quoted by my local team, and they are the ones picking up the mess. they will also tell you success rate of further surgery is low and you risk losing a testicle.

I am afraid I'm having complications after my epididimectomy and may end up having the operated testicle removed yet. I'm crossing my fingers it improves.

As for pain. How about setting your plumbs on fire. Pain can range from a dull ache, upto stabbing pains. Thats what I have every day.

My GP is now revising their own code of practice after my case. As for how long, how does the the rest of your life sound. It's called a syndrone. The experts don't know how to fix it, nor what causes it.

If you have a choice, get it done at a hospital and not at the GP surgery. The nurses at my Trust said they see many men coming in after vasectomy at local GP practices for further surgery.

I would suggest your GP does some research, as the advice being given is wrong. I was told the same thing at the time, hence my practice revising it's code of practice. I also had zero aftercare from the GP who performed my vasectomy, totally drefusing to beleive I had problems upto 4 months later. I've been offered no councelling. My GP is horrified. I would like to name the practice and GP that mutilated me, but I'm not allowed !

Of that though 90% do go well. So good luck what ever you do !

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mrcon said on 09 December 2013

Hi, not had op yet but a bit put off by the 10% "long term pain". Can anyone quantify what severity of pain this is talking about and how "long term" it might be?

Wife has talked to the GP about this who says she does not recognise the 10% figure and that chances of problems are "extremely slim" - perhaps 1:1000.

Where has the 10% figure come from and why is it not recognised by our GP?

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Ouchy said on 04 December 2013

Epididymectomy now performed. Unfortunately it's not cleared up the pain, and I am still woken in agony every day. The surgery has cleared up some of the mess the GP made in the original vasectomy and has removed that pain, but I'm now left very uncomfortable where the epididimis was and my testicle is stitched into place along a 4cm scar on the bottom of my scrotum. It's quite uncomfortable if the testicle is moved, as it pulls the scrotum with it. This is permanent as the testicle has to be completely removed from the scrotum to remove the epididimis, then stitched into place so it can't twist, causing torsion.

Really not sure what the next move is as that's about it now for surgery. Medication is a choice of anti epilepsy drugs which I won't be taking. No point having the other done as still left with PVPS in both. Consultant even said removing both testes doesn't get rid of the pain.

90% go well, but I really don't think a 10% risk of pain and damage to your relationship is worth it (you won't be wanting any frisky time with PVPS folks).

Don't do it.

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rapid ralph said on 02 December 2013

I highly recommend getting the snip. Looked at this site the day before I had the op and was filled with dread, but obviously most people only comment here if they've had a bad experience.

I had very little pain (though some discomfort, mainly internal tugging) during the op, some stinging for the next day and then bruising and tenderness for about a week afterwards. Back 'in the saddle' after 8 days, and pick-axing tree stumps (no that's not a euphemism) out of the garden by day 9 . The local anaesthetic started to wear off during the op so I felt the first stitch go in, but even that wasn't much of an issue.

The doctor gave me some paracetamol directly after, probably didn't need it though. I didn't bother taking any other painkillers afterwards.

My biggest issue was having to wear the tight fitting pants for a week of so. I definitely benefited from their support, but by Christ they were uncomfortable and if the snip doesn't sterilise you, the y-fronts certainly will!!

Only after effect seems to be my right hand testicle sits in a slightly different position than that before the op.

So man up fellas and get it done, surely it can't hurt as much as child birth!

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MaxMax70 said on 27 November 2013

I had a Vasectomy about 6 years ago. It was done under local anaesthetic and I felt the pulling and tugging. Not a pleasant experience.

A week later I realised I had an infection and my scrotum swelled to the size of a grapefruit. I had to have two weeks off with antibiotics.

Now, 6 years later, I've got severe pain in my right testicle due to an infection in the epididymis. I'm on antibiotics for it. I hope it gets better because it's pretty painful. Probably about as painful as when I had the op done in the first place.

If I could go back in time I would definitely not have had a Vasectomy.

Don't let your mrs or girlfriend nag you into it lads. I regret giving in and having the op. It is not worth it.

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legsylula said on 27 November 2013

Six months later and samples revealed a successful sterilisation. No pain, no swelling, no lumps, no side effects.

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The Cake Is A Lie said on 01 November 2013

I had my vasectomy eight months ago, it has almost destroyed my life.

I had bad pain immediately after the surgery. I slept most of it off however with co-codamol.

Within 4 days I had a secondary infection which was v painful. I was squeezing pus out of my balls at one point like toothpaste. An antibiotic and a lot of painful salt bath, raw detol and TCP use involving cotton buds cleared.

Then I had a tooth rise in my jaw which required £700 to have the root excised, and recently a crown fitted. I had never had one in my life before.

I then developed a severe ear infection, which became a balance damage problem I felt like I was sky diving at times, this has taken seven months of private appointments to bring under control.

The diagnosis was that as well as the damage from the infection I have "silent" balance migraines now. Those did not exist before the surgery.

Throughout I had persistent ball pain. This started at the wound site and with general testicle "fullness" the pain never goes away .

The pain has changed in nature, I have had hard lumps develop in my testicles and then disappear again.

The epydidymis pain however still persists, when driving I sometimes am crying out with pain as I complete my two hour daily commute and do my best to keep my job.

Prior to this I was working 60 hr weeks and doing well, now I'm on occuptional health referal and always scared for my job.

Vasectomy is surgery, all surgery carries risks. I have come out on the wrong side of those.

If the pain persists I may seek a private reversal (the NHS don't do these, they cost about £3000)

The NHS seem to underbrief on the pain risk.

Please search and read the following before you proceed:

British Association Of Urological Surgeons Vasectomy Guide (10-30% chronic pain stated)

Leslie TA, Illing RO, Cranston DW, Guillebaud J. Incidence of chronic scrotal pain after vasectomy (15% new onset pain stated)

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Osen Blum said on 20 October 2013

I wish I had been advised that post-vasectomy pain is common and can be severe.

There is no choice to select gender of nurse who assists and dresses you.

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FormYl said on 05 October 2013

I had a vasectomy 7 months ago and it is the worst mistake I have made. Despite a discussion on the matter of consent the risks were presented as low. I have now found out that low risk does not mean high pain levels.

The operation was deemed to be successful and I am not delivering any sperm in my samples. 3 months after the operation I found I had a dull ache in my groin which gets worse on occasions. This has now increased in level and rate.

I am left with no option but to seek out Epididymotomy surgery which should help although there are no guarantees.

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Ouchy said on 23 September 2013

12 months on now and scheduled for surgery, first of two, unless the first doesn't go to plan. Only 50% success rate. Really do hope this works.

12 months of constant pain.

Can any NHS professionals reading this please make practitioners state that Post Vasectomy Pain is common and if you develop it, treatment is very difficult ? Shame no-one will tell the patient, as it's a nice little money earler for a 30 minute procedure, and of course it's much cheaper than the alternatives.

I'll update some weeks after my next surgery.

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Davey Jones Locker said on 11 September 2013

I thought I'd write to share my personal view regarding vasectomy procedure on the 8 September 2013.

I spoke to my local GP in Loughborough. She gave me the go ahead after asking some questions regarding marital status, kids and age etc.

I received a letter in the post from doctor my GP referred me to in Long Eaton. It confirmed a date for another interview with him two weeks later.

In that interview, I was given details of the procedure, underwent a basic scrotum check up and confirmed the date for procedure circa 1 week later.

The op was great. They give you plenty time to change your mind (that's maybe why it's only local anaesthetic)

They cover you with iodine, so take along spare track suit and spare supportive cotton jocks; don't use trunks! Make sure they clean, because the nurses dress you.

Two jabs in the balls with the needle - very sore; dull aching pain; I found taking about the Rugby was the best approach.

Op takes 45 minutes. You can feel but not much pain. The pain comes afterwards from swelling and bruising. Take pain killers, keep the dressing on & don't look down.

5 days in and my balls still ache from being swollen - concerned.

They operate on circa 400 blokes a year + increasing.

Let the fun begin! Good luck.

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donros4 said on 08 September 2013

I did lots of research before my vasectomy on 24/07/13. GP didn't mention possible risk/complications. Took 3 weeks to get procedure done from time of seeing GP.
Dr (not the GP) who did procedure was very good and during the pre op consultation he went through all the risks and possible complications.
During the Op the Dr and nurse were great and chatted and joked throughout the 20 minute procedure which helped relax me... a little!
Bed rest after the Op for the whole day. Up and about next day but sore. Went to work 3 days after op. Initially all was well but on day 3 of work I couldn't walk without pain in abdomen. Called Dr who did op. Confirmed I had a urinary tract infection - painful! A week course of antibiotics sorted me but it took about 3 weeks for me to get fit enough to go back to gym. 7 weeks later, I did a 10 mile run yesterday and feel great.
My advice is do lots of research, Rest after the Op and keep an open mind. Don't assume you'll be running around the day after the Op, chances are you won't.
I recently found out a man died recently from complications linked to his vasectomy (google Vasectomy complications). This is of course extreme but supports my thoughts that you have to do your own research and make your own mind up.
Would I go through it again? Yes.

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Sussexlad said on 17 August 2013

I had my vasectomy on the 28th October 2010. I had been dreaming of the time I could no longer be in danger of fathering a child again. My fiancee was lukewarm about the idea, but I wasn't prepared to get married unless there was a clear understanding that there would be no more children.
The operation under local was completely painless, but seemed to take ages. Everyone in the operating theatre had a good sense of humour and it was not an unpleasant experiance. My scrotum swelled to double it's size, but the pain was dull, more of an ache.
I sent in the samples (by post as I was told) and after the second sample, got a letter telling me to send in another one. After the third sample, I got yet another letter asking for another sample. This carried on until September 2011, when I was told that the vasectomy had failed and I would have to see my GP to organise another one under general.
My GP organised another operation, this time at the hospital scheduled for March 2012. I was wheeled into the operating theatre, put-under and then woke up with the recovery team talking to me very quickly about semen samples, giving me a cuppa (all while I was still half asleep) and getting me out. The after-affects were no worse/better than the first operation and I went to talk to my doctors surgery about how to return samples.
I was told by the surgey reception that I would have to produce a sample and get it to the hospital lab (12 miles away) within an hour. Which I haven't been able to do. Consequently, my wife and I have to use condoms as there is no way of knowing whether the operations have been successful

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rover41 said on 15 August 2013

As many have said, you can only speak from your own experience.
My wife had our second child two years ago and prior to the birth, the decision had been made for me to have a vasectomy. The primary reason for this was that my wife was unable to take any kind of chemical contraception and it seemed reasonable for me to take responsibility for birth control.
It turned out during discussions that vasectomy was very common and many of my friends had already had the procedure without any difficulties.
After an initial consultation with my GP, I attended my appointment 3 weeks later. Under local anaesthetic, the procedure was completed within 20 minutes.
48 hours of rest with tight briefs and frozen peas and I felt 'normal again'. There was of course, some pain during this period but what else would you expect.
In the time since, I have been very fortunate not to have had any difficulties. I feel no less of a man and I would say that it has strengthened my relationship with my Wife.
That said, a work colleague has recently had the procedure and has had pain for several weeks now. By his own admission however, he was doing physical work within hours of the operation. He is waiting to see if things calm down.

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footballmad55 said on 24 July 2013

My own experience with having a vasectomy was very upsetting I felt " wronged"" The misery of the testicles being severed and hanging is not properly understood until it`s to late. Yes you need tight undies but I was often finding my balls slipping out. Not comfortable.
My main complaint has though been that my P.V.P.S.has just got worse each year. I now wish like hell that I had never had this awful operation. I have regular pain killers but this only reduces the pain and I lose hours of sleep every night.
The NHS admit 1 In 10 patients have long term pain.This is not good enough.

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andyvm said on 22 July 2013

Wrote a comment here in June saying how long the scars took to heal from having the op on the 18th March. All healed up with no pain now. Anyway just had my first test result back after 4 months and countless ejaculations and its come back positive!! Sperm still there or op has failed!! Oh we'll time for another test!

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NavyPilot said on 17 July 2013

A bit of background first - I am 30, employed in the military, now married for 7 years and have three children aged 5, 3.5 and 22 months.
My wife and I have three children so in 2012 I decided to get a vasectomy; the reason for choosing it over other forms of contraception was that I didn't want my wife to be taking chemicals of one kind or another for the rest of her life (pill/injection/etc.) and I felt that surgery was a much more permanent solution to condoms or relying on the pill to be 100% effective. I saw the doctor several times to discuss the procedure and had the operation/procedure performed in Oct 12; let's be clear - getting injections into your scrotum is not pleasant. and neither is the smell as they cauterise the ends of the vas deferens! However for the 20 minute procedure and the two days of discomfort afterwards I can state it has been completely worth it, we now have no worries regarding pregnancy and had sex without protection (after my all clear came through last week) this week for the first time in 3 years. Complications I have had were a small amount of blood in my first few ejaculations after the procedure (perfectly normal despite the horror of seeing it!) and some slight pain for no discernible reason twice. I am a keen cyclist and doing long rides has caused no more discomfort either pre or post procedure; I do believe there are some scare stories out there but wanted to reassure those sitting on the fence that it does work for the vast majority. Several colleagues at work have also had the procedure either before or after I did it and all are in agreement. I hope someone finds this useful!

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legsylula said on 21 June 2013

While I empathise with those who have suffered discomfort after the event, I am afraid I can only recount my own experiences. This neither makes me "irresponsible" nor does it amount to "disregarding" anything. While it is laudible that you seek to highlight the risks, let's not poo poo those of us who merely seek to point out that there are good news tales for every horror tale, shall we?

Anyway, some four weeks after the event and all bruising has long gone and to date (because we mustn't rule out that it might happen months/years later now, must we?) all pain has long gone and tight pants are a thing of the past. Small issue of the scar healing and sticking to my underwear for a few days but this was trivial. Next step is the samples in a month or so.

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OrdinaryJo said on 20 June 2013

Just returned from having this procedure and I have to say it was much better than expected. My wife and I have three kids so decided to go ahead. Saw the gp a week ago and received a choice of where or how fast I would like the procedure. I opted for a quick appointment which was in Truro health centre. The surgeon was a GP and a nurse was there and it was quite a relaxed affair, like a visit to the dentist. I had the scalpel free version. You do feel a small scratch when the gp gives the anaesthetic then numbness then some movement which is disconcerting. The procedure I had involved cauterising the tubes so there was some 'burnt hair' smell but nothing too concerning. The embarrassment and thought of the procedure is worse than the event. I was out after about 20 minutes, dosed up now on paracetamol and ibuprofen and expect that to continue. Just resting and watching movies in bed now... Good luck and hope your experience is as positive as mine has been.

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Blue Balls said on 17 June 2013

Not sure who wrote this page, a long way from the truth, but here is the truth: you can have this done by local or general, I had a general. It is painless until the general wears off. Then paracetomol and ibuprophen won't even slightly touch the pain which will last for around 5 to 7 days. Your balls have done 5 rounds with Mike Tyson so you will have problems getting dressed, sitting and standing etc. You will have severe pulling sensations followed by feeling winded and sometimes stinging. Forget horror stories these are the facts from my personal experience, can't believe in this day and age it isn't explained as it is. Oh, word of further advice, get some tight pants, you'll need them for around two weeks afterwards. In contrast it would seem that those who chose local are more likely to have lesser after effects. Not for the faint hearted.

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Omphalodes said on 11 June 2013

I had a vasectomy in April 2012. I was told this 'simple operation' went to plan. I had slight bruising and mild pain for a day or so.
Three weeks later I was in agony which came and went over the coming days. I went back to my GP who advised I had two sperm granuloma caused by pressure built up after the vasectomy. My option is to go for a reversal or removal to ease the pain but this is not guaranteed.
Pain killers help a little but the pain can be quite difficult to live with. I do not recall being told of this risk before my operation.

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Ouchy said on 10 June 2013

Well, two months further down the line from my last report and I'm still in considerable pain. Those that have just had the procedure are hopefully the lucky ones.

The sad fact is that you won't be told about the consequences before you have the surgery. It's only after, and if you go back to your GP and onto Urology do the hard facts come to light.

I try as much as possible to avoid pain killers, until the evening. I spend at least two nights a week on the sofa to let my partner have a good nights sleep. I am a keen cyclist, so you can imagine the impact of having painful 'plumbs' is causing. I find I only get relief from the pain (less pain that is) if I do not do any exercise at all - that is not happening.

I'm currently waiting for a epididymectomy, basically your scrotum is cut each side, your plumbs are popped out and the vas and epididymus is cut away from each plumb, hopefully avoiding the blood supply and nerves that surround the vas. Then they are popped back in. As 'youhavebeenwarned' says, it's a 50/50 gamble.

My current symptoms are badly swollen epididymus (these are the squishy pipes that are attached to your plumbs which lead to the vas) - these get inflamed as your body still produces sperm, but it is blocked - so think dull aches and stinging pain which varies. Both plumbs also have a nasty habbit of swelling up, both independantly and it's quite alarming, and they go hard.

My other option is to have both plumbs removed, AND I won't beat about the bush, this is looking an option to get rid of the pain and swelling. Alarming eh. I've discussed this with my GP, so it's off to the see what the Urologist thinks.

Oh and a big downer, getting frisky makes it much worse, so it will devastate your sex life

Not something you might have expected eh. Jokes about the snip/firing blanks and pressure about 'it's your turn'. OK simple op, yes over quickly, even when the GP makes a mess.

BUT if you get PVPS you are up the creek

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YouHaveBeenWarned said on 04 June 2013

It is quite irresponsible for posters to disregard the so called horror stories on here after posting only a matter of days after the procedure when the most common complication can occur immediately, weeks, months or even years after the procedure.

If these stories serve any purpose it to alert men considering this operation to get the full facts and do not rely on the NHS sources to provide it accurately.

It took some time for this website to acknowledge the incidence of Long Term Testicular Pain or Post Vasectomy Pain (PVP). However, the statistics given on this website differ from the statistics given by the British Association for Urological Surgeons which is as high as 30% [source: baus website] of men having a vasectomy will experience some form of long term pain.

Even now the video provided by the expert (bizarrely on the vasectomy reversal page, whereas this page’s video appears to appeal to a younger audience for temporary contraception) gives the impression that most complications are pretty much disregarded.

I now live with prescription pain killers in my pocket to be used at anytime and exercise very little, whereas before I was active. Weight gain is now a constant issue. One testicle appears to retract into my abdomen (stop smirking) when it is cold and the retraction reflex kicks in. That is especially painful. I am awaiting further surgery but have been told it is possibly only 50/50 that it will provide any sort of relief.

My advice isn’t not to consider this procedure but make sure you are fully informed before going ahead. This we are entitled to and should expect from the NHS.

The chances are you will be satisfied but the risk that you won’t are higher than we are told.

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legsylula said on 26 May 2013

I read this page's comments before I had my vasectomy and I wanted to add my experiences to at least try to offer another side to some of the horror stories on here. Don't be put off!

I had my vasectomy on 23rd May. It is worth saying that the surgery was done using a hyfrecator. This means no scalpel and no stitches. It also means sealing the tubes rather than tying them. I didn't choose this method but, if you are able to choose it, I would recommend that you do!

The procedure itself was fine. I can honestly say it is no worse than having a filling at the dentist. My advice would be to try to give yourself as little time to think about things before hand. The missus and I went for lunch immediately before (a last supper!) and I arrived in the waiting room bang on the time of my appointment. I was collected by the nurse, signed a form and then dropped my trousers and pants (wear loose trousers and TIGHT pants) and sat back on the table. Once you get over the fact that you have your trousers around your ankles, your testicles exposed and yet you are chatting to a nurse and a doctor, there really is nothing to it.

So what did it feel like? I could feel that he had grabbed my scrotum and I felt a little discomfort for a few seconds and I could smell burning flesh for a few seconds too. In all honesty, I wasn't able to see what he was doing and I couldn't tell by the feel either. All I know was that it was done in about ten minutes and it really wasn't traumatic at all. Once it was done, a sterile pad was popped on and I walked out. I had the opportunity to sit and have a cup of tea for 30 mins but I felt well enough to leave straight away and so I did.

Three days on and I have a small, neat scar (he did both through one incision). I had a dull ache on day one but since then I've had very little pain. I have a little bruising which came out today but nothing drastic and it certainly doesn't hurt. In fact I've just mowed my lawn. Good luck and don't worry.

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Mr Sanchez said on 26 May 2013

I had the 'no scalpel' procedure and it went really well. Yes there was a little pain and some swelling but after a few days I was back to normal. Totally recommend it to those who are considering it.

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andyvm said on 15 May 2013

I had a vasectomy on the 18th March 2013. All went well and was up and about after a few days after the operation. After a week or 2 I noticed that both of the scars were struggling to heal and one side in particular healing from the inside out which is not normal. After several weeks and on and off bleeding things slowly started to heal. As of this week (8 weeks later), all is now healed up and everything seems to be back to normal. I have not had any after op pain or discomfort in the testicles, but is it too early to tell? Overall op went went went but took a long time to heal up, but now all seems fine.

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The Cake Is A Lie said on 05 May 2013

Now 3 months since the snip. Still have daily burning pain in my testicles. Still getting so dizzy I am often unable to drive or work and at the end of my sick pay entitlement.

I used to love the NHS and always defended it, now I hate it with my every fibre.

1. No advice or councilling on pain, or side effects.

2. The surgeon did not even break breath to me.

3. Once pain started I repeatedly called the urology surgeon, he never responded once.

4. Bumped onto a series of endless useless GP appointments to be talked down to and have my intelligence insulted but nothing actually sorted out.

I had this op to look after my family, the advice was non existent as was after care. The NHS is a life destroying joke. If this was an op for women every risk would be called out. But its for men on their goolies, so it's just a big joke all round. Ha ha your whole life is wrecked!

Go to hell NHS, along with every useless uncaring slopey shouldered "caring professional" I have encountered in the last three months. Useless.

If you are considdering this op, forget it. Especially if you have problems afterwards, the health service could not care less.

I am now going private at my own expense to get the NHS's idiocy sorted out, hopefully before it loses me my job.

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raphurious said on 05 May 2013

ok iv commented before but it seems to have been removed. but I have a small bout of* pain lasting about 2 days but it had then cleared so I am nearly 1 year in to having the snip ad so far all is ok. I had the non surgical version and I would recommend it to others. as was mentioned here before yes we all hear a out the negatives on oages like this but I feel that's because ppl only want to omment if negative issues arise those who are happy don't tend to come to pages like this. I know more that are happy and personally never experienced anyone being unhappy.. as I said I would definitely recommend the non surgical procedure.

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Ouchy said on 24 April 2013

I can only echo the comments above about problems. I'm over 6 months post snip and still in considerable pain. Active sports person too. Aftercare is appaling, as no-one really knows what to do. Been offered to have my 'pipes' removed, but that's quite a nasty operation. I'm still under Urology.

Things go wrong for 1 in 10, and if you are one of those then it's tough luck. Would have been nice to know this before - I knew risks, but the fact that there is just about nothing they can do for you after.

GP doing the operation for the area has denied anyone has ever had PVPS after his thousands of operations, YET the local NHS Trust's own Urology consultant's say 'oh it's quite common, at least 1 in 20 get problems' . Cheers. How long to be recovered - we don't know.

I get good weeks, and bad weeks. At least we don't have to worry about pregnancy now, although the op has had a bad effect on 'contraception' - read the other posts above.

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Rubiaceae said on 04 April 2013

I had a vasectomy 8 months ago and regret the decision as I know live with regular pain, that usual increases or intensifies during sexual activity.

The operation itself was straight-forward, other than having no choice of gender for the surgeon or nurse team who assisted. My only concern was the lack of concern for my modesty. It seemed that as I was a man any concern about being on display was irrelevant.

The first couple of days went as expected. The dull pain and slight bruising faded. 2 months later I began to notice a dull ache and this slowly increased over the next 2 or 3 months. After two further discussions with my GP I was referred back for further surgery which healed well but did not change the pain levels. The only option is to take simple painkillers when needed and hope the pain reduces to an acceptable level.

Long term pain was never discussed with me however both my GP and my surgery team asked me if the decision had been discussed with my partner !

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OSDguy said on 30 March 2013

I had vasectomy on Nov 15th 2012 and have been in agony ever since.

I note this page does not mention Post Vasectomy Pain Syndrome which is known long term risk of the procedure and what I have been diagnosed with and as the NHS admits this does effect 1 in 10 (actually maybe slightly higher to 15%) then surely as a open and honest provider they should be giving men all the facts.

If you read the long term testicle pain part trust me this really underplays the symptoms.
Pain on gaining an erection
Pain on ejaculation and for days after
As you can imagine this ruins your sex life and puts a huge strain on a relationship. You can forget masturbation too!

I'm currently on morphine for the pain, so that should give you a good idea of how bad the pain can be and trust me it barely takes the edge off the pain some days!

The pain is excruciating at its worst and just agony at its best. Try to imagine pain in your testicles 24/7 and you have a basic idea of PVP.

Given they do not mention PVP you should do some research on it and not trust the NHS - for a good base on symptoms try wikipedia.

Aftercare? Forget it! They do not know what causes PVP therefore they cannot fix it or cure it - all they can do is manage the pain via Pain Management Clinics or perhaps offer further surgery! And they don't treat this as an urgent problem either! I had snip in Nov 12 and won't get to see pain management until April 13.

The pain has also prevented me from working since December 2012.

Make yourself fully aware of all the risks from PVP.

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The Cake Is A Lie said on 20 March 2013

What a disaster vasectomy has been for me. I haven't had good health for 6 weeks now.

I took a secondary infection in the surgical wounds which felt like they were geing chopped off, plus with all the pus running out of me it looked like I had the ginitalia of Shrek, this pounded my immune system and needed to be cleared with antibiotics.

I then developed a related ear infection (autoimmune?) which has left me with severe vertigo and blurred vision and left me sometimes unable to work. This has required a second antibiotic and various ineffective andi nausea and vertigo medication which either hardly touched the problem of left me like a zombie.

I also seem to have had an additional immune reaction where two teeth spontaniously had the nerves start to die and needed root canals. Something I have never had in my life before!

Tonight I now have a new burning pain in my scrotum and a hard pointy lump by my left testicle.

I may be exceptionally unlucky, but this operation has been an utter disaster that has left me in continuous pain in a rotation of "new and interesting" ways and intermittently unable to go to work.

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hadthesnip said on 12 March 2013

I had my vasectomy this afternoon. Me and my wife travelled to the clinic, which, when we went for the consultation, was empty, however, as soon as we entered, it was like clapham junction (no pun intended !!). Was quite surreal walking into a room full of couples, all knowing what we were there for x-D. As each male came back from being called, there was an uneasy silence as we were checking if they were ok! Anyway, back to the operation. Firstly, a very cold liquid was applied, this was ok and rather cooling. Then the first injection went in. Was it painful? yes, it was the same feeling as getting an injection into the gum, try pinching the back of your hand with your nails, but very hard and for about 5 seconds (which seems a lot longer in the scrotum!). Then the only discomfort was a tugging feeling now and again, but I think the fact that I knew someone was doing something 'not normal' down there was more psychological. Then onto the left one, this was another injection and the same sensation again. The whole process took about 15 mins, then about 15 mins recovery. I went back into the room, with a look of pain on my face. Was funny to see the other guys reactions !!!. I did informed them that it was ok, and no need to worry. Now its 1957hrs and have had 2 doses of cocodamol. Just a slight burning sensation in my left one, but a bit of discomfort in the left side of my stomach for some reason !!! - If you are reading this, with your operation pending. i will update in a few days / weeks - don't rely on all the horror stories!! Also, my operation was a normal scalpel method, tied, no stitches. The right incision is about 2 inches, whereas the left is less than half an inch!

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salim786 said on 11 March 2013

I had my vasectomy last Weds. I was very nervous. It didn't help that I had read so much about the vasectomy on the internet for weeks before the operation. So by the time the day had come for the operation, I was just decided to go for it. I went to the clinic, and had to undress, put on the gown. At this point you realise you are about to have surgery. But I couldn't back out now. I had come too far. I then waited to be seen, went to the operating table. Lay down on the bed. The surgeon and the nurses were amazing, very kind and could see I was very nervous ! The surgeon lifted up the gown and said that he would need to shave my scrotum area as I has only used a trimmer though he said he would give me 8/10 for my effort ! That was not painful as I thought. Then the nurse put this cold liquid on my scrotum which was the ateseptic. Then I closed my eyes and prayed - but I did not feel a thing ! Within a 5 mns the surgeon said right I have done the right scrotum now will just do the left ! The pain was very little. Once it was all done they put some stitches which was a little discomfort but then it was fine ! Then said just take some painkillers once you get home and you will be fine ! They even helped put my underwear on ! They were so nice. I would say at this point that the best advise I can give is to make sure you bring tight fitting pants it will make a big difference ! Then I got dressed and my wife picked me up - would also say that this is very important make sure you get a lift home. Finally, reset at home put your feet up as this will relieve the pressure from your scrotum area. I didn't use any cold packs as the pain was not half as bad as what I had read. I still feel a bit of discomfort but thank God it was not anywhere as bad as I thought. Keep up the pain killers, don't pick up anything heavy. Shower at least 2 days after the operation and uses a soft sponge to wash around the scrotum area this will help. All the best.

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Media last reviewed: 28/08/2013

Next review due: 28/08/2015