Vasectomy (male sterilisation) 

A vasectomy is an operation to cause sterility in men. A consultant surgeon explains what the procedure involves and why you should use contraception for three months after the operation.

Find out about the risks of vasectomy

Transcript of Vasectomy (male sterilisation)

I'm Stephen Searle, I'm a consultant in contraception and sexual health

and clinical director of the sexual health services in North Derbyshire.

A vasectomy is just a male sterilisation.

It's a permanent method of contraception

for men who are certain that their family is complete.

We offer all couples a half-hour counselling appointment

before the operation is booked

and that gives them time to change their mind if they want to.

We cover all the things about the alternative methods of contraception,

any complications,

basically any worries or fears that the man might have.

We can strongly reassure you

that there's no effect on ejaculation or erection.

You still carry on producing semen with ejaculation just the same.

That comes from the prostate gland and the seminal vesicles.

We're just stopping the microscopic sperm coming from the testes,

so men shouldn't notice any difference

with ejaculation, the fluid or the feelings that go with it.

We try and make it as relaxed as possible.

We operate in a clinic in the community, out of hospital,

where we do ordinary family planning and contraception clinics,

so it's a much more homely, relaxed atmosphere.

Overall men often say that's a more relaxed procedure than they expected

and they can be in and out within an hour.

You tell the man to have a bath or a shower on the day of the operation,

just to shave that area of the scrotum that we're going to be operating on.

We ask them to put some local anaesthetic cream just under the penis,

where we're going to be putting the local anaesthetic in.

We inject the local anaesthetic on both sides

so that both tubes from each testicle are well numbed before we do anything.

Then we hold the tube through the skin, make a little puncture hole,

take the tube out in a loop,

cut a small piece out and seal both ends.

The man shouldn't feel anything.

Occasionally they feel a bit of tugging

and we can give some local anaesthetic, extra to what we've already given.

And then basically make sure there's no bleeding,

pop the tube back, do the same on the other side.

And then after the operation the man rests for 20 to 30 minutes,

during which time the nurse gives him some information

about basically doing nothing for at least 24 hours,

lying horizontal, being waited on,

to avoid the risk of any big bruising or infection.

Then we tell them to carry on with reliable contraception for three months

because it takes that long for the sperm to clear out of the tubes.

Surprisingly some men don't bother sending in a sperm test

and so they never know for sure that they've got the all-clear.

One or two times people have been caught out and ended up with a pregnancy

because they didn't realise they were still fertile.

As far as complications go,

about 95 or 97 per cent of men are fine after, with no complications.

The area should be kept dry for two days afterwards

and we want men to wear some tight support

when they leave the operating room.

Certainly for the first two days

it's best to wear some really tight briefs

or even swimming trunks, cycling shorts,

just to give that extra support and prevent any bruising and swelling.

Most men are back to work in a few days. Sometimes it takes longer.

Another possible complication is an infection.

Other complications, the vasectomy might not work.

There are two situations where that can happen.

The first is that the tubes heal up quickly after the operation

and sperm stay positive in the samples afterwards.

That happens in between three and five per cent of men

and that may mean that the operation may need to be done again.

Much more rarely is when you have your negative all-clear test

and months or years later you get a failure,

somehow the sperm find their way through.

It's called late recanalisation.

It's only about one in 2,000,

so as long as the men use a reliable method

until they get the negative all-clear test,

sterilisation, and particularly vasectomy,

is one of the most effective methods of contraception.


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