Vasectomy

There is no physical reason for your libido or sex life to be affected in anyway. Most couples would not notice a difference; however some couples may report their sex life being adversely affected while others may feel it is better.

No (only under a microscope). Virtually all the fluid is produced by the seminal and prostate glands inside the body.

The sperm, which are microscopic, continue to be formed, but on reaching the blocked Vas tube die and are absorbed like any other dead cell in the body.

Vasectomy is very effective; the early success rate of the operation is greater than 99%. That is in less than 1% of patients will semen sample testing after the operation show the vasectomy to have been unsuccessful.

You will need to provide at least one semen sample for analysis after the vasectomy. Once semen samples show no sperm, patients are given the “ALL CLEAR”.

Until you are given the “All Clear” you must continue to use your usual means of contraception.

Men occasionally have persistent low levels of dead sperm in the semen samples; in this instance men are given “SPECIAL CLEARANCE” – this is like the “All Clear” but is qualified by extra information.

The “All Clear” means that a man who has had a vasectomy operation can assume that he runs a very much reduced risk of conceiving a child, but there is a small ongoing risk estimated at 1:2000 that his fertility may return unexpectedly at some stage in the future. This can happen after the Vas tubes rejoin spontaneously.

Imagine you are stood in a crowd of 100 adult couples who are using condoms as a means of contraception. It would be likely that at least one couple in the crowd would conceive a pregnancy during the next year.

With the pill, copper coil, or depot injection; the likelihood of one couple conceiving a pregnancy during the next year can be as low as one in 1000 couples.

For Implanon, an injectable hormone lasting 3 years, and the coil the crowd would need to number 2000 couples, for one of those couples to be likely to conceive a pregnancy during the course of the next year.

With vasectomy, only one of those 2000 couples would be likely to conceive a pregnancy at any time during the remainder of their fertile life together.

– Common

There is some stinging/ discomfort for a few seconds as the local anaesthetic is injected. Local anaesthetic works very well for this operation.

Some bruising and a little swelling is to be expected, the amount is variable. There will be some discomfort/ pain after a vasectomy, this usually settles with the use of regular pain killers over the first two days.

– Uncommon

2-3% of men report a simple wound infection in the first two weeks after the operation; this would be treated with antibiotics.

It is uncommon for any postoperative pain to last more than a week and to require time off work.

– Rare

Bleeding within the scrotum after a vasectomy can cause the scrotum to swell and be painful; this ‘collection’ of blood is called a haematoma. Once a haematoma has formed, the treatment would usually be to let the body slowly absorb it. It would be rare for any further surgical treatment to be needed to stop the bleeding or remove the haematoma.

It is not uncommon for men to get occasional pain in the testicles/scrotal area, and this can occur more commonly following a vasectomy. In our experience it is however rare, probably less than 1:1000, for men to suffer with severe chronic pain following a vasectomy such that their quality of life is affected or further surgery is needed. This is called Chronic Post Vasectomy Pain.

A Sperm Granuloma is a tender swelling at the cut ends of the Vas tubes. This condition is not uncommon and will usually settle itself. Sperm Granulomas can rarely require surgical removal.

– Very rare

It is possible for the blood supply to one of the testicles to be damaged during a vasectomy; this can cause the testicle to stop functioning, be painful and extremely rarely to require surgical removal.

If you are having any problems after your vasectomy please make contact with our team.

You will be with us for less than one hour, the procedure itself takes approximately 20 minutes.

Please wear a pair of tight fitting pants on the day.

Please check with your car insurance company that you will be covered after a vasectomy. You may drive home if you feel well and are in full control of your vehicle.

We advise you to spend the rest of the day lying down quietly at home. You will need to take at least the next two days off work.

Do not do any heavy lifting or excessive physical exertion for a few days and until any swelling and discomfort has resolved. Do not have alcohol for 24 hours as this can increase the likelihood of bleeding. The anaesthetic will wear off after a couple of hours; take a couple of simple pain killers before this time, and regularly after that for the first two days.

A dressing will be placed over the cut on the scrotum. There will be a bloody discharge on this. Do not be alarmed as this is normal. If however, you can see blood leaking from the cut on the scrotum, apply firm pressure to this area by squeezing the skin between your fingertips, and keeping the pressure on for 15 minutes.

If the bleeding does not stop, or you are concerned by the amount of bleeding, call our After-Care line. In the extremely unlikely event of any emergency you should always call an ambulance.

You will need to keep the cut on the scrotum dry for a couple of days to allow it to heal; stitches are not usually used. There may be a yellow discharge for a few days before it starts to heal over. If the scrotal area is swollen and you are uncomfortable, you can apply an ice pack (a bag of frozen peas wrapped in a towel is ideal).

You can resume sexual intercourse when you feel ready, and sports after 10 days if all is well. Blood in the semen can occur for a few weeks after a vasectomy and will settle. If you have any worries regarding this please contact the clinic.

Infection can occur after any operation. If the area becomes red or painful, or you have a temperature or `flu-like` symptoms you need to consult with us or your own Doctor.

If you are worried by any problems you can call our After-Care line until 9.30pm on the day of surgery and between 8.00am and 6.30pm Monday to Friday. Outside of these times please call 111.

At least one semen sample (i.e. the fluid produced at ejaculation) will need to be collected and tested.

It is estimated that 24 ejaculations are required to clear the sperm that were already `upstream` of where the Vas Deferens tubes were cut.

Samples have to be obtained by masturbation. Using condoms or withdrawal can invalidate the results.

The form and container will be labelled with your name and date of birth. You will need to write the date of producing the sample on both the form and container.

We will write to you approximately a week after your last sample. Please wait for us to contact you. If we require you to provide further samples because of persistence of small numbers of sperm, we will advise you accordingly.

Continue using your advised/preferred method of contraception until you have been given the “All Clear”, otherwise you will risk conceiving a pregnancy.

(For information only, no signatures required)

Name of procedure: Vasectomy.

I have explained the procedure to the patient. In particular, I have explained:

1. The purpose of the vasectomy is to render the patient sterile and incapable of parenthood, and should be considered as a permanent means of contraception as reversal is often unsuccessful and is not available on the NHS.

2. The patient and his partner should use their usual means of contraception as advised by their doctor until they have been advised otherwise after semen analysis.

3. The early success rate of vasectomy is greater than 99%, but even after clearance has been given there is still the ongoing possibility of spontaneous reversal and pregnancy, I have estimated the risk at 1 in 2000.

I have explained the side effects and possible complications of vasectomy listed.

Common

1. Some degree of discomfort as the local anaesthetic is injected.

2. Some bruising and swelling is to be expected, the amount is variable.

3. Some discomfort/ postoperative pain.

Uncommon

1. Infection, which would usually require antibiotics

2. Discomfort/ post-operative pain lasting more than a week and requiring time of work

Rare (probably less than 1 in a 1,000 patients)

1. Ongoing chronic severe testicular/scrotal pain (Chronic Post Vasectomy Pain).

2. Bleeding, haematoma (collection of blood) in the scrotum and further surgery.

3. Sperm Granuloma.

Very rare

1. Testicular damage and surgical removal.

I agree to the procedure described above. I have received and read to my satisfaction the patient information leaflet. I have been given time to ask questions regarding the procedure, its side effects and complications, alternative forms of long acting reversible contraceptives and have been provided with information regarding postoperative care and semen analysis. I am aware that some patients will later regret having had a vasectomy. I understand that the procedure will involve local anaesthetic.

Responsibility for Semen Analysis Provision

I understand that it is my responsibility to provide semen samples as explained. I understand that without providing the necessary semen samples I will NOT know if the vasectomy has been successful. I will NOT therefore be able to stop using other means of contraception without being at risk of conceiving a pregnancy.

I understand that should I NOT provide the necessary semen samples and I father any children post-vasectomy, I will NOT hold my vasectomy surgeon or Independent Health Group responsible in any way for any costs or damages incurred.

1. Any local anaesthetic allergy.
2. Any latex allergy.
3. Implantable defibrillator.
4. 2 week wait referrals for cancer care.
5. Patients aged <18 years.
6. Patient weighing over 135Kg.
7. Patients who are detained under the Mental Health Act or are experiencing an acute psychotic episode.
8. Patients being detained by Her Majesty’s Prison Service, where security arrangements are deemed not to be appropriate.

NB We should also only treat patients who are deemed suitable for local anaesthetic treatment in the community and who prefer local anaesthetic over a general anaesthetic.

Patients on warfarin/ other anticoagulants