Vasectomy - what you need to know

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Whether you already have a young family or have decided that having children is not for you, a vasectomy can allow you and your partner to enjoy a sex life that is free from worries about unwanted pregnancies - and from worries about less effective methods of contraception.

If you are considering the procedure, here is what you need to know.

How does it work?
A simple and relatively risk-free procedure, a vasectomy works by cutting, blocking or sealing shut the tubes that carry sperm from the testicles to the penis. It does not affect sex drive, nor the ability to get an erection or ejaculate normally. The operation is usually offered free on the NHS, though the waiting list can extend to several months.

What should I expect?
The procedure itself is usually performed under local anaesthetic and takes approximately 30 minutes to complete. There are two types - what is known as the conventional vasectomy, which is widely used on the NHS, and the no-scalpel vasectomy, which is more widely available in private clinics.

The conventional type involves the surgeon making two small incisions in the scrotum, allowing access to the tubes that carry sperm. A tiny section of each tube is removed, and the ends closed either by tying or by sealing them shut with heat. The original incisions are then stitched.

With a no-scalpel vasectomy, the surgeon simply feels the tubes beneath the skin, holds them in place with a small clamp, and then makes a tiny puncture hole, allowing them to cut and seal the tubes in the same way as a conventional operation. This type of operation requires no stitches and is thought to be less painful with a reduced risk of complications.

The recovery time for a vasectomy is minimal. Most patients are able to go home the same day, and can return to work within one or two days of the op, though it is advisable to avoid sports or heavy lifting for a week or so. Most find they experience soreness, swelling and bruising of the scrotum for a few days following the procedure.

It is also possible to have sex as soon as the patient feels comfortable, though your doctor will recommend waiting a couple of days. It's important to bear in mind, however, that it takes time for the remaining sperm within the tubes to clear, so it's best to wait until you have had two clear semen tests before you rely on your vasectomy for contraception. Also remember that a vasectomy will not protect you from STIs.

It is rare for a man to develop complications after a vasectomy, but that's not to say the operation is entirely risk free. To avoid infection, it is important to keep the area clean after the procedure, being careful to properly and gently dry afterwards. Some patients experience a 'full' feeling in the testicles, usually caused by stored sperm filling the epididymis (the long, coiled tube at the back of the testicle). However, this is usually naturally relieved within a few weeks. Others find they get pain that continues to cause a problem. Should either problem persist, it is best to seek advice from your GP.

Occasionally the tubes that have been cut can leak a little sperm, and as the sperm collects around the tissue it can form hard lumps known as granulomas. This can happen either immediately or a few months after the op itself, and is typically treated using anti-inflammatories, but if your groin or scrotum becomes painful or swollen, you should visit your GP.

If your scrotum becomes very swollen and painful, it may point to a haematoma, where blood collects and clots in the tissue around a broken blood vessel, can occur. Though very rare, it may require further surgery so medical advice should be sought.

What to consider
A vasectomy is really a permanent sterilisation. It's true that it is possible to undergo a reversal procedure, but this is a delicate operation and is not guaranteed to work.
Therefore, it's essential to think long and hard before having the op. Your GP has the right to refuse you the operation if he believes it is not in your best interests, and many are loathe to perform a vasectomy on anyone under 30, particularly those without children.

However, if you are certain that you do not want children in the future, or already have kids and have discussed the situation fully with your long-term partner or spouse a vasectomy is a reliable and largely painless option that will allow you to enjoy a happy, healthy sex life without the need for other forms of contraception.

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