Vasectomy

Paimaun Zakikhani offers no scalpel vasectomy.  A vasectomy is an effective and permanent form of contraception. The operation is quicker, easier and more effective than female sterilisation. There is a very small failure rate. Sterilisation is only for people who have decided they do not want children, or further children in the future. It is considered a permanent method of contraception, as reversal is a complicated operation which is not always successful. 

Am I suitable for vasectomy?

If you are referred by your GP, he/she is likely to have counselled you about vasectomy.

However, there are a few certain categories whom I would always prefer to counsel additionally:

  1. Couples where either of the partners is under the age of 30 years
  2. Couples who have had no children
  3. Couples where the woman is pregnant or where the youngest child will not have reached the age of six months by the time the vasectomy is performed
  4. Couples where there is any doubt about the long-term stability of the relationship  e.g. short-term “common-law” marriages
  5. Men with a BMI more than 30 and/or weight more than 120kg.

It is important you are fully counselled in these situations prior to a vasectomy in order to confirm informed consent has been achieved.

The procedure

The testes (male reproductive organs), lie outside the body in a pouch of skin known as the scrotum. The sperm are passed from the testicles through a thin tube known as the vas deferens (vas) and with the secretions from the other glands in the body, form the ejaculate or seminal fluid. These tubes lie close to the skin on either side of the scrotum, and are therefore easily accessible. The operation itself involves the removal of a small section of these tubes. The operation usually takes between ten and twenty minutes.

Our surgeons use a non-scalpel technique for most patients which removes a piece from each vas (tube) through a single site in the scrotum. This is the technique recommended in the guidelines produced by the Royal College of Obstetrics and Gynaecology on male sterilisation.

Vasectomy technique

Our consultant urological surgeons use a no scalpel technique as recommended by national guidelines.

The reason this technique is recommended over other techniques is:

  • Less discomfort
  • Faster procedure
  • Faster recovery
  • Only one small opening of the skin
  • Less chance of bleeding and other complications
  • Just as effective

What do I do after the vasectomy?

 

In about one hour the effect of the local anaesthetic will wear off and some discomfort may be felt at the site of the cut in the scrotum. Some paracetamol or other simple pain relieving tablet may then be taken at the recommended dose (preferably not aspirin). If skin stitches are inserted, they will dissolve and do not need to be removed.

On return home, you should rest for 24 hours, and spend the following 24 hours resting at home. After that, most men are able to resume work unless it is physically strenuous. Some bruising of the skin around the site of the cut is not unusual. There may also be some slight swelling, but this will soon disappear.  Some men may experience pain in the scrotum or groin which may persist, and very rarely, can be severe.

Complications are rare, but as with any surgical procedure, bleeding, swelling, or infection is possible and may require medical attention. Complete recovery would still be expected, although it might then take several weeks or longer. The operation does not immediately make you sterile since there are many sperm in the storage space between the cut tube and the end of the penis, and time must be allowed for these to be flushed out at each ejaculation.

The effect of the operation is to prevent sperm passing from the testicle to the outside.
The sperm themselves are only a very small fraction of the seminal fluid so that its quantity and appearance are unchanged after the operation.

Sperm Tests

Your sterilisation is not confirmed until you are cleared by the clinic.

16 weeks (4 months) after the operation the clinic requires a specimen of semen for sperm testing.

In general the greater the number of ejaculations in the weeks following the operation, the shorter the time taken to clear the storage system. Even so, the time taken to get rid of the sperm varies considerably and it is not unusual for the clinic to request further specimens.

Most men clear the sperm from their semen within four months of vasectomy. In some cases, however, further tests may be requested and exceptionally a second operation may become necessary. The overwhelming majority of men remain sterile after the absence of sperm has been confirmed, although the reappearance of sperm in the semen has been reported in some very rare cases, even after some years.  Full instructions about the procedure for your semen test will be given at the time of the operation.

Information Sheets

 BAUS consent form for vasectomy