Andrology

Vasectomy

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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Medically Reviewed November 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons

What is a Vasectomy?

Also known as 'male sterilisation', a vasectomy is performed during a minor operation where the tubes that carry sperm from a man's testicles to the penis are sealed, preventing sperm from mixing with the seminal fluid (semen) and being ejaculated during sex.

A vasectomy is a quick and straightforward surgery, usually carried out as a day case using local anaesthetic and taking around 15 minutes in total. After the operation, up to two semen tests are carried out to ensure that all sperm have gone before the patient is given the 'all-clear'.

A vasectomy is a permanent method of birth control and is more than 99% effective at preventing pregnancy. However, you will still need to use contraception for around eight to 12 weeks after your vasectomy as sperm can linger in the tubes leading to the penis during this time.

There are few side effects associated with a vasectomy although on rare occasions a patient may be left with temporarily bruised, swollen or painful scrotum.

Vasectomy has a quick recovery time and you should be able to return to all your day-to-day activities in about a week after surgery.

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When is a Vasectomy appropriate?

A vasectomy is a good option for men who are in a long term relationship and don’t want any more, if any, children. It is a good alternative to female sterilisation as a vasectomy is a far simpler and safer procedure and the results are more reliable. A vasectomy is also much more affordable than sterilisation.

It is possible to have a vasectomy if you are single and have either completed your family or do not wish to have children. However, some surgeons are reluctant to carry out the surgery on men under the age of 30 in case they change their minds later. Contrary to popular belief, a vasectomy can’t always be reversed.

If you do decide after having a vasectomy that you would like to have a child, sperm can be retrieved from your testicles to be used in IVF treatment. However this procedure isn’t always successful and can be very expensive. So it is important that you discuss the matter extensively with your partner before opting for a vasectomy.

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The cost of a Vasectomy

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Who is suitable for a Vasectomy?

Cadogan Clinic considers individuals fit for a vasectomy if all of the following are true of them:

  • Physically and psychologically fit and healthy
  • Do not want to have children/anymore children
  • Have realistic expectations of what can be achieved by surgery

You will also be considered suitable if you are:

  • In a long-term relationship
  • Over the age of 30
  • Seeking a highly effective, permanent form of contraception

A vasectomy is permanent surgery, so you should consider this carefully before deciding to proceed.

How does the procedure work?

A vasectomy, also known as male sterilisation, is a quick and virtually painless surgical procedure. The tubes that carry sperm from the testicles to the penis are sealed preventing pregnancy. The procedure is effective and permanent and you will be able to return home the same day.

In the male genitalia, there are two tubes, called vas deferens, which carry sperm to the penis during ejaculation. A vasectomy disrupts each vas deferens preventing sperm entering and activating semen.

So, what happens to the sperm? Sperm cells stay in your testicles and are absorbed by your body. After around three months after your vasectomy, your semen won’t contain any sperm, so it can’t cause pregnancy. But this does not mean that you are not going to have semen. You can still ejaculate semen without the sperm present.

It is important that you carry on using an alternative method of contraception for two to three months after your vasectomy in order to prevent pregnancy. It is still possible to catch and spread sexually transmitted disease following a vasectomy.

Vasectomies at the Cadogan Clinic are carried out as a day case surgery under local anaesthetic. This means that only your scrotum will be numbed, and you will be awake for the procedure. You will not feel any pain, although it may feel slightly uncomfortable.

Occasionally patients prefer a general anaesthetic, but it is still a day case procedure. At the Cadogan Clinic we use TIVA (Total IntraVenous Anaesthesia) which is light and allows you to go home early.

The procedure takes around 15 minutes from start to finish and you should be able to return to your day-to-day activities in around a week post-surgery.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

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 over-the-counter painkillers, such as paracetamol.

It's common to have blood in your semen in the first few ejaculations after a vasectomy. Although you may find this alarming, rest assured that this isn't harmful.

It is advised that you wear close-fitting underwear, such as Y-fronts, during the recovery period in order to support your scrotum and help ease any discomfort or swelling. Make sure you change your underwear every day.

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

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.

It is important that you follow all the aftercare instructions issued by your surgeon. Failure to do so may hamper the recovery process.

 

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 re-join 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.

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 completely. You will need to use another method of contraception until you have had two clear semen tests.

You should not have sex immediately after the procedure. Ideally you should wait until you don’t feel any pain around the surgery site and feel comfortable to have sex. This may mean waiting a week or more after your procedure. On occasion, sex can hurt after vasectomy and intercourse may cause mild pain, soreness and bruising around your scrotum, blood in your semen and other symptoms which can last from a few days to a few weeks.

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

However, a vasectomy does not protect against HIV infection or any other STI's, so you should still use condoms with any new partner.

A vasectomy is a permanent surgery and should be viewed as such before you decide to go ahead with the operation.

Although it is possible to have a vasectomy reversed, the procedure is not always successful. There is a better chance of a successful reversal if the surgery is done very soon after the vasectomy. But it is worth mentioning that this reversal procedure is far more complicated than vasectomy itself.

If a reversal is carried out within 10 years of your vasectomy, the success rate is about 90%. This success rate drops if your reversal is carried out more than 10 years after your vasectomy. As demonstrated above, success rates are not perfect and there is no guarantee the procedure will work. Moreover, pregnancy still may not happen after a vasectomy reversal because your sperm may be less mobile than they were before.

So 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 absolutely certain before going ahead with the vasectomy.

Like any type of surgery, a vasectomy comes with pros and cons. It is important to weigh these up before deciding to go ahead with the surgery.

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 but some say it can make your sex better.
  • It will not affect the spontaneity of sex or interfere with intercourse
  • Vasectomy may be chosen as a simpler, safer and more reliable alternative to female sterilisation.
  • Vasectomies are easier and less expensive than female sterilisation.
  • Vasectomies are permanent and the success rate reaches more than 99% effective at preventing pregnancy.
  • Vasectomy doesn’t require hospitalisation of the patient as the operation takes only 15-20 minutes.

Disadvantages:

  • 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.
  • As with any surgery, complications can occur –risks are rare, but can include long-term testicle pain, haematoma, infection, bleeding, bruising, or swelling after the procedure.
  • Vasectomy doesn’t prevent the spread of sexually transmitted disease (STDs).
  • A vasectomy is not immediately effective as it may take 2-3 months to get tubes clear of sperm.
  • You need to keep using contraception for 2-3 months after surgery.
  • Vas deferens tubes could reconnect, but this is very rare.

For information on pricing, please get in touch and our team will be happy to assist and discuss your options.

If you choose the Cadogan Clinic for your vasectomy in London, you will get:

  • Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea
  • Your vasectomy at London’s leading specialist cosmetic surgery centre of excellence
  • 24/7 on-call nurse assistance
  • A Dedicated Patient Coordinator, as a personal point of contact through your journey with Cadogan
  • A preoperative medical assessment
  • Comprehensive aftercare courtesy of our specialist team of nurses

What are the risks?

Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. 




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