ABC of General Surgery

Vasectomy

1. What is a Vasectomy?
A vasectomy is an operation that is done on a man as a permanent method of contraception. A vasectomy is designed to make the man permanently sterile (unable to father children) without impairing the enjoyment of sexual intercourse in any way. Unlike a condom, a vasectomy DOES NOT protect against sexually transmitted diseases such as AIDS.

2. What does the operation involve?
A vasectomy is usually done as a day case procedure in the day surgical unit of your local hospital. A vasectomy can be performed under local or general anaesthetic. You should discuss which is best for you when you see the specialist in the outpatient clinic before your operation. The operation involves making two small incisions in the scrotum, removing a small part of the tube (the vas) that carries the sperm from the testicle and tying the ends of the vas to prevent leakage of the sperm. The skin incisions are closed with absorbable stitches.

3. What happens after the vasectomy?
A vasectomy is not usually painful and the wounds heal quickly. Most men are able to go back to normal activities in a couple of days. Strenuous work or exercise should be avoided for about a week and it is usually more comfortable to wear firm rather than loose underwear. It is important to know that you are NOT sterile immediately after the vasectomy operation as it takes several weeks for the "tubes" to clear. After the operation you should continue with your usual contraceptive methods. The hospital will arrange for sperm count tests to be performed at intervals after the operation. Other contraceptive measures can only be stopped AFTER these tests have been done and you have been notified by the laboratory.

4. Will I need to come back to hospital after the operation?
No, the sperm counts can be done as an outpatient. Complications after vasectomy are uncommon but if you have problems you should consult your GP who will decide if you need to see the specialist again. There is no known increased risk of cancer of the testicle after a vasectomy.

5. Can the operation fail?
Yes, but it is very uncommon. There are two ways a vasectomy operation can fail:

	If the tubes have not been removed correctly or the tie slips then the sperm count will show that the man is still fertile and you will be notified and should continue with your normal contraceptive methods. If this happens, a redo operation (usually under full anaesthetic) maybe required to ensure that the tubes are correctly identified and cut.
	If the tubes have been removed but manage to grow back together at a later date then the man will be sterile to start with but becomes fertile again later. This is very rare and is an unavoidable risk.

6. Points to Remember

A vasectomy is irreversible.
After the operation use other contraception until given the "all clear".
After a successful vasectomy there is a small risk of a late failure.
A vasectomy does not protect you against sexually transmitted diseases.

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