Vasectomy

A vasectomy is a form of permanent contraception for men. It is a simple surgical procedure that involves cutting the tubes that carry sperm from the testicles to the penis. Having a vasectomy does not affect a man's sex drive (libido), or the pleasure experienced during sex.

Sperm is produced in the testicles. Sperm then travels to the epididymis, where the sperm cells stay and mature. During sex, the sperm cells move from the epididymis through a tube called the vas deferens to the ejaculatory ducts. In the ejaculatory ducts the sperm cells mix with seminal fluid and are ejaculated through the penis. A vasectomy involves cutting the vas deferens.

After a vasectomy, a man's testicles will carry on producing sperm as usual, but the sperm are reabsorbed by the body (as happens naturally to any unused sperm in the body of all males).

In a vasectomy the vas deferens is cut to prevent sperm being released during ejaculation. 

Reasons for having a vasectomy

A vasectomy should only be considered by people who are certain that they do not want to have any children in the future. Although a vasectomy can be reversed, it is designed to be permanent, so not all vasectomy reversals are successful.

For couples considering permanent contraception, a vasectomy is usually recommended above the surgical options available for women (which include tubal ligation and tubal occlusion), because it is less invasive and carries a much lower risk of complications.

What happens during a vasectomy?

A vasectomy generally takes less than 30 minutes. First, a local anesthetic is injected with a fine needle to numb the area around the groin. In some cases a vasectomy may be performed under a general anesthetic. Once the area is numb, your doctor will locate the vas deferens by feeling through the skin of the scrotum.

The procedure is then completed in a few short steps:

• A small cut is made on either side of the scrotum to expose the vas deferens;
• A loop of the vas deferens is then exposed through the incision and cut;
• The cut ends of the vas deferens are then either tied off, clipped or treated with heat to seal them, and;
• The cuts in the skin are then closed with stitches or surgical staples.

What happens after a vasectomy?

Men can usually go home immediately after a vasectomy. After the procedure, it is best to rest for a few days and avoid sex, heavy lifting and strenuous physical activity.

Some men may experience temporary bruising, discomfort or tenderness following the operation. Any pain may be relieved by over-the-counter medication, such as acetaminophen. Check with your doctor if you are unsure which pain-relief medication to take, or if you experience severe pain after the procedure.

The success rates of vasectomy as a contraceptive method are very high, but there is still a small (less than one in 1000) chance of pregnancy occurring after a vasectomy.

Semen analysis

To confirm whether a vasectomy has been successful, men will need to have a semen analysis. This is usually performed six weeks to three months after the initial operation. By this time, any sperm should be naturally cleared by the body. Until analysis confirms there are no sperm present in the semen, an alternative method of contraception should be used to avoid pregnancy.

A vasectomy does not offer protection against sexually-transmitted infections (STIs). So it is important to practice safe sex even after a vasectomy. This generally means using a form of barrier contraception, such as a condom, when having sex.

Potential complications

A vasectomy is a relatively straightforward procedure. However, as with other operations, there are several potential complications, including:

• Infection of the skin around the site of incision;
• Excessive bleeding, and;
• A sperm granuloma, which is a hard lump of tissue formed by sperm leaking from the end of the tubes cut during the vasectomy.