VASECTOMY INFORMATION



VASECTOMY INFORMATION

You have expressed an interest in a Vasectomy operation which is a permanent form of contraception. The next stage in the process is the assessment appointment. This appointment gives you the chance to discuss the procedure and have answered any questions or concerns. It allows us to find out if there are any reasons why the procedure would not be able to be performed in your case.

It may be useful for your partner to come along too, but this is not essential. A date for the operation itself will be sent following the assessment appointment.

This leaflet tells you about the operation, its reliability and possible problems and is designed to give you the facts and to help you decide if the vasectomy is right form of contraception for you. It is not meant to sound off-putting but it is important that we tell you about the complications as well as the many advantages of the vasectomy.

Please keep this leaflet until after your operation, as it also tells you what to expect after the procedure.

What is a Vasectomy?

A Vasectomy is an operation to render you permanently sterile and you will not be able to father any more children following this procedure.

A tube called the vas deferens carries sperm from each testis into the penis. The Vasectomy involves blocking these tubes to prevent the passage of sperm. The operation does not interfere with the production of seminal fluid so you will notice very little difference in the fluid you produce when you ejaculate. It will not contain sperm and may not look quite as milky in colour but the volume should remain the same. It may look slightly bloody in the first few weeks after your operation. This is normal and will resolve by itself. If the fluid becomes blood stained again then you will need to report this as it may indicate some infection. There should be no difference in your sexual function. The vasectomy operation does not cause impotence.

The operation is done under local anaesthetic in the majority of cases; (similar to the injection used at the dentist). A general anaesthetic (GA) can be organised if the operation cannot be done under local anaesthetic (LA) for any reason or there is a stated preference for a GA. You would need to fast before a GA but it is better to make sure you eat normally before you come in for a local anaesthetic.

The Vasectomy operation takes about 20 minutes. A very small cut is made in the skin on each side of the scrotum, or sometimes just one cut is made in the centre. The tubes, which lie just beneath the skin, are blocked on both sides. The small skin cuts are closed with a dissolvable stitch. These do not need to be removed but if they become tight or uncomfortable they can be removed. Some men worry that their stitches gape a little or even come out, but this does not usually matter.

How effective is vasectomy? What is meant by short-term/early failure?

After the operation, you and your partner must continue to use another method of contraception until you receive the `all clear` from us. It takes 16 weeks or longer for the remaining sperm in your tubes to clear away. The time that this takes depends on how often you ejaculate. It can take up to 20+ ejaculations to clear the remaining tubes. You will be asked to send 2 semen samples, obtained during ejaculation, at 12 and 16 weeks after the operation. If both samples are free of sperm we will inform you that your “Vasectomy is complete” and you can now rely on it for contraception and can stop using your previous method of contraception. If your samples continue to contain sperm, we will ask you to continue to use another method of contraception and to send in further samples at 4 weekly intervals, until two consecutive samples are free of sperm.

Around 1-2% of men still continue to produce samples containing large numbers of moving sperm. This indicates that the operation has failed. This can be very disappointing and represents an “early failure” If this does happen you would be invited to speak to the surgeon about the possibility of repeating the operation, which sometimes needs to be done under GA.

What is meant by long-term failure?

This is a much rarer than early failure and only happens to 1 in 2000 men. The vasectomy is initially successful, there are two semen samples free of sperm and the all clear is given. At a later stage, months or even years later, the ends of the tubes join back together and allow sperm to pass again, which may result in pregnancy. No form of contraception is 100% effective.

Rare non-motile sperm

Up to a third of men may produce a positive result i.e. sperms are present, in the twelve week sample. This shows only a tiny number of sperm. This very often clears to become negative in subsequent samples but in some men it takes a long time to clear. Again this is very disappointing. If this situation persists you will be asked to send in a “fresh sample” and then you will be contacted by phone or offered an appointment to attend to discuss your future management. This may include sending in more samples, accepting a “special clearance” or, rarely, a further operation.

What are the advantages of a Vasectomy?

A Vasectomy is the most reliable method of contraception available. Following the “all clear” of two negative semen samples the failure rate is 1:2000. Female sterilisation is not as effective with a failure rate of 1:200. The IUD and IUS have similar failure rates to female sterilisation. The implant is the most effective form of female contraception with a failure rate of ................
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