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Scenario

Technician Vicky is coming out of the consultation room when she bumps into Joanna, who works in the bakery next door. “Oh good, I was hoping to see you Vicky,” says Joanna. “My husband is going to have the snip this afternoon and I just wondered if there was anything in particular I needed to get for him – other than a lot of sympathy. I went to the first appointment when we talked about it with the nurse, but Alec has lost the leaflet they gave him when he went back and signed the consent form, and now he is so worried about the procedure itself that he can’t tell me anything!”

Answer

The most common after-effect of a vasectomy (commonly referred to as “the snip”) is – unsurprisingly – mild discomfort, bruising and swelling of the scrotum for a few days. Simple painkillers, such as paracetamol or ibuprofen, can help, and Alec should wear close-fitting underwear during the day and at night to provide support. He can wash as normal, though care should be taken when drying the genital area – a hairdryer might be a gentler option than a towel. In most cases, dissolvable stitches are used, so Alec is unlikely to need to have them removed.

While some people recover quickly and are back at work the next or even the same day, a couple of days’ off isn’t out of order if Alec is feeling very sore. He should refrain from heavy lifting and sport for at least a couple of weeks, and avoid impact sports for a few weeks longer to reduce the risk of complications. Sexual intercourse can be resumed as soon as Alec feels up to it, though an additional form of contraception should be used as it can take more than 20 ejaculations to clear the tubes of sperm.

Alec needs to submit two semen samples for analysis – he will be given sample pots and dates of submission after the procedure – and he and Joanna should not have unprotected sex until he is given the all clear. The most common complications of a vasectomy are the development of a haematoma (a blood clot in the scrotum) or an infection. If Alec notices severe swelling or is in a lot of pain, he should seek medical advice.

The bigger picture

Vasectomy has been available as a contraceptive choice for many years, and is considered a relatively minor and quick surgical procedure that usually takes place under local anaesthetic. Because many vasectomies are carried out on a private basis, there is no data available on the number of operations performed in the UK, but in 2005, over 28,000 vasectomies took place in NHS hospitals or clinics. Predictably, older men tend to be the ones most commonly choosing it as their preferred method of contraception once their family is complete.

The operation itself involves cutting, blocking or sealing the vas deferens (tube) that carries sperm from each testicle to the penis. This results in there being no sperm in the semen ejaculated during sex, so fertilisation is not possible. The procedure is over 99 per cent effective. While it is possible for a vasectomy to be reversed, it is not straightforward and the success rate if it is attempted within 10 years of the original procedure is around 55 per cent. Reversal surgery is not usually funded by the NHS, and can be expensive.

This is one of the main reasons why men who are thinking about a vasectomy are usually asked to attend a consultation with their partner and someone experienced in the procedure to discuss the impact it can have on a couple’s lives before deciding whether or not to proceed.

Extend your learning

• Vasectomies are performed in a range of settings, not just hospital, as outlined here (scroll down to the section entitled “how vasectomy is carried out”). Do you know where operations can take place in your local area? Try to find out, remembering that not all procedures are funded by the NHS
• Female sterilisation is considered much more major surgery than a vasectomy, and usually takes place under general anaesthetic. Find out more by reading the section entitled “how female sterilisation works” here.
• Given that there is no lower age limit for sterilisation, how would you deal with a young person who is thinking about it as a contraceptive option? To get some ideas, have a look here.