What to expect after a vasectomy

Around 11,000 vasectomies are performed in the UK every year. A vasectomy refers to surgical sterilisation for men. It is usually performed in men who are in a long-term relationship but have decided with their partner that they don’t want to have any or any more children. A vasectomy acts as a permanent form of contraception. 

How to prepare for a vasectomy

It is important to be completely certain that you don’t want to have any or any more children before you go ahead with a vasectomy. Although there is a surgical procedure to reverse a vasectomy, which is only available privately, it is a complex surgery and is not always successful. 

Success rates for the reversal of a vasectomy drop the longer you wait after your initial vasectomy. For example, within three years of a vasectomy, the success rate is 75%. It drops to 50–55% after three to eight years and drops again to 40 to 45% after nine to 14 years.  

The procedure

A vasectomy is usually performed under a local anaesthetic, so you won’t feel any pain, and it takes around 10 to 20 minutes. It is a day case procedure, which means you can return home on the same day as your procedure. 

Your surgeon will make two small cuts, one on either side of your scrotum — the sac that contains your testes. This allows your surgeon to expose the vas deferens, which is a coiled tube that transports sperm out of your testes and to your penis. 

The vas deferens will be cut and the free ends sealed using heat or tied. Finally, the cuts in your scrotum will be closed using dissolvable stitches. 

This procedure is permanent and highly successful. It is theoretically possible for the two cut ends of the vas deferens to rejoin in a process called spontaneous recanalisation; however, this is incredibly rare. 

Complications of a vasectomy

Although a vasectomy is a low-risk procedure, as with any surgery, there is always the chance of infection and/or bleeding. 

In the case of a vasectomy, scrotal bleeding can lead to a collection of largely clotted blood in the scrotum called a haematoma. This will turn back into fluid over seven to 14 days and then be gradually absorbed by your body.

In around 1–2% of cases, there is a risk of chronic post-vasectomy pain (CPVP), where you experience constant or intermittent discomfort in your testes for longer than three months after your vasectomy. The discomfort can range from a dull ache to severe pain that affects your quality of life. 

CPVP is usually treated with painkillers and non-steroidal anti-inflammatory drugs (NSAIDs), and wearing supportive underwear. 

A more common complication is the development of a sperm granuloma — a firm, hard nodule that develops where sperm has leaked out of the cut end of the vas deferens. 

Sperm granulomas do not usually cause symptoms, but in cases where they do, you can expect some tenderness and discomfort radiating to your groin. This is treated by taking NSAIDs and over time, the sperm granuloma will disappear as it is absorbed by your body. 

If you experience any signs of a complication, such as pain or discomfort that doesn’t improve over time, contact your hospital care team or see your GP.

Recovering from a vasectomy 

You can expect some aching and discomfort for the first two to three days after your vasectomy. This can usually be managed with over-the-counter painkillers, such as paracetamol and ibuprofen. Wearing tight-fitting or athletic underwear can help by better supporting your scrotum. 

For the first 48 hours after your procedure, keep your wound site dry and avoid strenuous activity, getting sweaty or dirty. You can return to driving and work a day or two after your procedure.

You should avoid exercise, sports and heavy lifting until your wound has completely dried up, which usually takes seven to 10 days. Your dissolvable stitches will have disappeared by this point.

Sex after a vasectomy

For the first two weeks after your vasectomy, you should avoid having sex. After this point, you should continue to use contraception until you have a negative semen test. 

You will be given a semen testing kit when you leave hospital and 18 weeks after your procedure, you will need to collect a semen sample and deliver it to the hospital where the lab will analyse it under a microscope.

The more you ejaculate before your semen test, the more likely you will have a negative test result. This is because as you ejaculate, you will clear out any sperm remaining in your vas deferens. 

You will, therefore, need to have ejaculated at least 20 times before you collect your semen sample; however, you also need to abstain from ejaculation for at least 48 hours before your test. 

If your semen test is positive, you will need to take the test again and should continue to use contraception until you receive a negative test result. 

When having sex, you will not see any difference in your libido or the volume of your ejaculate.