Should you get a vasectomy? Making the right choice
22 July 2022
The decision to have a vasectomy should not be taken lightly.
While vasectomy reversal is possible, the procedure is generally considered permanent, as the operation required to reverse it is more invasive and therefore carries greater risks.
There is also no guarantee that a reversal will work, especially if carried out a long time after the original vasectomy. To have one, you must therefore be 100% sure that you do not wish to have any/more children in the future. On the plus side however, it's a quick and relatively painless procedure from which you should recover fully within a few weeks.
It's also safer and easier than performing a sterilisation on a woman, which is why people in committed relationships who are looking for a permanent method of birth control often opt for vasectomy over sterilisation.
Did you know?
GPs and surgeons are not obliged to agree to a vasectomy and may be reluctant to approve the procedure for men aged under 30.
What you need to know to make the right choice
What is a vasectomy?
A vasectomy is a short surgical procedure that results in a highly effective form of permanent birth control.
During a vasectomy procedure, for which you should only generally need a local anaesthetic, the "vas deferens" (the two tubes that carry your sperm cells) are cut and sealed.
This prevents sperm cells mixing with your semen, meaning your semen can no longer fertilise a woman's egg and cause a pregnancy.
There are two main types of vasectomies: conventional and "no-scalpel".
During a conventional vasectomy, the doctor will use a local anaesthetic to numb your scrotum before making two small cuts in the skin on each side to access your vas deferens tubes. The tubes are then cut and sealed. With this type of procedure, you may need stitches but if you do then they will be dissolvable ones that will go away within a week.
In a "no-scalpel" vasectomy, your scrotum is numbed before the surgeon makes a tiny puncture hole in the skin to reach the tubes. The tubes are then closed in the same way as a conventional vasectomy, either by being tied or sealed, but no stitches are required.
As you might expect, this type of vasectomy is considered less painful and is also less likely to cause complications than the conventional method.
Know your numbers
The NHS performed 12,918 vasectomies in 2018-191.
How painful is a vasectomy?
The vasectomy procedure only takes around 15 minutes and is usually performed under a local anaesthetic. It will probably cause some swelling and bruising, but the resulting pain should only require paracetamol to be manageable and you can usually go back to work within one to two days.
However, it is advised that you avoid sport or heavy lifting for the next two to four weeks. In very rare cases, you may also experience Post Vasectomy Pain (PVP), with 1-2% of men experiencing discomfort up to 12 months after the operation2.
Will it affect my sex life?
A vasectomy is a low risk procedure that should not affect your sex life on either a short-term or a long-term basis; in fact, you can have sex whenever you feel ready after one week.
Your hormones will not change, and your sex drive will remain the same as before. You will also be able to ejaculate in exactly the same way.
Could anything go wrong?
The most common - but still very rare - complication is when hard lumps or "sperm granulomas" caused by sperm leaking from the tubes or an infection in the wound develop in the scrotum.
Having a vasectomy is not currently believed to increase your risk of any type of cancer.
What else do I need to know?
If you want to get a vasectomy, the first step is to make an appointment with your GP. Once there, you will complete a questionnaire and discuss your personal situation to find out whether it is the best option for you; if you decide to go ahead, there will also be a cooling-off period for you to change your mind if you want.
It's a good idea to book at least one day off work to recover from the procedure. You'll also need someone to collect you from the hospital/clinic or GP surgery on the day as you won't be able to drive yourself.
A few days before the operation, you'll also need to remove the hair from your scrotum using scissors or a hair-removal cream for sensitive areas.
Afterwards, you'll generally need to wait 24 hours to have a shower or bath, one week to have sex, and at least a week to do strenuous physical exercise.
It's also important to note that you won't be sterile immediately and will need to use another form of contraception until tests show there is no sperm in your semen - usually around 12 weeks afterwards.
If you would like to find out more, contraception clinics and sexual health or genitourinary medicine (GUM) clinics are also good places to seek advice on your options.
Know your numbers
A vasectomy is 99.8% effective. Correctly used, condoms are 98% effective3.
Having a vasectomy: pros and cons
Advantages
- A vasectomy is a 99% effective method of contraception
- It is considered permanent, so you don't have to think about birth control in the future
- It doesn't affect your sex drive or your general health
- The procedure is safer and easier to perform than female sterilisation
- There is a very low risk of failure
Disadvantages
- There is some discomfort in the following days and weeks
- Although a vasectomy is reversible, it might not work and won't usually be available on the NHS
- A vasectomy does not protect against sexually transmitted infections
- You will not be sterile immediately - use other contraception until your semen is sperm free
- In around 1/2000 cases, the vas deferens tubes fuse back together4.