Vasectomy
What is it?
Vasectomy is the clinical name given to an operation that cuts and ties off the ends of the tubes (called vas deferens) that deliver sperm from the testes to the prostate to make semen. This stops the sperm from mixing with the seminal fluid made in the prostate. Therefore, when the man ejaculates, there are no sperm in the semen. Because 95% of semen is made up of seminal fluid, and not sperm, there is virtually no difference on ejaculation. Also, because the testes continue making the male hormone testosterone, this operation has no effect on a man's sex drive.
Preparing for a vasectomy
You will usually be asked to do three things on the day of your surgery. You will be asked to shave in the area where your penis joins your scrotum, and you should bring a pair of tight jockey shorts or other supportive underwear with you as support and to keep the bandages in place. It is also a good idea to arrange for someone to drive you home after the operation.
The operation
Usually, your vasectomy will be done as an outpatient case. The surgeon will first numb the scrotum with a local anaesthetic, then one or two cuts are made on each side of the scrotum. The vas deferens (the tube from your testes to your prostate) is found, a section of it is removed, and the ends are tied off. Stitches are used to close the cut in the scrotum.
A new development is the 'no-scalpel' vasectomy. Here, the vas deferens are clamped through a small puncture in your scrotum, rather than a cut. This tiny opening heals quickly without the need for stitches. This only takes about 10-20 minutes.
After the operation
It is normal for you to feel moderate discomfort for the first day or two, once the anaesthetic has worn off. Mild painkillers can help with the pain. You will normally be advised to rest and keep activity to a minimum for the first couple of days to decrease the risk of inflammation.
It is important to be aware that the vasectomy does not mean that you are instantly sterile. A large amount of sperm remains in the vas deferens above the portion that was cut and it takes 25-30 ejaculations over the next two months before the sperm count reaches zero. It is important to provide two negative sperm tests before stopping other methods of contraception.
Can a vasectomy be reversed?
The answer to this is technically yes, but the degree of effectiveness depends on the individual in terms of length of time since the original operation (the longer the period elapsed, the lower the success rate), the skill of the surgeon, and the condition of the tissue. Using surgery, the disconnected ends of the vas deferens can be stitched back together, allowing sperm to once more travel up to the prostate and into the semen.
Further information
Your local GP surgery is the best place for you to find information on vasectomies, especially if you have specific concerns about your symptoms or treatment. Charities can also be useful sources of information and support.
Men's Health Forum www.malehealth.co.uk
