Vasectomy

Vasectomy is a procedure that involves a small operation performed in men. A tube (called vas deferens) within each testicle is clamped, cut or sealed. This prevents the release of sperm during ejaculation. After a vasectomy, sperm continues to be produced in the testicles, but is no longer released during ejaculation or contained in the semen. The sperm that is produced is reabsorbed by the body.

Vasectomy is very reliable and in most cases will prevent pregnancy, but it is not quite 100% effective.

• Overall, 1 in 300 may fail. However, the failure rate drops to 1 in 2,000 after you have had negative sperm counts. 
• In a few cases, operations are not successful and tests show sperm are still present in semen after the operation. This occurs in less than 1 in 100 operations.

Advantages

• Vasectomy is a safer, cheaper procedure that causes fewer complications than tubal ligation in women (female sterilisation).
• Vasectomy is a permanent method of birth control. Once your semen does not contain sperm, you do not need to worry about using other birth control methods.
• Although vasectomy is expensive, it is a one-time cost. The cost of other methods is likely to be greater over time.

Disadvantages

• The effect of vasectomy in preventing pregnancy is not immediate; it may take a few months before the semen is free from sperm.
• As a vasectomy is permanent. Some people regret having a vasectomy, especially if their circumstances change. 
• A vasectomy does not protect against STIs, including infection with the human immunodeficiency virus (HIV). Condoms are the most effective method for preventing STIs. 

Vasectomy is a simple operation, which takes about 15 minutes. It can be done at a Sexual Wellbeing Aotearoa clinic, doctor's surgery or hospital.  It is usually done under a local anaesthetic. This means you are awake but have an injection into the skin so that you do not feel pain. Sometimes vasectomy is done under a general anaesthetic. Read more about anaesthesia.

In no-scalpel vasectomy:

• Local anaesthetic is injected into a small area of skin on either side of the scrotum above the testicles (testes).
• The doctor feels the tubes under the skin and holds them in place with a small clamp. 
• They then make one tiny puncture and gently stretch the opening so the tubes can be reached.
• The tube is brought to the surface through the small opening. Different doctors use different techniques, but all are designed to ensure the 2 ends of the cut tubes remain separate.
• The second tube is treated in the same way through the same hole.
• There is very little bleeding with this technique.
• No stitches are needed to close the opening, which heals quickly without leaving a scar.

Your doctor or nurse will let you know what to expect and how to take care of yourself after your operation.

Self-care includes:

• staying home and resting as much as you can for a few days after the procedure
• pain relief if you need some
• avoiding heavy lifting, exercise or sexual intercourse for 7–10 days.

You can return to light work after 2 days. You can expect some soreness and bruising around the operation site for a few days to weeks.

You will need to have tests after your operation to find out whether your semen still has sperm. These tests are usually done 3 months afterwards. If you are having vaginal sex, your partner will need to use another method of contraception until your semen samples have no more sperm. 

No – your hormones will be the same after a vasectomy as they were before. Your sex drive and ability to have sex will not change. You will still have erections and orgasms. You will ejaculate about the same amount of semen but it no longer contains sperm. The only change is that you cannot get someone pregnant. 

For the most part, vasectomy is a safe procedure with very few complications. Most men have no problems after a vasectomy.

However, the following may happen:

• There is a small risk of a wound infection after the surgery.
• Bruising around the operation site may occur but it will go in a week or so.
• Sometimes sperm may leak into the scrotum and form a swelling which may need treatment.
• You may experience a dull ache in the scrotum for a few weeks or months after the operation. This usually settles within 3 months.