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everything you need to know about surgery, sex and reversal


If you elect to go private, you can book your consultation directly with the provider, who will usually also check whether you qualify for NHS funding. Costs vary between clinics. MSI Choices, for example, takes NHS referrals and charges private patients £70 for a consultation and £480 for the procedure. Thames Valley Vasectomy Services, which is also an NHS-approved provider, charges £490 for a complete no-scalpel procedure, including consultation, procedure and follow-up semen test. Clarewell Clinics charges £750 for a consultation and procedure.

How do I prepare for a vasectomy?

Sarah Salkeld, the associate clinical director at MSI Reproductive Choices UK, explains: “A good starting point is to get as much information as possible through a reliable website, such as ours, or the NHS. It’s important to be well informed to start with.

“Most people are suitable for treatment, but occasionally there may be a medical reason why we can’t perform the procedure – if, for example, someone is taking certain types of blood-thinning medication.”

Some clinics, such as Thames Valley Vasectomy Services, hold webinars for patients.

What are the risks?

As with any minor surgical procedure, you can expect to experience some discomfort after the procedure but, in most cases, this is minor pain, swelling and bruising that lasts for a few days and can be reduced with paracetamol. An ice pack is also recommended to reduce swelling. It is also advisable to wear tight-fitting underwear under shorts for the first few days and nights after the procedure to help support your scrotum.

Generally, vasectomy is a low-risk procedure. There is a small risk of infection, so it is important to keep the area clean, and shower or bathe before attending your appointment.

According to a study published in 2023, vasectomies are much less likely to cause complications than expected. Data analysed by researchers from Gloucestershire Hospitals NHS Foundation Trust, from the outcomes of over 90,000 vasectomies performed over 15 years, showed that existing leaflets explaining the potential complications to patients are based on outdated figures.

For example, one of the most significant complications of a vasectomy is chronic scrotal pain, which is quoted as affecting “up to 5 per cent of all patients” in the British Association of Urological Surgeons (BAUS) patient information leaflet about vasectomies. Reviewing the more recent data, the team found that the rate was in fact as low as 0.2 per cent of patients.

The chances of post-operative infection, quoted as between 2 and 10 per cent of patients in the BAUS statistics, was actually closer to 1.6 per cent. Haematoma rates in patients could be as low as 1.9 per cent. Vasectomy failure rates, where motile sperm is found after three months, is 0.6 per cent, and late failure, which occurs when the severed ends of the vas deferens join up, occurred in just 37 patients out of a total of 72,624 who answered the relevant question from the dataset used in the study – or 0.04 per cent.

How soon can I have sex, exercise, work and drive?

It is not advisable to drive home after the procedure, as leg motion on the pedals may aggravate the wound, and insurance may be invalidated in the event of an accident.

Patients are advised to wait until tenderness subsides before any long periods of standing, walking or driving. Contact sports should not be played for a month afterwards.

NHS guidance states: “You can usually return to work one or two days after a vasectomy, but should avoid sport and heavy lifting for at least a week after the procedure to prevent complications. See a GP if you still have symptoms after a few days.”

“If you have a manual job, I will usually say stay off for a week,” adds Dr Kittel.

Patients are advised to avoid sexual activity for at least seven days after having a vasectomy. It is common to find some blood in the first few ejaculations after the procedure. Patients must have a routine semen test between 12 and 20 weeks after the procedure to make sure it has worked, and it is important to use another method of contraception until you have a negative test, as it can take time for the remaining sperm to leave your tubes.

Salkeld explains: “You can’t rely on it as a contraceptive method until after you’ve had that check to make sure it’s worked.” 

Dr Kittel leaves a 20-week gap. “I am one of the latest testers in the UK,” he says. “I’ve only ever had one possible late failure in over 12,000 patients. If you test too early and you have a positive result, you must do other tests.” 

What happens to the sperm in the testes after a vasectomy?

Sperm is still produced by the testes but it is absorbed back into the body. The same process occurs when a man does not have sex for a long time. The testicles continue to produce testosterone, which enters the bloodstream, so libido, sensation and the ability to have an erection are not affected.

Can a vasectomy be reversed?

Vasectomy should be considered a permanent solution. Some men decide to have the procedure reversed if their circumstances change and they want to have children, but the process does not always work, and the NHS does not fund vasectomy reversal. In a vasectomy reversal, surgeons reconstruct the vas deferens tubes.

The chances of success for a vasectomy reversal depend on how long it’s been since the initial procedure, the type of vasectomy you had, what surgery you may have to reverse it, and how experienced your surgeon is. A successful reversal does not guarantee a pregnancy. According to Bupa statistics, the chances of a pregnancy after vasectomy reversal are 75 per cent if the reversal is within three years of the original vasectomy, reducing to less than 10 per cent if the vasectomy was more than 20 years ago.

Sperm produced in the testes after vasectomy can be obtained by testicular biopsy and subsequently used in assisted conception. However, a 2005 study concluded that sperm yields “significantly decreased” post-vasectomy.

Vasectomy myths busted

“It is a very minor procedure,” explains MSI Reproductive Choices’ Sarah Salkeld. “Some people tend to think that female sterilisation is better, but it has a higher failure rate and is mostly a general anaesthetic procedure, whereas vasectomy is local anaesthetic, quick and less invasive. A lot of men don’t realise how minimal it is and how quick the recovery is.”

And, according to Dr Kittel, common misconceptions include the vasectomy causing impotence and that the procedure involves an injection into the testicles.“It is a small incision in already numb skin so you cannot feel anything. It is a very straightforward procedure with tiny needles,” he says.

*Name has been changed. Procedure prices were correct at the time of compiling



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