A vasectomy is a surgical procedure which cuts and seals the tubes that carry sperm from the testicles towards the penis. After a successful vasectomy, the man’s ejaculate no longer contains sperm and he cannot father a child.
It’s considered a straightforward procedure, and is much simpler than the corresponding procedure for women (tubal ligation). It’s sometimes possible to reverse the operation later, but don’t count on it. The operation doesn’t affect sexual function.
The surgical details, and the practical details relating to the operation, will be made available to you beforehand, probably in leaflet form as well as verbally, so I won’t cover those here. Instead, I’ll describe what it’s like to go through the operation, based on my experience five years ago. There are different ways of performing a vasectomy, but mine was done using a scalpel. An alternative method punctures the skin instead of cutting it open, but the difference is not as great as you might assume.
At the clinic were half a dozen other men also coming for a vasectomy. Every person we saw (the receptionist, the nurse, a junior doctor and the surgeon) asked us in detail what procedure we were coming for. I guess a vasectomy is something you don’t want done to you by mistake!
I was dressed in a hospital gown and allocated to a bed. When it was my turn I was wheeled into the operating theater, and the surgeon again asked me what I was there for. A local anaesthetic was applied, and I was offered a sedative which I refused. I figured I may as well be alert to what’s going on, just in case something was about to go wrong.
The gown was then propped up to expose my genitals (and to block my view of what was going on). I was aware of the surgeon making a cut near my right testicle, although there was no pain. I then felt a pulling sensation as a section of the vas deferens (the tube) was pulled out. If they were to cut the tube without pulling out a section, it would be more likely to grow back and rejoin. The surgeon then tied the ends of the severed tube (using, I presume, forceps) and there was a slight smell of burning as he cauterised the cut ends.
Next the surgeon worked on the tube from the other side, the left testicle. This time, every move during the pulling or knotting of the tube caused a deep discomfort, a dull but powerful feeling like being kicked in the testicles, except that each “kick” was more drawn-out, as if in slow motion. At the time, I assumed that this would have been alleviated if I had accepted the sedative. However, speaking later with the other patients they all described exactly the same discomfort—even those who were sedated—but only during the operation on the left hand side. It was extremely unpleasant, but I focused on my breathing and relaxed as much as I could, knowing that it would be over in a few minutes.
I was then wheeled out to the recovery ward. After a while I was brought a cup of tea, then after a couple of hours I was discharged. There was a small amount of bruising which cleared up in a couple of days, and no other ill-effects. I was required to bring a sample of ejaculate to the clinic six weeks later, to check that the procedure was successful (which it is in over 99% of cases).
Some people freeze some sperm before the operation “just in case”, but that service was not offered under the UK’s National Health Service. Because the operation is not always reversible, and to keep the health budget down, the NHS does not routinely make the operation available to men under 40 years old. However, one of the guys in my clinic, who was in his mid 30s, had managed to persuade the health service to let him have the operation as he already had four children and was adamant he didn’t want any more.
I was already well over 40, so this policy didn’t affect me. My wife and I are happy that two children per couple is enough, as it maintains a stable human population, and this part of the world certainly doesn’t need more people.
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