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Vasectomy is a simple and reliable method of contraception. It is sometimes known as male sterilisation. Although a vasectomy is reversible in many cases, it is not possible in all cases. Therefore, vasectomy should be considered a permanent form of contraception. The procedure works by preventing sperm from the testes reaching the semen that is ejaculated during sex.
A vasectomy has no effect on your sex drive or ability to enjoy sex. You will still have erections and ejaculate normally. The only difference is that the semen you ejaculate will not contain sperm. The body continues to produce sperm after the procedure, but the testicles naturally reabsorb the unneeded sperm.I
n some parts of the UK vasectomy is available free under the NHS, but in others you may have to pay for it privately.
Why should it be done?
Vasectomy may be suitable when a couple have made the decision not to have children or when they dont want to have any more children. It may be chosen as a simpler and more reliable alternative to female sterilisation.
As vasectomy is normally permanent, once it has been carried out successfully and semen tests have shown there are no sperm present, long term partners may not need to use any other form of contraception.
However, a vasectomy does not protect against AIDS or sexually transmitted infection (STI). So, even after a vasectomy, you should continue to protect yourself with condoms with any new partner and an STI test is a good idea before ceasing to use condoms with an existing partner..
When should it be done?
A vasectomy should be performed when you are certain that you dont want to have any more children. If you have any doubts at all then you should consider an alternative method of contraception until you are 100% sure.
If you have a partner then you should discuss having a vasectomy with them and make sure you both agree before you proceed. Some doctors prefer both partners to agree to the procedure after information and counselling. However, it is not a legal requirement to get your partners permission for you to have a vasectomy.
A vasectomy can be performed at any stage of adult life. However, research has shown that if you are under 30 or if you do not have children already then you are more likely to regret having a vasectomy.
Why is it necessary?
Vasectomy is a permanent and reliable method of contraception that does not interfere with sex or your enjoyment of sex. However, it does not offer any protection against sexually transmitted infections.
After sterilisation has worked, you don't have to do anything about contraception ever again. Vasectomy is a completely effective form of male sterilisation. It is done as an alternative to female sterilisation when a couple wish to have no children or already have a large enough family.
How is it performed?
A vasectomy is usually performed under local anaesthetic at your GP surgery, in hospital as a day patient appointment, or at a private clinic. It is possible to have a general anaesthetic in some cases, perhaps if you are allergic to local anaesthetic or have a history of fainting easily, but this is not normally necessary. There is usually no pain involved in the procedure and often the only sensation you will feel is some pulling. The procedure lasts about 30 minutes.
A vasectomy involves blocking the vas deferens the tubes through which sperm pass into the semen. Local anaesthetic is used to numb an area of skin on either side of the scrotum and small cuts are made in this skin. A section of each vas deferens is then gently pulled out through each cut. Each tube is cut, a small section removed and the ends of the tubes sealed off. The cuts to the skin are then closed using dissolvable stitches or adhesive strips.
In recent years a second technique has begun to be used. Known as the no-scalpel technique, a tiny puncture is made in the scrotum instead of a cut. The puncture is so small that it heals quickly and doesnt require stitches. Private clinics will often offer this technique.
After a vasectomy has been performed some sperm will survive in the upper part of the vas deferens tubes. Until your semen has been confirmed free of sperm there is still a risk of pregnancy and you should continue to use another form of contraception.
At least 8 weeks after the procedure you will need to produce 2 semen tests, 3-6 weeks apart, which will be checked for sperm. These tests will also help to identify the rare cases in which the tubes naturally rejoin themselves. Once the tests have been confirmed free of sperm the vasectomy has been successful and further contraception can be stopped.
After a successful vasectomy your testicles will continue to produce male hormone (testosterone) just as before the procedure. Your sex drive, sensation, ability to have an erection and the amount of semen you ejaculate wont be affected. The only difference is that there will be no sperm in your semen. Your body still produces sperm, but they are reabsorbed harmlessly.
There are no known long-term risks from a vasectomy. Concerns about an increased risk of prostate cancer have not been proved.
Reversal of vasectomy is possible, but the procedure is frequently unsuccessful. The success of the reversal will depend upon how and when your vasectomy was performed, but the failure rate is about 50%. The procedure is also not easily available under the NHS.
You should remember that although a successful vasectomy is a completely effective method of contraception, it does not protect you against STIs. You should continue to protect yourself with condoms if you are at risk.
You will probably have a little discomfort, swelling and bruising for a few days after a vasectomy, but this normally fades quite quickly. Taking a mild painkiller, such as paracetamol or ibuprofen, and wearing tight fitting underpants day and night can ease the discomfort, although ibuprofen is not recommended if you have a history of asthma, kidney, or liver disease. If any of these symptoms continue after a few days you should consult your GP.
You should avoid sport and heavy lifting while the discomfort lasts. Most men will be fit to return to work one or two days after their vasectomy.
You can have sex again as soon as it is comfortable to do so, though it is best to wait for a couple of days. However, you are not sterile immediately after the operation as it takes time to clear the remaining sperm in the tubes. Until you have had two clear semen tests you will still have to use another method of contraception.
Problems after a vasectomy are uncommon. There is a small risk of infection of the wound and some men do experience a dull ache in the scrotum for several weeks after the procedure. Bleeding can occur inside your scrotum, causing it to swell and become painful. This is called a haematoma. Occasionally, sperm may leak into the scrotum and form a swelling (sperm granuloma), or sperm may collect at the epididymis (the coiled tube through which sperm exits your testes) and cause epididymitis. Both can inflame the vas and cause prolonged pain, but both will usually go away with rest and anti-inflammatory medicine.'
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