Vasectomy: The Complete Guide to Male Sterilisation

A definitive, safe, and minimally invasive form of permanent contraception. I'll walk you through what vasectomy involves, what to expect, and how I look after you before, during, and after the procedure.

Quick Overview

What You Need to Know

If You Are Looking For

Definitive family planning

The Procedure

I use a modern no-scalpel access approach. This reduces tissue trauma, minimises bleeding and speeds up recovery. In around 70% of cases, I can perform the procedure through a single small access point.

What Is a Vasectomy?

A vasectomy is a straightforward surgical procedure that provides permanent contraception for men. It works by blocking the tubes (vas deferens) that carry sperm from your testicles to your semen, preventing sperm from being released during ejaculation.

Let me be very clear about what vasectomy does and doesn't affect: it does not affect testosterone production, erections, orgasm, or sexual sensation. Your testicles continue producing testosterone normally, and you'll still ejaculate – the only difference is that your semen won't contain sperm.

Understanding the Anatomy

The vas deferens are two tubes, each about 30cm long, that transport sperm from the testicles where they're produced to join the rest of the seminal fluid.

The reproductive anatomy involves several key structures:

The Testicles (Testes): These produce both sperm and testosterone. Sperm production continues after vasectomy, but the sperm are simply reabsorbed by your body – a natural process that happens safely and without any adverse effects.

The Epididymis: A coiled tube behind each testicle where sperm mature and are stored. This structure remains intact during vasectomy.

The Vas Deferens: These are the tubes I block during vasectomy. Each vas deferens runs from the epididymis up through the inguinal canal, eventually joining with the seminal vesicles to form the ejaculatory ducts.

The Seminal Vesicles and Prostate: These glands produce the fluid that makes up most of your ejaculate. They continue functioning normally after vasectomy, which is why you'll notice no difference in ejaculation volume – sperm account for only about 2-5% of ejaculate volume.

Important to Know: During vasectomy, I make a tiny opening in the scrotum to access each vas deferens, cut a small section, and seal the ends. This creates a permanent blockage whilst leaving all other structures completely intact. The no-scalpel access technique I use means this is done through an opening smaller than a traditional surgical incision, resulting in less discomfort and faster healing.

Related Information

Exploring Fertility Options?

Learn about male fertility assessment and treatment options before making your decision.

Sexual Health Concerns?

Explore our comprehensive sexual wellness hub covering ED, libido, and relationship support.

Is Vasectomy Right for You?

Vasectomy is an excellent choice for men who are certain they don't want to father children in the future. During our consultation, I'll ensure this is the right decision for you by exploring your circumstances, relationships, and long-term family planning goals.

I won't proceed if I feel you're being pressured. This needs to be your decision.

Critical Consideration: Permanence

Whilst vasectomy reversal is technically possible, success rates vary considerably and reversal is a more complex procedure with no guarantee of restoring fertility. I always counsel patients to approach vasectomy as a permanent decision. If there's any uncertainty about future fertility desires, I'll discuss alternative contraceptive options that offer more flexibility.

Who Is Vasectomy Suitable For?

Vasectomy is appropriate for men who:

- Are completely certain they don't want to father children in the future
- Have reached this decision independently, without pressure or coercion
- Understand the procedure is permanent
- Are in good general health

Who May Not Be Suitable?

Vasectomy may not be appropriate if you:

- Have any uncertainty about future fertility desires
- Are experiencing current scrotal infection or inflammation
- Have significant bleeding disorders or are taking anticoagulation medication (we assess these on a case-by-case basis)
- Are feeling pressured or coerced into the decision
- Have significant untreated anxiety about the procedure

If any of these apply, please discuss them openly during consultation. We'll explore whether vasectomy is right for you or whether alternative options might be more suitable.

Knowledge check

Quick Self-Assessment: Is Vasectomy Right for Me?

Answer honestly to help guide your thinking. This is not medical advice – we'll discuss your individual circumstances during consultation.

Who Typically Chooses Vasectomy?

Patient Profiles

Completed Families

Men who have children and are confident their family is complete. This represents the majority of patients seeking vasectomy.

Shared Responsibility

Partners who want to share contraceptive responsibility after years of their partner managing contraception, or when female contraception causes unwanted side effects.

Personal Choice

Men who have chosen not to have children and want reliable, permanent contraception that allows them to live life on their terms.

Medical Considerations

Men with genetic conditions or health concerns where pregnancy would pose risks, or who have partners for whom pregnancy would be medically inadvisable.

The Procedure: What Happens During Your Vasectomy

I perform vasectomies using the no-scalpel access technique under local anaesthetic. The entire procedure typically takes around 20 minutes, and you'll be able to go home the same day.

Step-by-Step Process

Your Clinical Pathway

1. Initial Consultation

We discuss your circumstances, medical history, and expectations. I explain the procedure in detail and answer all your questions. You'll have time to consider your decision – there's no pressure to proceed immediately.

2. Preparation

On procedure day, you'll be asked to shower and wear comfortable, supportive underwear. The scrotal area is cleaned and prepared. Local anaesthetic is administered – you'll feel a slight sting, then numbness sets in within minutes.

3. The No-Scalpel Access Technique

I locate each vas deferens through the skin and make a tiny opening (about 2-3mm) using a special instrument. In many cases, I can perform the entire procedure through a single small access point. Each vas is lifted, cut, and sealed. The no-scalpel approach means less trauma, minimal bleeding, and faster healing than traditional incision techniques.

4. Closure & Aftercare

The tiny opening often requires no stitches – it heals naturally. I'll provide you with detailed written aftercare instructions and arrange your follow-up semen analysis. You'll rest briefly before going home.

What You'll Experience During the Procedure

I believe in complete transparency about what you'll experience, so here's an honest account of the procedure from a patient's perspective:

Sensations During the Procedure

The anaesthetic injection feels like a small pinprick followed by a brief stinging sensation. This lasts only a few seconds, and within 2-3 minutes, the area becomes completely numb.

During the procedure itself, you won't feel pain due to the local anaesthetic. However, you may experience a pulling or tugging sensation as I locate and manipulate the vas deferens. Some men describe a brief feeling similar to being "flicked" in the testicle – this is normal and temporary. If you feel any sharp pain, tell me immediately so I can administer more local anaesthetic.

Anxiety management is important. Many patients feel understandably nervous, which is completely normal. I talk you through each step, and you're welcome to bring headphones to listen to music if that helps you relax.

The Environment

The procedure room is private, clean, and maintained at a comfortable temperature. You'll be lying on a procedure table with proper draping to maintain your dignity. I maintain a calm, professional atmosphere focused entirely on your comfort and safety.

My Commitment to You: I perform vasectomies regularly, and this experience means I can work efficiently whilst remaining attentive to your comfort. If at any point you need me to pause, slow down, or provide more anaesthetic, simply tell me. Your wellbeing is my priority throughout.

Why I Choose the No-Scalpel Access Technique

"No-scalpel" refers to how I access the vas (tiny puncture rather than an incision). The evidence shows this approach is associated with:

- Less bleeding and bruising:
- Tissue is gently spread rather than cut
- Lower infection rates:
- Smaller wound means reduced infection risk
- Less post-operative pain:
- Minimal tissue trauma
- Faster recovery:
- Patients typically return to activities sooner
- Often no stitches required:
- The tiny opening usually heals naturally

Overall effectiveness depends on the occlusion technique (how I seal the vas) and correct follow-up semen testing, which I'll arrange for you.

Recovery and Aftercare

Recovery from vasectomy is generally straightforward, though everyone heals at their own pace. Here's what to expect and how to optimise your recovery.

Recovery Timeline

First 48 Hours

Days 3-7

Weeks 2-4

Sexual Activity and Contraception After Vasectomy

You can resume sexual activity when you feel comfortable – typically around 7-10 days after the procedure, once any discomfort has settled.

Critical: Continue using contraception until you have written clearance from me.

I arrange your post-vasectomy semen test at 12+ weeks (and typically after around 20 ejaculations). You must keep using contraception until you have written clearance. Some labs can clear you with no sperm seen, or with a very small number of non-moving sperm — I'll explain exactly what your result means.

Whilst vasectomy is a safe procedure, like any surgery, complications can occur. I believe in complete transparency about risks, however uncommon:

Common (Occurring in a Meaningful Proportion of Cases)

- Bruising and swelling:
- Almost all patients experience some degree of this, typically resolving within 1-2 weeks
- Discomfort:
- Mild to moderate discomfort is normal for the first few days, managed with over-the-counter pain relief
- Small haematoma:
- Minor blood collections may form but usually resolve without intervention

Uncommon Complications

- Infection:
- Can occur in a small proportion of cases, treated with antibiotics
- Sperm granuloma:
- A lump formed by sperm leaking from the cut vas, usually painless but occasionally requiring treatment
- Epididymal congestion:
- A feeling of fullness or aching that may persist for weeks or months in some men, typically resolves spontaneously

Rare But Important Complications

- Chronic scrotal pain:
- Research suggests ongoing pain affects a small minority of men post-vasectomy. Most cases are mild, but in rare instances, it can be more troublesome
- Vasectomy failure:
- The vas can rarely reconnect spontaneously (recanalization), though this is uncommon. This is why post-vasectomy semen analysis is essential

When to Contact Me Urgently:

- Severe pain not controlled by regular painkillers
- Fever or feeling generally unwell
- Increasing swelling or redness
- Discharge from the wound
- Rapidly expanding haematoma

I provide you with my contact details and ensure you know how to reach me if concerns arise. My commitment to intrinsic ethics means I want to hear about any complications immediately, regardless of how minor they might seem – early intervention prevents problems from escalating.

Effectiveness and Success Rates

Vasectomy is regarded as the gold standard for definitive male contraception, with an effectiveness rate exceeding 99% once clearance is confirmed via semen analysis.

What Makes Vasectomy So Effective?

Unlike other contraceptive methods that require ongoing adherence or can fail due to user error, vasectomy provides permanent, passive protection once clearance is achieved. There's no pill to remember, no device to check, and no failure due to improper use.

The key is confirming that your semen no longer contains sperm through post-procedural semen analysis. Until then, you must continue using alternative contraception.

Understanding Failure Rates and Recanalization

Whilst vasectomy is highly effective, it's not absolutely perfect. Two types of failure can occur:

Early Failure

This occurs when sperm persist in the semen analysis performed at 12+ weeks post-procedure. This happens in a small proportion of cases and may require:

- Further semen samples to confirm persistence
- Rarely, a repeat procedure to address the technical issue

Late Failure (Recanalization)

Even more rarely, the vas deferens can spontaneously reconnect months or years after a successful vasectomy. This phenomenon, called recanalization, is uncommon but documented. This is why I recommend periodic checking if you have any concerns, especially if your partner experiences an unexpected pregnancy.

My Approach to Minimising Failure: I use meticulous surgical technique including adequate length removal and secure sealing of the vas ends. However, even with perfect technique, biology can occasionally find a way. This is why post-procedure semen analysis is mandatory, not optional.

Comparing Contraceptive Options

Understanding vasectomy's effectiveness is best done in context of alternative contraceptive methods:

Method: Vasectomy | Typical Use Effectiveness: >99% | Notes: Once clearance confirmed; permanent

Method: IUD/IUS (Female) | Typical Use Effectiveness: 99% | Notes: Long-acting, reversible; requires insertion

Method: Contraceptive Implant | Typical Use Effectiveness: 99% | Notes: Long-acting, reversible; hormonal

Method: Combined Pill | Typical Use Effectiveness: 91% | Notes: Requires daily adherence

Method: Condoms | Typical Use Effectiveness: 82% | Notes: User-dependent; provides STI protection

Method: Withdrawal | Typical Use Effectiveness: 78% | Notes: Highly user-dependent; not recommended

Source: NHS contraception effectiveness (typical vs perfect use).

Frequently Asked Questions

No. Vasectomy does not affect testosterone production, erectile function, orgasm, or sexual sensation. Your testicles continue producing testosterone normally because vasectomy only blocks sperm transport – it doesn't affect the hormonal function of the testicles or the blood supply that delivers testosterone to your body.

Research has consistently shown that men report no changes in sexual function or satisfaction after vasectomy. In fact, some men report improved sexual satisfaction due to the freedom from pregnancy concerns. Some men do experience changes in libido over time, but these are related to ageing, health status, relationship factors, or other life circumstances – not the vasectomy itself.

No noticeable difference. Sperm account for only 2-5% of ejaculate volume. The rest comes from the seminal vesicles and prostate, which continue functioning normally. Your ejaculate will look, feel, and be the same volume as before – the only difference is that it won't contain sperm, which isn't visible anyway.

Your testicles continue producing sperm after vasectomy, but the sperm are simply reabsorbed by your body. This is a completely natural and safe process – your body has been reabsorbing excess sperm throughout your adult life. The immune system recognises and processes these cells without any adverse effects.

Vasectomy reversal (vasovasostomy) is technically possible but should not be relied upon. Success rates vary depending on:

- Time since vasectomy: Success rates are higher within the first few years
- Surgical technique and surgeon expertise
- Individual factors including partner's age and fertility

Even when sperm return to the ejaculate after reversal, pregnancy isn't guaranteed. Reversal is also more complex and expensive than the original vasectomy.

My advice: Only proceed with vasectomy if you're certain about permanent contraception. If there's any doubt, consider long-acting reversible contraception instead.

Vasectomy is not immediately effective. Sperm can remain in your reproductive tract for several months after the procedure. You must continue using alternative contraception until I confirm your semen is sperm-free through analysis.

I arrange your post-vasectomy semen test at 12+ weeks (and typically after around 20 ejaculations). Some men require additional samples if sperm persist. You are considered sterile only when semen analysis shows no sperm (azoospermia) or, depending on the laboratory protocol, very rare non-motile sperm below a specified threshold. I'll explain exactly what your result means when we review it together.

This is critically important: Unintended pregnancies have occurred because couples stopped using contraception before clearance was confirmed. Please take this seriously.

No. Vasectomy provides no protection against STIs. If STI protection is needed, continue using condoms regardless of vasectomy status. This is particularly important if you're not in a mutually monogamous relationship or if either partner has potential exposure to STIs.

If you have concerns about sexual health, please see our STI screening and sexual health services.

This has been extensively researched. Current evidence does not support an association between vasectomy and increased risk of prostate cancer, testicular cancer, cardiovascular disease, or other conditions. Multiple large-scale studies and systematic reviews have found no causal relationship.

Early studies that suggested a possible link had methodological limitations and have not been supported by subsequent higher-quality research. Major medical organisations, including the American Urological Association and British Association of Urological Surgeons, agree that vasectomy does not increase disease risk.

The cost of vasectomy includes your initial consultation, the procedure itself using the no-scalpel access technique under local anaesthetic, post-operative care, and follow-up semen analysis to confirm success.

For specific pricing information and what's included in your care package, please contact us or ask during your initial consultation. I believe in complete transparency about costs before you commit to proceeding.

These concerns are understandable and worth discussing openly. Let me address the facts:

Physical masculinity: Vasectomy doesn't affect testosterone, muscle mass, body hair, voice, or any other masculine characteristics. These are all controlled by testosterone from the testicles, which continues normally after vasectomy.

Sexual function: Research consistently shows no changes in erectile function, orgasm, or sexual satisfaction. Many couples report improved intimacy due to freedom from pregnancy anxiety.

Psychological aspects: Whilst vasectomy is a physical procedure, fertility can be emotionally complex for some people. If either partner has concerns about how vasectomy might affect your relationship or self-perception, I encourage you to discuss these openly, perhaps with professional support if needed.

I welcome partners to attend consultations so we can address concerns together and ensure both parties are comfortable with the decision.

Myths vs Facts About Vasectomy

Vasectomy is surrounded by myths and misconceptions. Let me set the record straight:

✓ Fact: Vasectomy has no effect on masculinity, testosterone levels, muscle mass, body hair, voice, erectile function, or any other characteristic associated with being male. Your testicles continue producing testosterone normally. Masculinity is multifaceted and certainly not defined by fertility alone.

✓ Fact: There is no biological mechanism by which vasectomy could cause erectile dysfunction. The blood supply, nerves, and hormones necessary for erections remain completely intact. Research consistently shows no relationship between vasectomy and erectile problems. If erectile difficulties arise after vasectomy, they're coincidental or related to other factors – not caused by the procedure itself.

✓ Fact: Vasectomy is NOT immediately effective. Sperm remain in your reproductive tract for months after the procedure. You must continue using contraception until semen analysis at 12+ weeks (and typically after around 20 ejaculations) confirms you're sperm-free. Unintended pregnancies have occurred because couples incorrectly assumed immediate sterility.

✓ Fact: This is biologically impossible and frankly rather amusing. Your body has been reabsorbing excess sperm throughout your adult life – after vasectomy, this natural process simply continues. There's no pressure build-up, no explosions, no problems. The reabsorption process is safe and causes no adverse effects.

✓ Fact: Whilst reversal is technically possible, success is not guaranteed and decreases with time. Reversal is more complex and expensive than the original vasectomy, and even when sperm return to the ejaculate, pregnancy isn't assured. Always approach vasectomy as a permanent decision. If you have any doubts about future fertility, consider long-acting reversible contraception instead.

✓ Fact: There is no biological mechanism by which vasectomy could cause weight gain. Your metabolism, appetite hormones, and testosterone levels all remain normal. If weight changes occur around the time of vasectomy, they're coincidental and related to other factors like lifestyle, diet, age, or stress – not the procedure itself.

✓ Fact: Modern no-scalpel vasectomy under local anaesthetic involves minimal discomfort. You'll feel the initial anaesthetic injection (a small sting), then the area becomes numb. During the procedure, you may feel pulling or tugging sensations, but not pain. Post-operative discomfort is typically mild and well-managed with over-the-counter pain relief. Most men describe the experience as far less uncomfortable than they'd anticipated.

✓ Fact: You won't notice any difference. Sperm account for only 2-5% of ejaculate volume – the vast majority comes from the seminal vesicles and prostate, which continue functioning normally after vasectomy. The volume, appearance, and sensation of ejaculation remain unchanged.

Ready to Take Control of Your Fertility?

Book a consultation to discuss whether vasectomy is right for you. During your appointment, we'll explore your circumstances, answer all your questions, and ensure you make an informed decision about permanent contraception.

Call: 020 7123 4567

📍 GGO Med | 369 Fulham Road, London SW10 9NH
Private consultations available at times to suit you

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My Approach to Vasectomy Care

As a Consultant Urological Surgeon specialising in andrology and male reproductive health, I believe vasectomy deserves the same careful consideration and surgical excellence as any other procedure I perform.

What Sets My Practice Apart

Intrinsic Ethics Over Regulatory Minimums

I operate according to what I call "intrinsic ethics" – providing immediate transparency about complications, uncertainties, and alternative approaches regardless of whether regulations require it. If something goes wrong, you'll hear about it from me directly and immediately. This approach reflects my belief that honest, open communication builds trust and leads to better outcomes.

Technical Excellence

I use the no-scalpel access technique because evidence demonstrates it provides better outcomes – less discomfort, faster recovery, and fewer complications. My surgical approach emphasises precision and meticulous technique to minimise failure rates whilst maximising your comfort and safety.

Shared Decision-Making

Vasectomy is a significant life decision. I invest time in ensuring you understand the procedure, its permanence, alternatives, and potential complications. I welcome partners to consultations and encourage questions. My role is to provide expertise and guidance – the decision is ultimately yours, and I respect that completely.

Whole-Person Care

I recognise that men seeking vasectomy may have other urological or sexual health concerns they're hesitant to raise. My practice provides a safe, non-judgemental environment where you can discuss anything affecting your urological or sexual wellbeing. If you have concerns about erectile function, sexual health, or other issues, please mention them – we can address multiple concerns during your consultation.

Have Questions About Vasectomy?

I'm here to help you make an informed decision. Book a consultation to discuss your individual circumstances, or call my team with any immediate questions.

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References and Further Reading

Clinical Guidelines

1. British Association of Urological Surgeons (BAUS). Patient Information on Vasectomy. Available at: https://www.baus.org.uk
1. British Association of Urological Surgeons (BAUS). Post-Vasectomy Semen Analysis: Patient Information. Available at: https://www.baus.org.uk
1. Faculty of Sexual and Reproductive Healthcare (FSRH). Male and Female Sterilisation (2014, updated 2023). Clinical Effectiveness Unit.
1. NHS. Vasectomy (male sterilisation). Available at: https://www.nhs.uk/conditions/contraception/vasectomy-male-sterilisation/
1. NHS. How effective is contraception at preventing pregnancy? Available at: https://www.nhs.uk/conditions/contraception/how-effective-contraception/

Research Evidence

1. Sharlip ID, Belker AM, Honig S, et al. Vasectomy: AUA guideline. Journal of Urology. 2012;188(6 Suppl):2482-2491.
1. Cook LA, Van Vliet H, Lopez LM, et al. Vasectomy occlusion techniques for male sterilization. Cochrane Database of Systematic Reviews. 2014;(3):CD003991.
1. Barone MA, Nazerali H, Cortes M, et al. A prospective study of time and number of ejaculations to azoospermia after vasectomy by ligation and excision. Journal of Urology. 2003;170(3):892-896.
1. Leslie TA, Illing RO, Cranston DW, et al. The incidence of chronic scrotal pain after vasectomy: a prospective audit. BJU International. 2007;100(6):1330-1333.
1. Tandon S, Sabanegh E Jr. Chronic pain after vasectomy: a diagnostic and treatment dilemma. BJU International. 2008;102(2):166-169.

Safety and Long-term Health

1. Holt SK, Salinas CA, Stanford JL. Vasectomy and the risk of prostate cancer. Journal of Urology. 2008;180(6):2565-2567.
1. Siddiqui MM, Wilson KM, Epstein MM, et al. Vasectomy and risk of aggressive prostate cancer: a 24-year follow-up study. Journal of Clinical Oncology. 2014;32(27):3033-3038.
1. Schwingl PJ, Guess HA. Safety and effectiveness of vasectomy. Fertility and Sterility. 2000;73(5):923-936.

Last updated: January 2026
Author: Mr Gian Giacomo Ollandini FRCS(Urol), Consultant Urological Surgeon
Next review: January 2027

Medical Disclaimer: This information is intended for educational purposes and should not replace professional medical advice. Please book a consultation for personalised guidance about your specific circumstances. Vasectomy is a permanent procedure and requires careful consideration.