The service is run by Dr Nick Robinson who is a full time GP at the surgery. We have performed over a thousand vasectomies at Grosvenor Medical Centre since 1995 using the no-scalpel cautery technique. We appreciate that you may well be anxious about this procedure. However, we are confident that, with the help of our nurse, we will be able to put you at ease and make the whole experience far easier than you expect.

It is very important that you read and understand this leaflet prior to your vasectomy appointment to enable us to be certain that you are in a position to give valid and informed consent. You will, of course, be able to ask any questions on the day of the procedure. It sometimes helps to make a note of anything you wish to ask to remind yourself on the day. We have left a space at the end of the leaflet for this purpose.

What is a vasectomy?
Vasectomy is a surgical procedure which seals the sperm carrying tubes, preventing sperm getting into the fluid you ejaculate. The quantity and appearance of the fluid is not affected.

Who chooses vasectomy?
Anyone who feels that his family is complete or who is certain he will never want to have children. We will consider anyone, regardless of whether you are married, or whether you are already a dad.

We will counsel you on the day of your vasectomy so that we can answer any of your questions and ensure that you are happy with your decision. Your partner is very welcome to be present for this.

If you are under 25 we will recommend that you have extra counselling before you make a final decision. Whatever your age, you should consider vasectomy to be a permanent step and you should not undergo the procedure if you have any doubts. Vasectomy is NOT the answer if you are experiencing sexual problems or difficulties in your relationship.

How effective is vasectomy?
Vasectomy is highly effective and has a lower failure rate than any other method of contraception. However, there is a small chance of both early and late failure of the operation.

Early failure: Sometimes the sperm-carrying tubes (vas deferens) re-connect very quickly. This usually happens immediately after the procedure and we detect a large number of sperm in your semen test sent by post 14 weeks after the operation. If this happens you cannot rely on your vasectomy and we will need to arrange some further semen tests. Some men have a larger store of sperm and take longer to clear. If the semen still shows a significant number of active sperm we will offer to repeat the procedure. The chance of this happening is approximately 1% (that is one in every hundred men having a vasectomy)

Late failure: In very unusual circumstances the sperm-carrying tubes reconnect some years later. You will have no way of knowing if this has happened. The chance of this happening is estimated at 1 in 2000 (out of 2000 men having had a successful vasectomy, one man can expect to become fertile again.) This figure is almost certainly exaggerated, and needs to be compared with the failure rates of the other available long-term contraception options when deciding on your vasectomy.

Vasectomy: failure rate 1 in 2000
Female sterilisation: failure rate 1 in 300
Mirena Coil (IUS): failure rate 1 in 500
Combined oral contraceptive pill: failure rate 1 in 200
Condoms: failure rate 1 in 50

Preparing for the appointment
We are located in the centre of Tunbridge Wells and offer parking at the rear of our building. You should bring your partner if possible and arrange for someone to take you home. You should plan on having 2-3 days off work after the procedure, more if you have a strenuous job. You will be advised to avoid physical exercise for 3-4 weeks and swimming for 2-3 weeks. If you have changed your mind about the procedure, or if on the day of the procedure you are running late, please let us know so that the appointments can be used efficiently. You can eat and drink normally. Please have a shower prior to the procedure. There is no need to shave your scrotum. Please come to the appointment wearing tight underpants / swimming trunks as this gives more support and enables the dressing pad to stay in position after the procedure. If you are a private client please bring payment in the form of a cheque or cash.

How is it done?
At the clinic we perform the “no-scalpel vasectomy” method under local anaesthetic. The two local anaesthetic injections (similar to the ones used by dentists) are placed just under the skin and around the vas deferens. Your testicles are not injected as some men fear! Once you are numb, a single small opening, measuring less than 1cm, is made in the top of the scrotum using a small cautery device. Through this the doctor can reach the sperm-carrying tubes (vas deferens) and seal them using the same cautery instrument. The wound closes naturally and no stitches are required. The procedure takes ten minutes on average from start to finish.

Does it hurt?
The only painful part of the procedure is the two local anaesthetics (similar to the one dentists use) which are used to numb the skin and the vas deferens. The pain from the injections is usually mild and only lasts a few seconds. Our vasectomy nurse will be with you and her “vocal local” is greatly appreciated by our clients. Most men leave the clinic smiling with relief because the procedure is less painful than they feared. The anaesthetic lasts approximately 3 hours and afterwards there is sometimes a dull ache which can be relieved by taking regular ibuprofen (e.g. Nurofen) or paracetamol. Some men use a bag of frozen peas wrapped in a towel and applied to the area which can help.

What happens after the procedure?
After the procedure, you and your partner will be taken to a quiet room where you will be offered tea/coffee and biscuits. You will then receive further information about how to look after yourself and the procedure for collecting your semen tests will be explained. The semen tests are sent by post direct to a laboratory in Stockton-on-Tees.

What are the risks?
Vasectomy is very safe and long-term effects are extremely rare. However, any surgical operation carries a small risk of complications such as pain, bleeding and infection. In the unlikely event that you develop any problems after your vasectomy you can contact our centre during normal working hours (8.30am until 6.00pm weekdays) and one of the doctors will advise you over the phone or see you at short notice in our clinic. If you have a problem out-of-hours you can contact On-Call Care (08451 552255).

Infection: Infection is very rare as we do not use any stitches, and occurs in less than 1% of cases. Most infections are mild wound infections requiring a short course of antibiotics. The signs of infection are redness, swelling, pus around the wound and you may have a fever.

Bleeding: Most men will get some mild bruising and swelling around the scrotum and base of the penis. This can be minimised by wearing tight underwear and resting as much as possible during the first 48 hours after the operation. A painless lump (pea-sized) may develop in the sperm carrying tube (vas deferens) and persist for a while. This is caused by the body’s natural healing reaction and, again, no specific treatment is usually needed. Occasionally there is bleeding from a damaged blood vessel near the vas deferens. This causes a collection of blood called a haematoma. This is the most common complication of vasectomy: approximately 1% of men (one in every 100 men having the operation) develop a haematoma. This usually occurs within the first 48 hours and hence you should do as little as possible after the operation to minimise the chances of this happening (we advise 48 hours with your feet up on the sofa if at all possible). In our experience some men develop a haematoma after a week, often having returned to work and normal activities too soon. Remember, the wound is very tiny and most of the operation took place inside where you can’t see it, so try not to assume that if the wound is healed up you are fully healed on the inside as well. If you think you have developed a haematoma you should let us know: it is painful, but not dangerous, and will gradually settle after a few weeks.

Post-vasectomy pain syndrome: A condition called “post vasectomy pain syndrome” has been reported in the medical literature. Unfortunately the evidence of the condition is based upon poor quality studies. It is thought that up to 5% of men (one in twenty) may experience a dull, intermittent aching sensation during the first six months after vasectomy. This rarely interferes with their normal activities and settles with time and some anti-inflammatory medication. Rarely, these men may require another operation, such as excision of the vas or reversal of the operation to help this pain. This is extremely rare, occurring in less then 1 in 100,000 cases.

Does vasectomy increase the risk of cancer?
There is no conclusive evidence linking vasectomy and cancer of the prostate or testicles. But we advise all men, whether or not they have had a vasectomy, to have regular health screening, including an examination of their testicles.

Is vasectomy reversible?
You should only decide to have a vasectomy as a permanent method of family planning. If you think you might change your mind then you and your partner should consider an alternative method of contraception and wait until you are 100% sure of your decision. Approximately 1% of men who have a vasectomy regret their decision at some stage, usually because of unforeseen changes to their family circumstances.

Will vasectomy affect my sex life?
Many couples find greater sexual freedom once the risk of unwanted pregnancy has been removed. Erection, orgasm and ejaculation are not affected. Sperm continue to be produced by the testicles but their passage to the penis is blocked and they are re-absorbed by the body. Vasectomy has no effect on the production of male hormones.

You can have sex again as soon as you feel comfortable. We recommend that you wait a few days to give the incision time to heal. You will need to use another method of contraception until we write to tell you that your vasectomy has been effective based upon the result of your sperm test.

Will I need to take time off work?
You will need to take the next day off work and take things easy for the next couple of days. If you have a physically demanding job you may need to take up to a week’s leave from work. Please telephone us for advice if you are concerned about your particular circumstances.

How long will I be at the clinic?
You will see a counsellor, have your vasectomy, and then be given a cup of tea. You will only be at the clinic for about 45 minutes. Your partner is welcome to attend and you can see the counsellor together if you wish. Afterwards, we recommend someone accompanies you home. It is illegal for you to drive home after the procedure and not advisable for you to travel by public transport. Reception can order you a taxi if needed.

When can I play sport again?
Physically strenuous sports such as squash, soccer or rugby should be avoided for at least four weeks. More gentle exercise such as swimming can be resumed after about two weeks. Please telephone us for advice at any time if you are unsure about certain activities.

How do I know if the vasectomy has worked?
We will ask you to supply a semen specimen 14 weeks after your vasectomy. Your sample is checked under a microscope to see if sperm are present. If there are no sperm in your sample we will send you an “all clear” letter. You can then have sex without using another method of contraception. It can take quite a number of ejaculations to clear the tubes of sperm, so we may need to ask you for more samples. We will keep you updated on what is happening, and why, at all stages.

We ask that you read and understand the information on this page prior to booking your vasectomy.

If you think that vasectomy is the right choice for you, but you have any additional questions please write them down and bring this form along to your appointment. You will have the opportunity to discuss any concerns with the doctor prior to the procedure.

If, having read our information on vasectomy, you are unsure whether vasectomy is the right choice for you please feel free to call the surgery (Dr Nick Robinson) to discuss your concerns.

Remember Before the operation

• Wear tight supportive underwear
• Buy some paracetamol and ibuprofen (Nurofen)
• Arrange for someone to drive you home

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