Although I spend quite a lot of my time performing microsurgical vasectomy reversals I also perform vasectomies. This is the operation to render a man infertile.
Although microsurgical vasectomy reversal has much better results than simple reversal one should still view vasectomy as a one-way process.
The operation can be performed either with local anaesthetic or general. The need for this depends on the patient. Many men are happy to undergo the procedure with local and find it entirely satisfactory, some men (including me!) would rather spend the 20 minutes that the op takes fast asleep!
I perform the procedure using a very small single incision in line with the seam of the scrotum. Although the no scalpel technique is seen widely on the internet, this process depends on tearing the tissues and I therefore feel it is better to make a single controlled 1cm cut instead. The stitches are dissolvable and the procedure, even under general anaesthetic, is a day case (you'll be going home a couple of hours after the procedure).
Although it is one of the safest forms of contraception it can fail. This can happen early after the operation and hence you will need to continue with other forms of contraception until your two semen specimens have been analysed and proven to be clear of sperm. Failure can also occur after many years (approximately 1 in 2000 couples). Usually, this becomes evident with a surprise pregnancy. This does not mean that the original operation failed but that the tubes have managed to join up again. The remaining side effect is testicular pain. About 1 in 25 men suffer long-term testicular pain that comes and goes for many years. Usually the pain can be controlled by simple pain killers such as paracetamol. The risk of this pain has to be balanced against the (potential) pain of further children!
Local anaesthetic vasectomy is often provided in a special clinic by a local GP. In order to have an general anaesthetic (i.e. be asleep for the op) you will need to have the procedure performed at a hospital. If you wish to have this done on the NHS you will need to discuss whether this is available with your GP as funding is not always available via your primary care trust.
Should you wish to have the procedure performed privately under general anaesthetic the inclusive price of the operation in the Nuffield Hospital Derby is £1273 or as a private patient at the Kings Treatment Centre £850, both prices include surgeon's and anaesthetist's fees, contacts here.
Where ever and however you have the operation it is clearly important that you give it a great deal of thought and have the opportunity to discuss it with a doctor prior to having the surgery.
Samples after vasectomy
After the operation, usually at 12 and 14 weeks you'll be provided with a (ridiculously small) pot for a sperm sample. This will need to be checked under the microscope.
Until you have received the all clear you should continue to use other forms of contraception
Modern intra-uterine devices ('the -coil') contain female hormones. These are as successful as vasectomy but have the advantage of potential reversibility. The disadvantage is that up to 10% of women suffer symptoms from the hormones such as PMT.