Male Sterilisation (Vasectomy)
Information
Male Sterilisation (vasectomy) is one of the most effective forms of contraception. In NHS Lothian, all referrals are made to Chalmers Centre for Sexual and Reproductive Health. From there they are allocated to an assessment appointment (over the telephone) and then an operation appointment. Operations are performed primarily under local anaesthetic at the Chalmers Centre in Edinburgh or at the East Lothian Community Hospital. Rarely, men may require vasectomy under general anaesthetic (due to anatomy, previous operations/scarring, or patient preference) and they will be referred onwards to colleagues in Urology. Men should not be referred directly to urology, but first be assessed within the vasectomy service.
Men wishing vasectomy can self-refer and should also be encouraged to view the video and other information: https://www.lothiansexualhealth.scot/specialist-services/vasectomy/
Post-vasectomy semen analysis is coordinated by the Chalmers Centre to confirm success of the procedure – this is done by postal samples at 12- and 16-weeks following procedure. Men should be advised to ejaculate a minimum of 30 times between procedure and first sample to clear residual sperm. Around 10% of men never provide a sample.
Anyone who has defaulted, but wishes to have a post-vasectomy semen analysis can telephone Chalmers on 0131 536 1512.
Who can refer:
Any clinician, but self-referral is the preferred method: patients should be directed to call the referral telephone line on 0131 536 1512.
Who to refer:
Any man who wishes to have a vasectomy. If a patient has particularly complex medical or social needs, or requires an interpreter, please send a referral via SCI gateway (Chalmers). In all referrals, please include BMI, and any history or scrotal/testicular surgery. Those with a BMI >35 require a pre-operative examination to check that surgery is feasible.
How to refer:
Self-referral is the preferred method: patients should be directed to call the referral telephone line on 0131 536 1512. Please use SCI Gateway if the patient is not self-referring. Where that is not possible, or men wish to self-refer by post, referrals can be sent to:
Vasectomy Secretary, Chalmers Sexual Health Centre, Chalmers Hospital, 2A Chalmers Street, Edinburgh, EH3 9ES
Following Vasectomy, patients can experience the following minor complications:
1. Infection:
Around 10% of men will experience a mild, localised infection at the site of incision. Some will experience swelling/redness/tender/discharging wound in the first 2-3 weeks following procedure and can be treated with standard antibiotic regimes.
2. Bruising/Swelling:
Bruising and swelling in the scrotum are common and can sometimes take several weeks to resolve. Regular NSAIDs, ice to the area and avoiding strenuous exercise are important, but most swelling/bruising is self-limiting and will resolve.
Major Complications are rare but possible:
1. Haematoma:
A small number of men may develop haematoma following the procedure and are counselled to seek emergency department care if they experience a sudden, rapidly growing swelling in the scrotum, particularly in the first 2-3 days after vasectomy. Patients should be directed towards the emergency department if they make contact with primary care in this situation.
If they attend primary care after 72 hours of onset of swelling, please contact the Chalmers Centre Vasectomy secretary (0131 536 1512) who will alert medical staff and provide advice, as emergency drainage is unlikely to be performed at this point. Patients are given the secretary’s number in their appointment letter and can phone themselves.
2. Failure of procedure:
This is uncommon but can only be identified by post-vasectomy semen analysis and so all men should be encouraged to complete these samples. If a man presents to primary care having not provided samples, please encourage him to make contact with the vasectomy service (using the referral phoneline above).
Please direct all patients self-referring or being referred for vasectomy to the following web page to watch the information video, read the information sheets and look at the consent form:
https://www.lothiansexualhealth.scot/specialist-services/vasectomy/
