{"id":4506,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/vasectomy\/"},"modified":"2026-07-24T10:57:55","modified_gmt":"2026-07-24T09:57:55","slug":"vasectomy","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/sexualreprohealth\/contraception\/vasectomy\/","title":{"rendered":"Vasectomy"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Vasectomy is a permanent method of contraception for people who are sure they do not want any more children or are certain they do not want to ever have any biological children. It is one of the most effective forms of contraception available, with an early failure rate of 1-2% and a late failure rate of 1 in 2000. It should be regarded as permanent and irreversible \u2013 neither vasectomy reversal nor post-vasectomy fertility treatments are available in NHS Lothian.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">All vasectomy referrals should be made to Lothian Sexual and Reproductive Health Service. From there, they are allocated to a telephone assessment appointment and subsequently an operation appointment. Some people will also require an additional pre-op appointment with a doctor (due to e.g. medical complexity, increased risk of regret, or for a pre-op examination).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Operations are performed primarily under local anaesthetic at the Chalmers Centre in Edinburgh or at the East Lothian Community Hospital. Occasionally, someone 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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline\">The procedure:<\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Local anaesthetic is injected under the skin on either side of the scrotum.<\/li>\n\n\n\n<li>One or two small hole(s) are made in the skin and a small portion of each vas deferens is removed.<\/li>\n\n\n\n<li>The ends of the vas are then blocked, either by passing a small electric needle down the centre of each vas or by suturing end of the vas.<\/li>\n\n\n\n<li>Sutures may be used to close the wound(s) on the skin.&nbsp; Sutures normally dissolve within one to three weeks.<\/li>\n\n\n\n<li>Pain or discomfort should be expected and regular pain killers (ibuprofen, unless contraindicated, plus paracetamol) will be required, especially for the first few days. After this they can be taken as needed.<\/li>\n\n\n\n<li>Bruising and swelling is very common and should be expected.<\/li>\n\n\n\n<li>Tight fitting underpants and\/or cycling shorts (not boxer shorts) should be worn immediately after the procedure and for the following 3 days and nights and the during the day for the next 1-2 weeks<\/li>\n\n\n\n<li>A minimum of two days complete rest should be planned.&nbsp; Icepacks or frozen peas wrapped in a pillowcase\/towel to cradle the scrotum should be used during this time.&nbsp;<\/li>\n\n\n\n<li>Physical exertion\/sports\/gym\/heavy lifting etc should be avoided for two weeks. Sex and masturbation should be avoided for 1-2 weeks. Flying should be avoided for 2 weeks.<\/li>\n\n\n\n<li>Someone must collect and drive the patient home after the procedure (or taxi). They cannot drive themselves home, walk home or use public transport.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Please see Primary Care Management for more detailed information about post-operative care and potential complications.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Post-vasectomy semen analysis is coordinated by the Chalmers Centre to confirm success of the procedure. Samples should be produced after a minimum of 16 weeks, and at least 20 ejaculations after the vasectomy, in order to clear residual sperm. The initial sample is analysed at the lab at St John\u2019s Hospital. At the time of the vasectomy, instructions are given as to how to produce the sample and how to book an appointment for analysis (online booking). Further information can be found here: <a href=\"https:\/\/policyonline.nhslothian.scot\/wp-content\/uploads\/2024\/07\/Vasectomy-samples.pdf\" data-type=\"link\" data-id=\"https:\/\/policyonline.nhslothian.scot\/wp-content\/uploads\/2024\/07\/Vasectomy-samples.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Vasectomy Samples<\/a>. Alternative contraception should continue to be used until the vasectomy has been confirmed as successful.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"text-decoration: underline\">Semen analysis results:<\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If the sample is free of sperm, an \u2018all clear\u2019 letter will be issued and alternative contraception can be stopped.<\/li>\n\n\n\n<li>If sperm are still present, further samples are needed:\n<ul class=\"wp-block-list\">\n<li>Special clearance will be issued if there are two samples with &lt;100 000 immotile sperm\/ml and no motile sperm present. Contraception can be stopped.<\/li>\n\n\n\n<li>The procedure will be deemed a failure if there are any motile sperm present &gt;28 weeks after the vasectomy<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.M &amp; K.B &#8211; 23-7-26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who can refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Self-referral: patients should be directed to call the referral telephone line on 0131 536 1512.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">or<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Clinicians can refer, using SCI Gateway.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Anyone wishing a vasectomy.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">If a patient has 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 of scrotal\/testicular surgery. Those with a BMI &gt;40 require a pre-operative examination to check that surgery is feasible.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">Vasectomy post-operative advice can be found here: <a href=\"https:\/\/policyonline.nhslothian.scot\/wp-content\/uploads\/2024\/07\/Important-advice-following-your-vasectomy.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Important-advice-following-your-vasectomy.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Patients are advised to rest for the first 24-48 hours to prevent putting pressure on the scrotum. Most people will be able to return to work 2-3 days after their vasectomy, but anyone with a manual job is advised to take 2 weeks off work and will need certification for that.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Most procedures will be completed through a single incision, with no external sutures. Occasionally, suture(s) will be required to close the wound(s). These should usually dissolve in 1-3 weeks.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><u>Following Vasectomy, patients can experience the following minor complications<\/u><\/strong>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">1.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<span style=\"text-decoration: underline\">Infection<\/span>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Around 10% of people will experience an infection at the site of incision in the first 2-3 weeks following procedure. This can be treated with standard antibiotic regimens.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">2.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<span style=\"text-decoration: underline\">Bruising\/Swelling<\/span>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bruising and swelling in the scrotum are common and can sometimes take several weeks to resolve. Regular NSAIDs, ice to the area, wearing supportive underwear and resting can help. Most swelling\/bruising is self-limiting and will resolve.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">3. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <span style=\"text-decoration: underline\">Pain<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Paracetamol and ibuprofen should be used regularly for at least the first 48\u201372 hours and then as needed. Ice packs\/frozen peas wrapped in a thin tea towel and held on the genital area can be helpful in preventing and reducing swelling and pain.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Some people will have pain that lasts for months after the operation. Using regular anti-inflammatory medication (e.g. ibuprofen) and tight, supportive underwear can help until it settles.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><u>Major Complications are rare but possible<\/u><\/strong><strong>:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">1.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<span style=\"text-decoration: underline\">Haematoma<\/span>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">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. Patients should be directed towards the emergency department if they make contact with primary care in this situation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">2.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<span style=\"text-decoration: underline\">Failure of procedure<\/span>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This can only be identified by post-vasectomy semen analysis and so all patients should be encouraged to complete this. If someone has lost their post vasectomy semen analysis pack\/instructions, they can call the vasectomy secretaries to request another one &#8211; 0131 536 1512.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In the case of a vasectomy failure, the vasectomy team will contact the patient and arrange a review to discuss the results and options \u2013 repeat procedure under local anaesthetic; repeat procedure under general anaesthetic; or use alternative contraception.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">Please direct all patients to this further information: <a href=\"https:\/\/www.lothiansexualhealth.scot\/specialist-services\/vasectomy\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.lothiansexualhealth.scot\/specialist-services\/vasectomy\/<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/policyonline.nhslothian.scot\/wp-content\/uploads\/2024\/07\/Important-advice-following-your-vasectomy.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Important-advice-following-your-vasectomy.pdf<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Vasectomy is a permanent method of contraception for people who are sure they do not want any more children or are certain they do not want to ever have any biological children. It is one of the most effective forms of contraception available, with an early failure rate of 1-2% and a late failure rate<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3820,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[633],"class_list":["post-4506","page","type-page","status-publish","hentry","category-vasectomy"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/sexualreprohealth\/contraception\/vasectomy\/\" rel=\"tag\">Vasectomy<\/a>","rttpg_excerpt":"Vasectomy is a permanent method of contraception for people who are sure they do not want any more children or are certain they do not want to ever have any biological children. It is one of the most effective forms of contraception available, with an early failure rate of 1-2% and a late failure rate","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4506","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4506"}],"version-history":[{"count":8,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4506\/revisions"}],"predecessor-version":[{"id":29127,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4506\/revisions\/29127"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3820"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4506"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4506"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}