This information has been written to answer any questions you may have about your operation. We hope we have covered everything but if there is anything that you are unclear about or have any further questions it is very important that you speak to a member of our Urology Team before the procedure.

You will have requested through your GP a permanent method of not having any more children. This is a very personal decision and it is therefore extremely important that you are happy this it is the right way forward for you.

The most important preparation is that you have carefully considered the operation and are happy to go ahead. You should remember the following points:

• Vasectomy should be considered as an irreversible method of sterilisation
• It is not effective immediately as you need to clear the sperm stored near the base of the penis by ejaculation after your operation. We can only say that you are sterile if you have given us 2 consecutive semen samples that are clear of sperm. You must therefore continue with your usual method of contraception until given the all clear.
• Vasectomy can fail. The chance of failure is about 1 in 400 cases in the early stages and is detected by having many sperm in the semen samples given at 2 months. The chance of causing a pregnancy despite the samples being clear is about 1 in 5000.

On the morning of the operation, before you come into hospital, you should shave the top part of your scrotum with an ordinary (not electric) razor and have a bath or shower. If you hare having a local anaesthetic you needn't have anyone with you, although it is best not to drive to and from the hospital.

When you arrive at the day treatment centre you will be asked some questions about your health and have a few simple measurements taken such as your blood pressure. The doctor who will perform the operation will see you and go through your consent form again. You will also be given an explanation of the procedure and the anaesthetic.

You will then be taken to the operating theatre and asked to lie on the couch. One of the staff will sit with you and "talk you through" the operation. The surgeon and assistant will clean your scrotum and penis with a mild antiseptic and cover your legs and stomach with sterile towels. The doctor will then give the local anaesthetic. This involves an injection with a fine needle in two places each side of the scrotum.

The first place is in the skin, which stings a bit. The second place is along the upper part of the sperm tube (vas) at the top of the scrotum. This can be quite uncomfortable and is similar to the feeling you get if you knock your testicle. The discomfort rapidly disappears in a minute or so as the anaesthetic begins to work. Once the injections have been done you shouldn't feel any more pain but may feel some pulling or touching sensations.

A tiny cut is then made in the scrotal skin on each side and the sperm tubes (vas) hooked out and a segment removed from each. The ends are then tied and separated before being dropped back in. Usually just one stitch is needed in the skin to close the hole, the stitch will drop out after a week or two.

You will be shown back to the day treatment centre and asked to lie down for a while until you are sure you have recovered. You will be able to have something to drink and eat then once the staff are happy with your recovery you can get dressed and go home. You will be given a couple of pots and forms to fill in as we need you to provide 2 semen samples about 2 months after your operation.

What problems may occur?

The injection of local anaesthetic into the sperm tubes is uncomfortable for everybody. Sometimes men feel sweaty and dizzy and may even faint - if this does happen our staff are on hand to look after you until you come round and feel better.

After the operation there is sometimes some bleeding. This can make the scrotum swollen and bruised and very occasionally the wound may become infected. If your wound does become red, tender or starts to weep, get it checked by the nurse at your GP surgery as you may need to be prescribed some antibiotics. The chance of bleeding or infection is small - about 2 in 100 (2%).

Some men experience discomfort in the scrotum for longer than the usual few weeks. We don't fully understand the reasons for this however the discomfort generally settles with simple painkillers and may occasionally continue for a little longer. If the discomfort continues, see your GP for advice.

What can I do when I get home?

After the operation it is very important to lie down at home for the rest of the day until the next morning. Your scrotum will be padded to ease any discomfort on the way home; you may like to continue to wear a jockstrap for a few days to provide support. The anaesthetic will wear off after a few hours and you will probably need to take some simple painkillers such as paracetamol for a few days.

You should have a daily bath or shower and keep your scrotum clean and dry - no dressing is needed on the small wound. Your testicles will feel swollen for a couple of weeks, so they will be helped by supportive underwear. If you have a job you can go back to work when you are comfortable, usually after a day or two. Remember to use your usual method of contraception if you make love.

After two months you will need to provide the 2 semen samples as instructed and take them to the laboratory reception at the Royal Victoria Infirmary.

Is the operation always successful?

Vasectomy has the highest success rate amongst the different methods of contraception but it is not 100% failproof. Failure sometimes happens due to the sperm tubes rejoining and sperm getting through again. It is usually detected by seeing large numbers of healthy sperm in the semen samples after the operation - the risk of this happening is around 1 in 400. If this does happen the operation will need to be repeated.

There have been rare cases where men have fathered children despite having no sperm in their ejaculation. This is very rare and we don't fully understand how this happens.

More frequently we see a few dead sperm in the semen samples. We then advise couples to continue other forms of contraception and to provide more samples over a 3 to 6 month period. If dead sperm are still present after a year we will see you in clinic to explain the situation and a repeat vasectomy may be advised.

Vasectomy should have no effect on your sex life.

What are the alternatives?

The method of contraception you use is entirely up to you. Various alternatives are available including natural methods, barrier methods (condoms, caps, diaphragms) contraceptive pills and injections, or sterilisation of the man or the woman.

You and your partner should make up your minds about what is best for you after finding out all the options availble to you from your GP, Practice Nurse or family planning clinic.

How to contact us

If you have any worries about your planned vasectomy operation, ring the Day Treatment Centre where a member of nursing staff will be able to give you confidential advice or ask one of the doctors to speak to you.

Ring the Switchboard on (0191 233 6161 and ask to be put through to the Day Treatment Centre.

Finally

Vasectomy is a quick, safe and effective method of contraception, and the vast majority of men who have it are very pleased with the results. However, you must be certain that it is the right method for you.