Vasectomy

Vasectomy is a permanent method of contraception for men. The vas deferens is the tube that carries sperm from each testis up towards the prostate, and there is one on each side. Your surgeon divides both tubes, seals the cut ends, and often tucks one end behind a layer of tissue so the two cannot rejoin.

The testes carry on doing everything else. They continue to make sperm, which the body absorbs, and they continue to make testosterone, so nothing changes about hormone levels, erections, orgasm or the volume of semen you produce. Sperm makes up a very small fraction of the fluid and its absence is not noticeable.

Most vasectomies in India are done by the no-scalpel technique, where the skin is opened with a fine sharp instrument through a single small puncture in the middle of the scrotum instead of two cuts. The puncture is small enough to need no stitch. Treat this as a permanent decision. Reversal exists, it is a much bigger operation, and it does not reliably restore fertility.

This is a Day Care procedure under local anaesthetic. You are awake throughout and can eat normally beforehand. Your surgeon numbs the skin and then each tube in turn with a fine injection, which stings briefly; after that you feel pulling and pressure and no sharp pain.

The operation takes fifteen to twenty-five minutes for both sides. You lie on your back, the scrotum is cleaned and draped, and each tube is lifted to the skin in turn, divided and sealed. A brief cramping ache in the lower abdomen while a tube is handled is common and passes in seconds.

You rest for half an hour afterwards while the team checks the puncture, and then go home. Bring tight supportive underwear to wear home and for the following week. Take the rest of the day off, and arrange for somebody to drive you.

You are not sterile when you leave. Use other contraception until a semen sample confirms otherwise.

Take it easy for forty-eight hours with ice packs and supportive underwear, and expect a dull ache and some bruising of the scrotal skin for a week. Bruising can spread and darken over days and looks more dramatic than it is.

Most men return to desk work after two days and to heavy or physical work after a week. Avoid lifting, cycling and sport for a week. Keep the area dry for forty-eight hours, then shower normally.

Sexual activity is usually comfortable again after about a week. The first ejaculation may be blood-tinged and that settles.

The part of the recovery that gets forgotten is the confirmation. A semen sample is checked at around twelve weeks, or after you have ejaculated twenty or more times, and only a clear result means you can stop other contraception. Sperm stored beyond the cut ends takes months to clear, and pregnancies after vasectomy happen mostly to couples who stopped early.