What is a vasectomy?
A vasectomy is a procedure in which the ducts that carry sperm produced in the testes to the semen (vas deferens) are cut and sealed. After the ducts are sealed, sperm production in the testes continues; however, the sperm cannot reach the semen and are naturally absorbed by the body. Ejaculation therefore continues, but the semen contains no sperm.
A vasectomy is a permanent method of contraception for men. Compared with female sterilisation (tubal ligation), it is a simpler procedure that can usually be performed under local anaesthetic on an outpatient basis.
Who is it suitable for?
A vasectomy is a suitable option for men who are certain that they do not want to have children. It is usually chosen in the following situations:
- Couples who have completed their family
- When the partner cannot use hormonal contraception or an intrauterine device
- When pregnancy would pose a health risk to the partner
- Men who want a permanent method of contraception of their own
People who do not yet have children, are young, are uncertain about their relationship or made the decision during a period of crisis have a higher risk of regretting it later. For this reason, the decision should not be rushed and should, where possible, be made together with the partner.
Vasectomy and other methods of contraception
For couples, there are two main options for permanent contraception: vasectomy for the man and tubal ligation for the woman. A vasectomy is a simpler procedure, as it can usually be performed under local anaesthetic on an outpatient basis and does not involve entering the abdomen; however, protection does not start immediately and must be confirmed with a semen analysis. Tubal ligation, by contrast, is usually performed under general anaesthesia and involves entering the abdomen.
For couples who do not want a permanent method or are unsure of their decision, reversible options such as condoms, intrauterine devices and hormonal methods are available. Which method is suitable should be decided by considering the couple’s health and family planning expectations together.
Counselling before the procedure
A detailed consultation takes place before a vasectomy. It covers the fact that the procedure is permanent and does not provide immediate protection, its possible risks, reversal options and other methods of contraception. The scrotum is examined to check whether the ducts can easily be felt by hand and whether there is an accompanying condition such as a hernia, varicocele or hydrocele.
Under Turkish law, the procedure is performed with the written consent of an adult with the capacity to make decisions; for married men, the spouse’s consent is also obtained.
How is the procedure performed?
A vasectomy is usually a short outpatient procedure performed under local anaesthetic:
- The skin of the scrotum and the area around the ducts are numbed.
- The sperm duct on each side is located under the skin and brought out through a very small opening in the scrotal skin. In the no-scalpel vasectomy technique, this opening is made with a special instrument and often does not require stitches.
- A small section of the duct is removed; the ends are sealed by cauterisation, tying and/or placing tissue between them.
- The same procedure is carried out on the other side.
Patients can go home shortly after the procedure. For anxious patients or in anatomically difficult situations, sedation or general anaesthesia may also be considered.
Recovery
- Rest, supportive underwear and cold compresses are recommended for the first 24–48 hours.
- Mild pain, swelling and bruising decrease within a few days.
- Most men can return to desk work within a few days.
- Heavy lifting and strenuous sport should be avoided for about 1 week.
- Sexual intercourse can usually be resumed after a few days to 1 week, depending on comfort – but with another method of contraception.
When is it reliable?
A vasectomy does not cause immediate sterility. It takes time for sperm left in the upper part of the ducts at the time of the procedure to be cleared completely. For this reason:
- A semen analysis is performed about 3 months after the procedure and after at least 20 ejaculations.
- Another method of contraception must continue to be used until the semen analysis confirms that no sperm are present (or that the level is acceptable in the doctor’s assessment).
- If motile sperm are still seen in the semen analysis, the test is repeated; if necessary, the procedure can be repeated.
Risks
A vasectomy is generally a safe procedure, but it does carry some risks:
- Haematoma: a blood collection in the scrotum; it usually resolves on its own.
- Infection: inflammation at the wound or in the epididymis; treated with antibiotics.
- Sperm granuloma: a small, tender swelling that forms at the end of the duct.
- Long-lasting scrotal pain: may develop in a small number of patients; usually controlled with medication.
- Rejoining of the ducts: very rarely, the ducts can rejoin by themselves early or late after the procedure, and pregnancy can occur.
A vasectomy does not affect male hormone production, sexual desire, erections or orgasm. It also does not protect against sexually transmitted infections.
Is reversal possible?
A vasectomy should be planned as a permanent method. Nevertheless, for men who later wish to have children, there are two options:
- Vasovasostomy: rejoining the cut ducts using microsurgical techniques. Success cannot be guaranteed, and the likelihood of success decreases the longer it has been since the vasectomy.
- Sperm retrieval from the testis and IVF: sperm is taken from the testis with a needle or a small procedure, and pregnancy is attempted using IVF (microinjection, ICSI).
For more information, see the male infertility page.
Common misconceptions about vasectomy
- “A vasectomy affects masculinity.” Hormone production in the testes continues; sexual desire, erections and orgasm do not change.
- “There is no ejaculation after a vasectomy.” Ejaculation continues; sperm, which make up only a very small part of the semen, simply no longer mix with it.
- “You can have unprotected sex straight after the procedure.” You need to use another method of contraception until a semen analysis confirms that no sperm are present.
- “A vasectomy is a major operation.” In most patients, it is a short outpatient procedure performed under local anaesthetic.
- “It can easily be reversed if you change your mind.” Although reversal operations are possible, the result cannot be guaranteed; a vasectomy should be regarded as a permanent method.
What to consider on the day of the procedure
Before the procedure, ask your doctor whether you should stop certain medications used as blood thinners or painkillers. On the day of the procedure, it is recommended that the scrotal area is clean, that you bring supportive underwear and, if possible, that someone accompanies you home. Avoiding standing for long periods and resting on the first day after the procedure helps the swelling and pain settle more quickly.
Follow-up
If fever, increasing swelling, redness or discharge occurs in the first days after the procedure, seek advice without waiting for the check-up. The most important follow-up step is the semen analysis performed after about 3 months; do not rely on the vasectomy until the result has been assessed.
Vasectomy in Bursa, Turkey
Op. Dr. Mücahit Kabar graduated from Uludağ University Faculty of Medicine and completed his urology residency at the Urology Clinic of Ankara Training and Research Hospital. He has scientific studies in the field of andrology published in international peer-reviewed journals. In Bursa (Nilüfer), he sees men considering a vasectomy at Özel Medicabil Nilüfer Hastanesi (weekdays 08:30–12:00) and Özel Jimer Hastanesi (weekdays 13:00–17:00), providing detailed information during the decision-making process and with particular care for privacy.
Consultations are held in English or Turkish. The hospitals’ international patient departments can arrange interpreters for other languages and help with airport transfers and accommodation. If you are travelling from abroad, you can book the preliminary consultation in advance through the online booking page or appointment line of Özel Medicabil Nilüfer Hastanesi (weekdays 08:30–12:00, +90 444 8 112) or Özel Jimer Hastanesi (weekdays 13:00–17:00, +90 444 45 67). For questions before you travel, you can send a message via WhatsApp (+90 541 622 54 82). More information is available on the international patients page and the contact page.
