Vasectomy is a sterilisation operation i.e. it will make you unable to father further children.Whilst vasectomy can be reversed, you should consider this operation to be permanent as reversal is technically quite difficult, expensive and by no means always successful.Sperm are made in the testis and travel via muscular tubes called the vas deferens which enter the pelvis and pass behind the bladder and through the prostate gland to open just below the neck of the bladder. The vas deferens are joined by ducts from other glands, which lie behind the bladder known as the seminal vesicles. When a man ejaculates the semen produced is made up of three components. The majority of the fluid is produced by the seminal vesicles (approximately 60%) and secretions from the prostate gland (approximately 30%). The remaining 10% comprise sperm-rich fluid from the testicle delivered through the vas deferens.The operation of vasectomy involves removing approximately 1cm of the vas just above the testicle and sealing the two free ends by internal cauterisation. This prevents sperm passing beyond this point and after all the sperm stored up-stream in the vas deferens are used up, the semen will only comprise fluid from the prostate and seminal vesicles. Because the sperm make up such a small percentage of the total volume a man does not usually notice any difference to his ejaculation after a vasectomy.After a vasectomy the testicle continues to make sperm which is stored in a structure attached to the testes, the epididymis. As sperm break down and are removed new sperm are produced to replace them.I generally carry out the so-called no scalpel vasectomy avoiding the need to make incisions in the scrotum, which normally would have been closed with stitches. Occasionally where the scrotal skin is very thick or tight a traditional scalpel vasectomy will have to be carried out but this would happen only rarely.On arrival at the surgery I will carry out a minor shave. The position of the vas is then marked out on each side with a small marker pen, Emla cream applied and covered with dressing. This cream is absorbed into the skin numbing it to quite a reasonable depth. Although this takes approximately 30-40 minutes to become effective it results in virtually no sensation at all during the injection of local anaesthetic, the part of the operation most men dread the most. After the local anaesthetic is injected and the area numb the vas is manoeuvred to just under the skin and held in position by a special clamp. The vas is then delivered through a tiny spit in the skin and the 1cm segment removed. The two ends of the vas are then cauterised internally thereby sealing them off and reducing the chance of sperm leakage or rejoining. After carefully checking for any bleeding the ends of the vas are released and they drop back into the scrotum.The tiny split is to small no sutures are required and because no skin or muscle fibres were cut this will heal over very quickly and painlessly.Whilst the no scalpel vasectomy is technically a more difficult operation than the standard procedure and takes a little longer, it results in much less discomfort post-operatively. We carry out approximately ten vasectomies most weeks and thus have acquired a great deal of experience in the operation.Like any operation there are complications associated with vasectomy and it is extremely important you are aware of these and accept the possibility that they may occur in our case.In our practice, less than one in a hundred men would experience complications.Complications1. InfectionIf an infection occurs in the cut you will notice this to be red, tender and possibly swollen and you will require antibiotics. By carrying out the pre-operative instructions involving a shower as described later, the chances of infection are extremely small.2. HeamatomaHaematoma is the medical term for the collection of blood in tissue. Following the vasectomy some of the small thin walled veins around the vas may start bleeding, although every care will be taken to seal these off during the procedure. Because the area is so elastic, quite a large blood clot can build up before the bleeding stops. This will result in anything up to a large egg-like swelling above the testicle which is extremely painful if you try to work or walk around with it. If you are unfortunate enough to have a haematoma, and the chances are approximately 1% or less, you will probably require to take three or four days off work and rest up. The body will reabsorb the haematoma over a period of about a week to 10 days and you will not be left with any long-term problems.In addition bleeding can occur into the skin layers itself which will leave a black looking bruise, but this is painless and therefore of no consequence. Bleeding can also occur from the cut itself, but this simply requires a dressing and usually stops within half an hour of surgery.Fairly commonly there is some residual haematoma in t