What is a vasectomy?
A vasectomy (male sterilisation) is a surgical procedure to cut or seal the tubes that carry a man's sperm to permanently prevent pregnancy.
It's usually carried out under local anaesthetic, where the patient is awake but does not feel any pain, and takes about 15 minutes. In rare cases general anaesthetic may be used where the patient is asleep during the operation.
There are two types of vasectomy, a vasectomy using a scalpel (surgical knife) and a no-scalpel vasectomy.
A vasectomy using a scalpel (surgical knife): With the vasectomy that uses a scalpel (known as a conventional vasectomy) the doctor first numbs the scrotum with a local anaesthetic.
They then make two small cuts in the skin on each side of the scrotum to reach the tubes that carry sperm out of the testicles (called vas deferens). Each tube is cut and a small section removed. The ends of the tubes are then closed, either by tying them or sealing them using heat. The cuts are stitched, usually using dissolvable stitches that go away on their own within about a week.
A no-scalpel vasectomy: The no-scalpel vasectomy has the doctor first numbing the scrotum with local anaesthetic. They then make a tiny puncture hole in the skin of the scrotum to reach the tubes.
This means they don't need to cut the skin with a scalpel. The tubes are then closed in the same way as a conventional vasectomy, either by being tied or sealed. There's little bleeding and no stitches with this procedure. It's thought to be less painful and less likely to cause complications.
Patient eligibility criteria
The CCG will fund vasectomy in the following circumstances:
- The patient (and where possible, the partner) has given fully informed consent for the permanent sterilisation procedure and have been informed that reversal of sterilisation is not available on the NHS and reversal of sterilisation has poor success rates, AND
- Minimally invasive vasectomy is the first choice of procedure under local anaesthetic in a commissioned community clinic setting, AND
- The patient has been fully informed of the post-operative follow-up and post procedure semen analysis.
Vasectomy will be funded in an in-patient setting under general anaesthetic ONLY in the following circumstances:
- The patient is allergic to local anaesthetic OR
- The patient is taking anticoagulants or antiplatelet medications and risk of bleeding is high OR
- The patient has anatomic abnormalities, i.e. there is an inability to palpate and mobilize both vas deferens or large hydroceles or varicoceles OR
- There is past trauma which has resulted in scarring of the scrotum.
This means (for patients who DO NOT meet the above criteria) the CCG will only fund the treatment if an Individual Funding Request (IFR) application proves exceptional clinical need and that is supported by the CCG.
Advice and guidance
- For more information, search for ‘vasectomy’ at www.nhs.uk
- Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses
- The British Association of Urological Surgeons. 2017 - vasectomy
- Family Planning Association. 2015 - male and Female Sterilisation.
Local vasectomy service
The local vasectomy service is provided by the British Pregnancy Advisory Service, BPAS Birmingham South, 162 Station Road, Kings Norton, Birmingham B30 1DB.
Treatment policy for patients covered by NHS Birmingham and Solihull CCG