Category Archives: Vasectomy

Does vasectomy increase the risk of torsion of the testicle

Question by a patient: Does Vasectomy increase the risk of torsion of the testicle?

Image of testicular torsion

Dr Kittels response to the patient asking about increasing risk of testicular torsion after vasectomy.

Thank you for your feedback and your interesting question about testicular rotation, which has not been asked before, so I thought it is worth dropping you a line. I can see the logic of your argument. But while there was one study possibly confirming increased rotational mobility of the testicle after vasectomy https://pubmed.ncbi.nlm.nih.gov/19022992/ there has been so far no evidence to show increased torsion.

Torsion means that the arterial blood supply stops and the testicle gets “ischaemic” i.e. under-supplied with Oxygen.

It is even more interesting and complex than that as I sometimes see patients with extremely tortuous vas deferens in vasectomy, who must have twisted their testicles multiple times without any ill effect.

Equally some patients with previous torsion attending my vasectomy clinic have completely straigth and smooth vas deferens.

So, the answer is, despite of 12,000 vasectomies, I cannot answer your question. The body is a conundrum and for the time being and according to my current knowledge we are no closer to the understanding of what causes a torsion of the testicle.

Dr M Kittel, February 2023

Vasectomy with a Campervan

Interesting: After vasectomy some men choose to recover in their own campervan

Image of a campervan

Campervan Vasectomy

Patients choose to recover from their vasectomy in a campervan

Today we treated another patient for a vasectomy who arrived in a Campervan. Patients coming from further afield increasingly choose to recover in their own known surroundings. Of course they have everything including a kitchen, a cup of tea, ice in their campervan freezer and can step into their own home straight after the procedure.

Their are plenty of Campsites locally, beautiful countryside, great market towns and the journey to a number of good campsites is comparably short. Todays patient was the third patient choosing to stay in a campervan. Before COVID we never had any.

Patients come alone and park on the hospital car park or with their partner and choose a local campsite to spend time in the nice surroundings of East Berkshire or Buckinghamshire. Motorhomes are a perfect space for a recovery and avoid long travel after your vasectomy, so its particularly good if you come from further away. If you go for your vasectomy in a campervan dont forget to stock up with ice bags, painkillers and good food.

Young men choose vasectomy more than ever before

A new phenomenon: Young men choose vasectomy as safe form of contraception

Picture of young men

Why do young men choose vasectomy?

Introduction

In the last 2 years, certainly since COVID we have seen a sharp increase in requests of young patients under 30 for vasectomies and some as young as 18-22 years of age. 10 years ago we used to see about 1 every 3 months. Now we get 1-3 enquiries a week. Our definition of a “young” man is anyone younger than 30 without children and anyone younger than 25, who already has children. This may be arbitrary, but “feels” right for our organisation.

Reasons for early vasectomy requests in young patients

The overwhelming reason for this request is climate change and the fact the “world is so full”. There seems to be a real change in attitude to this issue in the younger generation, a change that the older generation sometimes cannot understand.

Of course we also still get the requests of patients who had their children early and don’t want anymore, but the climate change reason is getting overwhelmingly the most common issue.

Other reasons are medical conditions, like autism, the feeling of inability to look after a young child. People make those decisions a lot more readily than my generation used to.

But is it the right decision?

We know that patients that are very young have a higher statistical likelihood of regret of their decision, also young unmarried patients or patients that are not currently in a relationship or in some cases never have been in a relationship. The usual rate of regret is 2-3% and the overwhelming reason for regret is meeting a partner, who wants children and therefore a changing attitude over time. Equally, there are also increasingly ladies out there, who do not want the risk of children and cannot tolerate hormonal contraception and on many occasions couples see us together.

Most young men have thought about this for quite some time, commonly years. They often start thinking about it in puberty and it often takes patients 5-10 years until they contact us.

In summary

There is no right decision over vasectomy. While it is to be seen as permanent it can be in many cases reversed successfully. But some cannot be reversed, so sperm freezing is an option. We do perform vasectomies for young patients, but due to the higher regret rate we require young patients to think about a few questions we ask them “What if…” etc. This is part of our young patient pathway and there is a special form for young patients to complete, which does a bit of soul searching and requires a bit of reflection to answer…

Click here for further information and more organisation specific information about the TVVS pathway for young patients.