5 Things to Know Before Your Vasectomy

Think before you snip

Doctor using digital tablet with patient
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So you and your wife are thinking about a vasectomy? Or, your wife is telling you you're cut off until you get the cut? Either way, you should go into this procedure informed. Vasectomy is a surgical procedure that renders a man infertile by blocking sperm in the vas deferens. After a man ejaculates, sperm can’t come out into the semen because of the surgically induced blockage. It's a very safe procedure with a low complication rate and frees up the female partner from needing long-term birth control pills or going through a more invasive procedure to get her tubes tied.

Methods of vasectomy:

The traditional vasectomy involves either one midline or two lateral incisions about an inch or so long in the scrotum. The surgeon then brings up the vas deferens, a tube about the thickness of a piece of spaghetti, and cuts out a piece of each vas deferens.

The no-scalpel vasectomy involves a small puncture incision over each vas deferens where the surgeon accesses the vas through incisions roughly ¼ of an inch and uses special instruments to perform the procedure. The advantage of this approach is smaller incisions but no studies have shown faster recovery times or lower complication rate with this approach.

The no needle no scalpel vasectomy replaces the hypodermic injection needle with a spray anesthetic to numb the skin prior to incision. The man still feels the pressure and cooling sensation of the numbing medicine but no needle stick.

  1. Ask your doctor how many vasectomies he or she performs. The more procedures a doctor does, the better she gets at that procedure.  If you can choose, why go to someone who does 2 or 3 a year versus someone who specializes in the procedure. Most busy vasectomy doctors can perform a vasectomy in 10 to 20 minutes.
  1. Are you sure? As a specialist who has made a career out of reversing vasectomies, I stand to gain the most if men change their minds and want their vasectomies reversed. Around 50% of marriages end in divorce in the United States. Many men who remarry marry women that want to have children and therefore one can see why vasectomy reversal is a robust business. Ultimately, success rates of vasectomy reversal are high, but reversals are longer procedures that health insurance usually doesn’t cover.
  1. Take a week off from heavy activity. Although vasectomy is considered a minor procedure, major complications can happen. The most common complication after vasectomy is transient pain. The more active a man is in the first few days after vasectomy, the more likely he’s going to hurt, swell and in very rare cases, bleed and form a hematoma.
  2. Get checked. Vasectomy has a very high success rate. The chance of having sperm in the ejaculate after vasectomy is well under 1%. But if you’re in that statistic, better up your college fund contributions. At about 6 weeks after the vasectomy, return to your doctor with a semen sample so he or she can examine it under the microscope and give you the all clear for unprotected sex.
  3. Speaking of unprotected sex, vasectomy just keeps sperm from traveling into the ejaculation.  It is by no means a form of sexually transmitted infection control. The good news for men is that the sensation of ejaculation or the amount of fluid that comes out with an ejaculation won’t change after vasectomy. The majority of ejaculation fluid (semen) comes from the prostate gland and seminal vesicles which are far up stream from the vasectomy site.

    I congratulate you for making the decision to take control of your fertility and wish you the best of luck. You are joining an international fraternity of men that have done the same thing. Each year, in the late Fall, there is an event called World Vasectomy Day where internationally thousands of vasectomy providers perform many vasectomies as a show of solidarity for Men's Health. This year, it's November 18, 2016. There may be a provider in your neighborhood you can consult with.

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