FREQUENTLY ASKED QUESTIONS ABOUT VASECTOMY
Who will be in the room during my procedure?
Only the patient and male provider.
Will it decrease my sex drive?
Changes in sex drive are rare, far more rare than the changes in drive experienced by women who take contraceptive pills and shots. A study published in the Journal of Sexual Medicine in 2014 showed that the sexual drive and responses of women often improve after their partners undergo vasectomy.
Will it decrease my performance?
90% of men notice no change, but when there is a change, it is usually a positive one.
Will it decrease testosterone production?
There is no change in testosterone production
Is it reversible?
Yes, however the chances of vasectomy reversal success depend on how much time has passed between the vasectomy and the reversal.
How is vasectomy done without a scalpel?
A pointed hemostat is used to make a tiny opening into anesthetized skin of the scrotum. A ring clamp is then used initially to secure each vas tube through this opening. The pointed hemostat is then used to spread all the tissue layers surrounding the vas tube to then deliver a small loop of the vas through the opening as the ring clamp is released. The vas tubes are then divided and the upper end cauterized with a hand-held cautery unit so that it will seal closed.
How is vasectomy done without a needle?
Traditionally, a local anesthetic has been injected into the skin and alongside each vas tube using a needle. However, most people do not like needles... A MadaJet® is a spray applicator which delivers a fine stream of liquid anesthetic at a pressure great enough to penetrate the skin to a depth of about 3/16", deep enough to envelop the vas tube held beneath the skin. Each vas is positioned in turn beneath the middle of the front scrotal wall and given 2 or 3 sprays. This numbs the skin and both vas tubes adequately for 99% of men. The other 1% (usually men who have thick skin or scarring due to prior surgical procedures in the area) will require a bit more anesthetic delivered with a fine needle, usually with no pain at all because of the partial anesthesia achieved with the MadaJet.
How are the ends prevented from rejoining?
After the vas is divided, the one end is allowed to slide back down into the sheath, while the other end is held outside the sheath. A small clip (the size of a grain of rice) is then used to close the empty portion of the sheath between the 2 ends. It would be like making a lengthwise opening in a wire's insulation, reaching in and dividing the wire, lifting one cut end out through the insulation, then putting a clip on the empty portion of the insulation, thereby holding one end outside and one end inside, the insulation itself serving as a barrier between the two ends. Most clips are made of titanium, a non-magnetic metal used for many types of implanted medical devices such as dental implants, heart valves, and joint replacement.
Where does the sperm go after the vasectomy?
A man does not eliminate all of the sperm he produces throughout life. The body is able to break down and re-absorb what is not otherwise ejected. The small volume of spermatic fluid containing the sperm is thus reabsorbed after vasectomy in a process that was present before the vasectomy. The prostate continues to make semen, however, which is ejaculated in the normal fashion after vasectomy…there’s just no sperm in it anymore. You don’t notice any difference after vasectomy in this way.
How much pain or discomfort should I expect following vasectomy?
During 104 consecutive follow-up calls on the day after vasectomy, men were asked (1) if they had taken any non-prescription pain pills (Tylenol or ibuprofen), (2) how many times they had taken pain medication, and (3) whether they had taken the medication because they were uncomfortable or just as a precaution to prevent expected discomfort. (Note: All men had received a small packet of 2 Tylenol pills in their "goody bags" following their vasectomies.) Here are the results:
45% of men took no pain medication following their vasectomies, not even the Tylenol that was provided. They had so little discomfort that they saw no need to take anything.
15% of men took pain medication (the Tylenol that was provided or home supplies of ibuprofen) one time "just in case", that is, as a precaution to prevent expected discomfort, not because they needed it.
29% of men took pain medication one time for discomfort, then did not need any additional doses.
11% of men took pain medication more than one time (two or three times), though at least 4 of these 11 men said that they had taken it more to prevent expected pain than because they were actually having discomfort.
0% of these men felt that they needed something stronger than Tylenol or ibuprofen, but we are asked for a prescription medication by about 1 in 500 men.
Can I take a Sauna/bath/Jacuzzi/Whirlpool after the vasectomy?
Wait at least 5 days and until the small hole in the scrotum is completely healed. Showers are fine starting the morning after the vasectomy.
Is there anyone else in the room during the procedure?
On occasion the doctor has other physicians visiting to observe the procedure. All physicians greatly appreciate the opportunity to learn from others…but you may decline if you feel strongly otherwise. On the same note, however, no family members or partners will be allowed to attend. There is a difference between watching to learn as a physician and watching a loved one go through a surgical procedure.
Why wait 12 weeks for testing after the vasectomy?
Because the sperm live for some time in your body. We want to be sure that enough time has passed so that all the sperm ‘downstream’ have died before doing the test. If your test shows zero sperm, it won’t be an issue. However, if a second test is necessary, and we find a few dead sperm (which is not unusual) we can be sure that they are just ‘leftovers’. Doing the test earlier risks finding these ‘leftovers’ still alive and then we have to wonder if they are new (meaning a failure of vasectomy) or old.
How soon can I travel afterward?
The considerations here are two-fold. Firstly, should a problem arise, it is a good idea to be able to come back to see the doctor to check things out. Secondly, you want to avoid lifting luggage. It’s probably best to consider avoiding travel for 7-10 days after the vasectomy.
Do the clips set off airport metal detectors?
No. Clips are made of titanium and only a couple millimeters in size. They are placed in a way that you should not be able to feel them.
Do I have to wear the support 24 hours a day? To sleep?
You should wear snug fitting underwear while you are awake for the first 7 days and then anytime that you work out or exercise for the first month.
When can I pick up my kids?
No lifting for the first week.
How can a vasectomy fail if you’re cutting and burning the tubes?
The body has a remarkable ability to heal itself and, in rare cases, the tubes will ‘rejoin’ (about 1 in 2000 on average). Nothing in life is 100%. However, vasectomy has the lowest failure rate of any form of contraception. Period. Can it fail even after a clear test at 12 weeks? Yes, but this is extremely rare. You can test your semen every year, if you choose, but this is very seldom done.
What was the “older” technique and what is the advantage of “no-scalpel-no-needle”?
A scalpel, or knife, was used to cut through the skin and all the layers of tissue to get down to the vas deferens, the tube that carries the sperm. That means that we cut through blood vessels on the way down. With no-scalpel technique, we make a tiny opening and stretch it just enough to pull out the vas deferens and block it. By stretching a tiny opening, we push the blood vessels to the side instead of cutting through them. You would think that this results in less bleeding and that is precisely what it does…by about 90%. And remember that bleeding is the major painful complication of vasectomy. No-needle anesthesia (numbing) uses air pressure to push the anaesthetic solution through the skin quickly and easily. Instead of a needle, you feel a ‘pop’ like a small rubber band against the skin. Aside from the fact that “you don’t have to get a needle down there”, this method results in a more rapid (seconds) and profound (deeper) numbing. Many men feel nothing during the vasectomy, others may feel some mild pressure or pulling.
Will it hurt to pee (urinate)?
What holds the testicles if you cut the tube?
The vas deferens, the tube that carries the sperm, is only one of many structures that hold the testicles in place. There are blood vessels and other tissues that provide support and these are not disturbed. Your testicles will still be supported after the vasectomy, they won’t roll around loosely in your scrotum.
How soon will I know if there are complications?
Most complications will occur in the first week. This is the really critical period. But you don’t want to traumatize the area (like horseback riding) for the first month. Most other activities that don’t involve an impact to the scrotum are unlikely to cause problems after the first week. Rarely problems can arise after the first week.
How do I know if it’s okay to start exercising?
You’ll have to take my word for it, ease back into your exercise after one week. Of course, you’ll know if you can’t start exercising if you continue to have pain or discomfort. Otherwise, if you are feeling okay, consider that a sign that you can go ahead.
Does no sex for 7 days also mean no ejaculation at all?
Yes no ejaculation for 7 days.