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Let's talk about vasectomy...

A vasectomy is a time tested, safe, easy, and quick procedure.  It has been greatly misunderstood and we are here to tell you the facts.  Hopefully after you read this, you will be more at ease with your decision.

The testicles are charged with producing the male hormone, testosterone.  Their other function is to produce sperm cells.  These are the cells that will join with the eggs to produce a baby.

The sperm cells produced in the testicle then travel through a long tube that lands in the prostate. This long tube is called the Vas Deferens and is the target structure during a vasectomy.  Once they reach the prostate, the sperm cells sit in accessory glands called the seminal vesicles until the time of ejaculation when they are thrust to the outside.  They travel in a rich ejaculatory nutrient mix produced by the prostate which is called ejaculate or semen.  The testicles only produce the sperm cells, the ejaculatory fluid is produced by the prostate.

During a vasectomy, the only thing that happens is that the vas deferens is interrupted, disconnected, or transected so that sperm cells do not reach the prostate.  Your ejaculation remains all the same. It simply has no sperm cells in it.

 

A vasectomy WILL NOT

--reduce the ejaculation fluid

--reduce your sexual desires

--reduce or change in any way your ability to have an erection

--reduce or change in any way the experience of the orgasm

--change your testicle shape or size

--increase your chances of prostate cancer or any other disease for that matter

 

A vasectomy WILL

--make you infertile (which is the goal)

--bring peace of mind (safe family planning)

--make you a hero with your loving partner

--make you feel more responsible and accomplished

 

The definition of manhood includes many things but avoiding a vasectomy is not one of them.

 

So, what is the process?

The vasectomy can be done under general anesthesia, usually at a surgery center.  More often, it is done under local anesthesia where only the scrotal area is numbed.

Most insurances cover the procedure, but some cover it only under local.  It will be important to check with your insurance.  Usually, the doctor's office will do that.

On the day of your vasectomy, it will be better to come in with someone who will drive you home.  You should have plenty of ice packs at home which will be critical for your recovery as you will see in the next paragraphs.  Once the anesthesia is working, the procedure is simple.  A very small incision is made right over the vas deferens which is very easy for the physician to feel through the skin. Through that incision, we bring out a segment of the vas, which is transected (cut).  Each end is folded on itself after cauterizing the tip and then it is tied with a permanent suture.  The procedure is repeated on the other side. 

There has been much publicized comparing a standard vasectomy, a single incision vasectomy, and a no-scalpel vasectomy.  These are all variations on the same theme, and are mostly marketing efforts to capture larger segments of the market.  In our office we do all of them and respect the patient's preferences but in the end, there are no practical differences between them.  The procedures, results, and post-operative care are nearly identical.  After the procedure, you should have one, or at best 2 stitches on the skin incision site.  These stitches disappear on their own and do not need to be removed

The most important part of your vasectomy is the postoperative period.  After the visit, you should move on straight home to your couch and this is when the ice packs are imperative.

During the following 3 to 4 days, you will keep to a very sedentary level of activity.  No lifting, no carrying, no pushing, no sports, no running... well, you get the idea.

Take MANY opportunities during the day to apply your icepacks for generous periods of time.  Three to four days of ice pack therapy will make a huge difference.

You can start taking showers as early as the next day.  Do not scrub the area, but soap and water are fine.  What you cannot do is sit in any body of water (tub, pool, sea, jacuzzi....) for at least 10 days.  This is to protect your stitches and incision.  As your discomfort disappears, you can slowly taper up your physical activity.

Sexual activity is fine as soon as there is no discomfort But PLEASE remember, you need to continue using protection.  Whatever it was you were doing for contraception, keep on doing it.  This will be the case until 3 months after the vasectomy when a semen analysis must be completed.  Until then, the risk of persistent sperm cells is real, as well as missed vasectomies and reconnection situations that are unusual, but can happen.  Until you have a post-vasectomy semen analysis, do not have sexual activity without protection.

Hopefully this brief summary of the vasectomy facts is helpful and successful in answering most of your questions and alleviates your concerns.  Of course, when you come to the office, there will be ample time during your consultation to discuss all of this again.  You can also bring questions that perhaps you may still have.  The vasectomy is perhaps the most successful and safest of all permanent family planning methods.   We will be happy to see you in consultation.

Raul A Hernandez, MD

President Fog City Urology

Author
Raul Hernandez, MD Raul A. Hernandez, MD President, Fog City Urology - President, Golden Gate Urology

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