Undergoing a Vasectomy: What to Expect
Written: Mar 23 '00
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Product Rating:
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Pros: Very low complication rates, very high reliability, quick recovery, simple procedure
Cons: Permanent procedure, some men are highly disturbed by the idea of a knife near their groin
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| WorkingMomof2's Full Review: Birth Control |
The Big V
We’ve come to that point in our lives where we face the big question on children – do we want more? No, we both say, looking at our two adorable (but active) children. So we discuss the options, and with a little encouragement my husband agrees to talk to the doctor about a vasectomy.
We had looked at the options (continued birth control methods, tubal ligation, and vasectomy). Since birth control methods range greatly in reliability (which was our primary consideration, convenience was secondary), we wanted a “permanent” solution. A tubal ligation is a major surgical procedure for a woman (unless performed while the woman is undergoing another open abdominal procedure, like a c-section) and carries a host of serious health risks, we both agreed that the vasectomy was the preferred option.
I say “we” – but know that my husband was not totally thrilled with the idea of anyone going anywhere near his groin with a scalpel. Nonetheless, it only took the reminder of the alternative (unreliable birth control, since we had ruled out a tubal ligation) to convince him that this is a small price to pay. A number of friends and co-workers all telling their tales of success added to his confidence.
The Process
At least with our insurance (an HMO/PPO program), the process is this: First the husband must see his primary care physician to get referred to a specialist. He declares his intent to have a vasectomy, and talks to the doctor about the consequences.
Next we waited approximately three weeks for a referral letter to arrive. This came from the insurance company, and said that we had been approved for referral to a Urologist in the local area. It gave us all of his contact information, and carbon-copied the doctor on the letter. My husband made an appointment with the doctor, who was not able to see us for approximately four weeks.
When we went in for our initial consultation with the surgeon, we were both required to attend. This is to prevent a husband from getting a vasectomy without the clear knowledge and approval of his wife. I am sure there are some difficult situations that have arisen to require this rule; however, since we were both in agreement this was just fine. We had to sign a written document acknowledging that we knew this was a permanent procedure, with no guarantee of a successful reversal (should that ever be desirable). There is a three-day waiting period after the document is signed in case you decide to rescind your decision.
I looked my husband in the eye and said, “Well, if I were to die suddenly, after you went through an extended grieving period and then married Bambi the Playboy Bombshell, would you want to have more children?” He said “No, and her name will be have to be Crystal the Playboy Bombshell”. I elbowed him, we both giggled, and went back to listening to the doctor. The doctor told us that some couples use a sperm bank to store sperm (for approximately $100 per year) “just in case”.
There was a physical exam on my husband (not the turn-your-head-and-cough type) but one requiring disrobing and examination of his penis and testicles. Neither one of us expected this and there was great blushing by both of us. Since he has not had to undergo a gynecological exam or childbirth, though, I had only limited sympathy for him. Nonetheless, I wish we had known to expect it.
The next step is to actually have the surgery done. There is about a two-month waiting list for this, so we are booked for late spring. This gives my husband plenty of time to get ready for the “Big Day”. I really need to stop singing “With a snip-snip here, snip-snip there…” around the house (to the tune from the Wizard of Oz). Luckily my husband is a good sport and realizes my superior wittiness (or more likely, just tolerates me doing this because he really, really doesn’t want any more children).
The Surgeon’s Input
During our initial consultation, we received numerous pamphlets, handouts and advice about the upcoming procedure. It actually was really informative, and I learned a lot about the surgery. I think it also had a very calming effect on my husband – not just knowing what to expect, but the matter-of-fact manner of the doctor in discussing it. He not only discussed each step of the process, but he also talked about the risks of certain complications, and was very honest about the pain and risk involved.
My husband was quite disappointed to learn that he would not be incapacitated for the entire weekend, as I think he was looking forward to a child-free weekend of lazing around on the sofa (with his handy-dandy icepacks). The surgeon scoffed at this and said, “Oh no, you’ll want to lay down the first evening, other than that you can just take it easy for the first day or two. You can walk or do whatever you need to, just don’t over-exert yourself. Try not to lift anything too heavy, but if the baby is crying, you can pick her up.” I smirked, and my husband complained (to the doctor), “You know, you aren’t helping me here…”
Preparing for the Surgery
This is what we were told, in very clear terms to do to prepare for the surgery.
1) Avoid aspirin and ibuprofen for two weeks prior to the surgery. Tylenol is okay, but aspirin can cause blood thinning which could, in a rare case, lead to excessive bleeding or complications during surgery.
2) The day of the surgery, shower thoroughly and wash the scrotum area completely. Shaving is not required (we were both surprised to hear this).
3) Eat a light snack two to four hours before the surgery (but not less than two hours prior).
4) Bring a clean pair of tight-fitting briefs or an athletic supporter to the surgery with you.
5) If you are very nervous, the doctor can prescribe some medicine to take just prior to the surgery to help calm you. My husband declined this, but took the prescription for post-surgical pain medicine.
The Surgery Itself
The procedure lasts about 30 minutes. I have been told that the actual surgery takes less than five minutes, typically, but the process of applying the anesthetic takes a lot longer.
The surgery itself involves the surgeon numbing the scrotum and groin with anesthetic. When this is done, two very small incisions are made in the skin of the scrotum with a small scalpel. Then the vas deferens (the tubes that carry the sperm from the testes to the penis) are ligated (cut), and the ends are clipped or cauterized. The skin incisions are closed with one or two stitches.
Recovery
Assuming you did not have medication for nervousness, you can drive yourself home from the hospital. You are supposed to wear the tight briefs/supporter you brought with you to the surgery. Then you are supposed to stay off of your feet as much as possible for the first two days. You can use an ice pack or a bag of frozen vegetables (peas are supposed to be wonderful for this) to help with the pain and reduce swelling. Pain medication can help (we were given a prescription for Vicodin).
Our doctor advised that my husband avoid heavy lifting for 3 to 5 days, and said he could resume normal activities (including sex) two days post-surgery. He said many men rush back to work too early, and then have complications. His advice was to basically do what you felt you could do, but stop when you get tired or felt pain.
Sterility
A vasectomy doesn’t affect the sexual function of the penis. It simply stops the flow of sperm. After a vasectomy, the man is supposed to have sex (or ejaculations) approximately 15 times within the first 6 weeks. Then he has an examination (of a semen sample) to check for sperm. This is repeated approximately three months post-surgery also (to address the very slight risk of re-growth of the tubes). When both samples are clear (no sperm), you are officially “sterile” and can then have unprotected intercourse. Until that time, you are supposed to use alternative birth control methods.
Possible Complications
Like any surgical procedure, there are some possible risks and complications of a Vasectomy. These occur very infrequently (according to our doctor), and include internal bleeding, infection, congestion (inflammation), prolonged testicular discomfort, and spontaneous return of fertility (almost always identified through the post-surgical samples). Our surgeon told us that these complications are extremely rare, and occur in only about 2% of all patients.
He also advised that the risk of internal bleeding and infection (the most common complications) can be greatly reduced by limiting post-surgical activities, especially if you are in pain.
Conclusion
Although I joke about this at home, I am grateful that I have a husband who is willing to take an active part in our family planning. I greatly respect his willingness to undergo this surgery. I also am glad that we have both read and researched this prior to the surgery, so we are informed and prepared. This is a delicate surgery on a “delicate” area, and should not be undertaken without serious understanding of the permanence of the procedure. I hope that I have helped you understand the procedure and process a little more also, and if/when the time comes to face this, your decision will be an informed one.
Recommended:
Yes
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WorkingMomof2
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