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5 things i wish you knew...

5 Things I Wish You Knew About My Vasectomy

The truth about this below-the-belt procedure.

Photo credit: Courtesy of Dan Weiss
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Most guys shudder at the thought of someone coming at their guy parts with a sharp instrument. And yet, every year, more than 500,000 men across the country choose to have a very delicate and intimate procedure: a vasectomy.

A few years ago, one of those guys was me.

My dad had a vasectomy, so in the back of my mind I always knew it would be something I’d do eventually. After my wife and I had our second baby, we decided it was time. And I have to admit, I was a little nervous. I didn’t do a whole lot of research beforehand so I didn’t know what to expect. And there are a lot of misconceptions about the procedure.

So I’ll do what no one ever did for me: I’ll tell you what I wish I’d known before …

1. It’s not nearly as bad as you think

When most men think of a vasectomy, their immediate reaction may be to cover their nuts. I mean, who wants someone coming at their testicles with a scalpel? But the reality is, most doctors don’t even use a scalpel anymore. Instead, the surgeon uses a special tool to make a tiny puncture in the scrotum. “The no-scalpel vasectomy is less invasive, less painful, with less bleeding and even fewer complications than traditional vasectomy,” says Bruce R. Gilbert, MD, PhD, professor of Urology at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, and director of Reproductive and Sexual Medicine at Smith Institute for Urology.

I mean, you're sore and in some pain after the procedure. And walking is not the most comfortable. But for the most part I’d say you feel more soreness than pain. I had to ice my scrotum for the rest of the day after the procedure, and I couldn’t do heavy lifting or sports for a week. But I only needed Tylenol for the pain, and I was back to work within a few days.

2. It doesn’t take effect right away

While vasectomy is nearly 100% effective at preventing pregnancy, you can still get your partner pregnant the first few times out of the gate. A vasectomy stops the sperm’s ability to get from your testicles to your vas deferens (the tube that gets them into your ejaculate), but there’s still live sperm in the vas deferens. In other words, you can’t put any new bullets into your rifle, but the rifle was already locked and loaded and that ammunition needs to get launched so it doesn’t result in an unwanted pregnancy.

Here’s the fun part—the more you ejaculate, the quicker the chamber will empty. Most experts say that takes about 12 to 24 ejaculations. “Contraception must be used until two separate semen analyses confirm there are no sperm,” says Dr. Gilbert.

3. A vasectomy is meant to be permanent

It is true that about 3% to 6% of men opt for vasectomy reversal, in which a surgeon rewires the pathway for the sperm to get into the semen again. When microsurgery is used, a vasectomy reversal works in about 85% of men. It can take four months to a year for a woman to get pregnant after vasectomy reversal, and pregnancy will be successful in a little more than 50% of partners. 

But nobody should go into a vasectomy thinking he’s going to reverse it later. The procedure to undo it is pretty complicated and delicate compared to a vasectomy: A vasectomy takes about 15 to 20 minutes, while a reversal can take up to six hours. There are fewer doctors who do the reversal and no guarantees that it will lead to pregnancy.

And it doesn’t come cheap. While health insurance usually pays for a vasectomy, it rarely covers the reversal, which can cost up to $15,000.

It took a lot of soul-searching before my wife and I agreed that it was time for me to have the procedure. After our second child, we were done with the diapers and ready to say no more kids.

4. Sex is exactly the same (or better!)

Some guys confuse sexual function with reproductive function. They may think that after a vasectomy their testosterone levels will be lower, they won’t continue to have a strong sex drive, or they won’t be able to get or maintain an erection. I can vouch for the fact that it is all 100% untrue. Although the very first time my wife and I had intercourse after the procedure, I went a little, I’d say, slow. But since then everything has been exactly the same. Sperm is only a small part of the semen. Most of the ejaculate comes from the accessory glands, including the prostate gland and seminal vesicles, not the vas deferens. After a vasectomy, the semen looks and feels exactly the same. There’s just no sperm in it—a fact you’d only know if you looked at it under a microscope.

I’ll do you one better. Some research shows that men who aren’t worried about unwanted pregnancy actually enjoy sex more than their fertile counterparts. A 2017 German study surveyed almost 300 couples and found that men who no longer have live swimmers reported having stronger erections, better orgasms, a higher sex drive, and overall better sex than men who had not had a vasectomy. Take that, fertile guys!

5. It’s a much easier procedure than a tubal ligation

I’ve never heard anyone say they’re looking forward to their vasectomy, but it is an easier and less invasive procedure than a tubal ligation is for women. Doctors don’t use general anesthetic with vasectomy, and the puncture they make in the scrotum is so small it heals without stitches.

My wife and I discussed having her tubes tied for, say, a nanosecond. But since I’m the one who wanted this done, I needed to be the one to suck it up and go through the procedure. And I’m glad I did.

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Published July 2nd, 2019
A young woman with dark curly hair is using mobile phone. Female is smiling while holding smart phone. She is lying on sofa at home.

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