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What it’s really like to get a vasectomy

Adrienne Heckler, MD

A vasectomy is a minor surgical procedure that prevents men from having children in the future. It’s fairly common: About 500,000 are performed annually in the U.S. For couples who don’t want children or who are done having them, and who are okay with permanent sterilization, a vasectomy can be a good option. It is less invasive and has a lower risk of complications than the female equivalent—a tubal ligation.

Before men get a vasectomy, they come in for a consultation. During this meeting, I review their health history, discuss the procedure, and answer questions. Some men may choose to have their consult well in advance of spring so that they can go through the procedure and recuperation during March Madness—though Vancouver Clinic tends not to see an influx during the college basketball frenzy.

Next is the actual procedure, which occurs in the clinic. Men are awake but take a medication to calm down. Their partners are often in the room. It’s at this time that I hear wives remind their husbands just how many children they delivered and how easy this is in comparison!

Then it’s time to lay down on the table. There’s a little bit of tugging as I look for the vas deferens, and a pinch and burn from the needle, which is used to insert lidocaine to numb the testicle. Once everything is numb, I make a small opening in the skin and bring out the tube. From there I can use clips to clamp it off, remove a segment, tie it off, or burn the inside of it. All of these are effective methods to create sterility. It takes about 20 minutes to do both sides. Most men need about 48 hours to recover. Many find that they are sore on day three because it’s the first day they feel like being active.

Complications are rare but can include infection and pain that lasts longer than expected. In .1 percent of cases the procedure doesn’t work and men are still fertile. For this reason, it’s important for men to adhere to the follow-up advice and drop off a semen sample six weeks after the procedure to make sure no sperm are present.

Men shouldn’t notice any long-term effects or problems with sexual function afterward. Only 5 percent of ejaculate volume is sperm. The rest comes from the prostate and seminal vessels, so there is little difference in there. In fact, some couples may experience increased sexual frequency and satisfaction because they no longer have to deal with the worry of getting pregnant.

Dr. Adrienne Heckler is a urologist at Vancouver Clinic. She employs advanced microscopic and robotic skills to provide excellent care to patients. She is also an expert in urologic oncology.