Liveblogging the Vasectomy Chronicles

Back in January several science bloggers had an exchange that degenerated into discussion of the process and aftermath of the vasectomy.

Well, as PhysioProf is wont to say, today I will sack up, literally. As part of my gift to PharmGirl for her [significant] bday next week I will undergo the knife this afternoon to render me no longer able to contribute to the gene pool. Of course, I won't be completely sperm-free until 20 to 30 post-operative ejaculations, the thought of which brings me great comfort. We have had one child and do not anticipate wanting any more - we got us a good one the first time! So, this was a long thought out decision and I had my consultation with my urologist two weeks ago - a retired Army doc, which made me a bit nervous.

Anyway, as a medical blogger, I will try to liveblog the process from my Palm Treo 700p at the Hospital-That-Tobacco-Built. While I hope it will distract me and relieve some of my anxiety, I'd like to post it on blog as a public service to other men who want to be selfish and make their wives have tubal ligation after the mother of their children suffered through birth(s). (I've blogged on PharmGirl's complicated C-section experience and having my scrotum hacked into pales in comparison to the pain she experienced.)

Because the Movable Type interface doesn't render on my Treo, I'll be posting to the ScienceBlogs backchannel discussion forums with the idea that it will be posted on-blog later - my Sb colleagues can attest to the fact that these entries were largely blogged live. Note: For those who might be offended by an all-too-personal experience about me and my anatomy, please feel free to change the channel. For those who think I am a self-effacing lunatic, you are correct.

And for PharmMom, RN, I remember those dinner discussions where you'd come home from the urology office and tell us kids about the men who'd come in for their intraurethral papaverine injections because "they must have a big weekend coming up." Surely you won't be embarrassed that your son is posting this, particularly since this is a medical public service.

2:20 check in for 2:45 appt

3:02 bp 117/67

nurse: have you shaved your scrotum?
uh, nope, no one told me to

take off clothes. nurse: no not socks, we're not operating there.

a single edged razor is brought in- doc says you should shave it dry. fucking lovely.

3:17 - taped penis to abdomen and set up surgical field. lathered down with ice-cold betadyne

doc comes in. 3 questions:
are you allergic to any meds? PCN
do you get faint giving blood or seeing blood? hell yeah
do you want a vasectomy today? Yes

3:47 procedure begins. much pulling on scrotum and squeezing to identify vas. warning the local anesthetic will sting. two injections into cutaneous tissue-slight sting. injections directly into vas felt deeper and radiated into lower abdomen but honestly not as bad as I antciapted

heard snip of 3-5 mm, pulling on innards (pressure but not pain). doc started asking about worlplace. told him about [controversial proprietary work] not being popular - he was not amsued and asks why anyone is opposed to such a thing. man has now exposed my vas deferens and is cutting it. I will not argue. smell buring flesh from cauterization. elapsed time for firs t ball: 7:48

2nd injections quick no warning. started cutting before totally numb. talked about doc being stationed in fla and colo before coming to [Hospital-That-Tobacco-Built]. total elapsed time from prep to finish: 20:48
[postscript: got confused by 7:48 above; my Polar RS200 watch reads 20:13.9]

script for tylenol #3 - pharm girl bless her soul gets it filled at hosp Rx

doc says let him know if swelling gets too bad. how big is bad? whatever worries you. uh, thanks

major vasovagal lightheadedness. ask for ice water. nurses remove surgical drape and point to an extrusion of skin I reconize as my penis, vintage age six. they ask me to remove tape mysef - thanks- hair not painful but skin on underside is screaming when tape comes off

need another glass of icewater. nurse slaps two gauze pads on either side of incision before I pull up requested tightie whities - was tlod my boxer briefs would be insufficiently antigravity.

still have to sit 10 more min with head between legs til enough blood gets to brain

arrived home 4:36 est. retrive ice gel pack from freezer. to bed. listen to npr. took t3. fearing pending hydrolysis oflidocaine. rest now. ice baby ice

It is now 7:50 pm and I have awoken from my codeine-induced sleep - no wonder Sertürner called the most prominent of these opiates "morphine" after Morpheus, the Greek god of sleep (gotta work natural products into this somewhere!). My lovely scienceblogger colleagues are asking for photographs and I have promised caliper measurements at some point. But sleeping with the icepack for 4 hr has rendered it room temp and I am now beginnng to experience significant discomfort. Will sign off for now.

But the very serious part of this post is to educate men on how mild a vasectomy is relative to tubal ligation in their female partner. As I said, this is the least I could do in return for my wife's true suffering in bringing our lovely daughter into this world.

If any male readers are considering the procedure, feel free to ask questions or express concerns.

Many thanks to my dear friends for all of the humor and best wishes.

More like this

Yes, I can attest - it was liveblogged live. I am not telling who fainted...

Congratulations - now go back to sleep!

Been there, done that.... keep a cold beer between your legs for the next couple of days...

major vasovagal lightheadedness. ask for ice water.

So that's what that feeling is when I sweat heavily and feel like I'm gonna puke and pass out. "Vasovagal lightheadedness." Man, the nurse with the iced sprite was a freaking angel.

By Craig Pennington (not verified) on 21 Feb 2008 #permalink

Congratulations. Vasectomies are totally righteous. I had mine last October. The op took about 20 minutes and was completely painless. The bruising disappeared after about a week (although it was a month before I got on a bicycle). I was also required to send in 2 samples a month apart to confirm it was successful (it was - the letter arrived 2 weeks ago). I would recommend it to anyone. Also here in the UK the operation is free of charge.

Congratulations upon your imminent sterility!

By Caledonian (not verified) on 21 Feb 2008 #permalink

I had a vasectomy 12 years ago, and you're experience is consistent with mine other than the shaving part. They must have taken care of that while I wasn't paying attention.

It's worked out just great. I can't figure out why most guys get so uptight about it.

I bet this was the first time your urologist had done surgery for an internet audience. Take it easy and enjoy the narcotics!

But the very serious part of this post is to educate men on how mild a vasectomy is relative to tubal ligation in their female partner.

A job well done Abel, well done.

Welcome to the club!
My only warning would be to remember that even after there is no pain with normal activity, a little jump of five or six inches can remind you very quickly that your giblets are still trying to heal.

Interestingly, mine was done up in my pubic area (after 3 kids). The doc reckoned it was better this way and, by the sounds of things, it was. The injection lead to the disconcerting experience of watching ones penis thrown around without being able to feel more than dull impact. Two patches of pubic hair shaved by nurse, who informed me that I was doing a public service (while moving aforementioned member around). Doc didn't make a scalpel cut, rather he tore the opening with tweezery things - because it would heal better. Cut vas deferens in two places, a good distance apart to avoid reconnection. Tape over gashes, Bob's your uncle, and drive home. Very minor pain and relatively rapid healing. Unfortunately I then missed out on all the tea and sympathy.

thanks for the account. but do you mean to tell me i only had to ejaculate 20-30 times after the procedure to flush all the lives ones out?!!?!?! they told me i had to wait 6 mos. i coulda taken care of it in an afternoon if i'd known.

i don't believe there was any shaving involved in my procedure, but the guy might have been a little new at it, his predecessor was sacked cause he was nuts. he was little testy though.

peace. -t

The worst part of my vasectomy was the sight/smell of the cauterization...but at least I was warned to shave ahead of time (my pre-op kit even contained a bottle of "anti-bacterial scrotal wash").

The best part was getting to jump the queue at the lab when dropping off samples; I got to "generate" them at home and deliver them to the lab office in time for the regular pickup.

I have wanted to get a vasectomy for years... but local anesthetics don't work very well for me (based on dental drills and one poor ENT's attempt to shrink my turbinates with an RF probe, heat sensations are not stopped AT ALL for me by any of the 'caines). Had a minor operation on my knee a few years ago... slept off 30 cc's of marcaine injected directly into bone in about 3 hours. As you can imagine, I'm terrified about the cauterization part of the vasectomy (I'm not particularly squeamish, but the thought of NO (functional) anesthetic when they go to cauterize the vas makes my skin crawl). Tried to write a doc on a website about vasectomy info ... his suggestion was to "try it and stop if it hurts." Ugh.

I'm at a loss. I don't want my wife to get a tubal ligation, but a pregnancy would be a disaster (we have no kids thanks to lupus and it would be pretty stupid to try, even if the cytoxan hadn't shut down (mostly) my wife's ovaries). I don't want to take the chance that a freak accident will leave her pregnant (her ovaries are still kinda "there"). Any suggestions?

Good for you in getting the operation done. Hope your recovery is speedy and relatively painless :)

By BlazingDragon (not verified) on 21 Feb 2008 #permalink

Wait. You got Tylenol 3 after a *vasectomy*?!? I was robbed, I tell ya, robbed!

I had mine last August. With very strict adherence to my icing schedule and wearing of compression shorts for a week, I consumed exactly one dose of OTC analgesic in the weeks after the procedure.

To quote from Roy Zimmerman's "Vasectomy", "it's about fifteen minutes of excruciating inconvenience". And I apparently had it easier than either Abel or Roy, judging from their accounts.

Guys, if you're thinking about it, do it. The procedure isn't anywhere near as bad as stressing about it. I was refereeing basketball a week and a half later, with absolutely no ill effects. Do it!

"But the very serious part of this post is to educate men on how mild a vasectomy is relative to tubal ligation in their female partner".

C'mon - when my partner had her tubal ligation, I didn't feel a thing!

But just reading "injections directly into vas felt deeper and radiated into lower abdomen" had me writhing in my chair like a beached trout.

You are a braver man than I. :)

By Gingerbaker (not verified) on 21 Feb 2008 #permalink

I had mine done two months ago and it wasn't bad. In fact, I was the urologist's first patient to watch and I even offered to "cut the cord" but he said he wouldn't be able to charge me as much. Besides having to ask for more lidocaine, it wasn't bad at all. The cautery was pretty simple. He used a tool much like a soldering pencil to cauterize the lumen of the vas so there wasn't much smoke. My wife had a bag of frozen peas for me at home and we've got 3 months before even checking for swimmers. One month to go....

Call me weird, but I didn't think having my tubes tied was any big deal. I woke up with one stitch in my belly button and was off on a week-long househunting trip 2 days later. Sore? Yeah, but nothing I couldn't handle (but I'd done 2 days of induced labor sans anesthesia - my choice - to squeeze out my son, so maybe that says something about my pain tolerance).

I wanted to be the one to get "tied and fried" anyway, because [1] my ex is Catholic and wasn't comfortable with the idea of having a vasectomy, [2] I was the one who really didn't want any more kids, and [3] his vasectomy wouldn't do a damn thing for me if I ever got raped (I have this "thing" about that - couldn't possibly have anything to do with having been "assaulted with intent" when I was 15, huh?).

BlazingDragon: I hear you about the lupus thing. My niece has lupus - fortunately it's been in remission for quite a while, and I don't think she's on a lot of meds currently - and had an early miscarriage a couple of months ago. The docs didn't know if the two were connected at all, but it was a scary experience for her and her hubby. They had decided to try to have a kid now while she's in good health, but I don't know what they're planning to do next.

Novocain is kind of "iffy" for me too, doesn't always work. I wonder, could you find a doc who'd be willing to put you out for the operation? I know there are some good short-acting general anesthetics around - they shot me full of some kind of stuff, it conged me on the head BAM!!!!!!!!, and I think I was out cold for all of 20 minutes when I had my wisdom teeth taken out (which hurt more, and longer, than when I had my tubes tied). Just a thought - can't hurt to ask.

JD: DIY surgery? =8-O That takes balls! :-\

p.s. Let's hear it for frozen peas - someone finally found a good use for them! (Unlike my mom, I've never made the mistake of confusing them with food.)

By anomalous4 (not verified) on 21 Feb 2008 #permalink

Did you consider increased risk of testicular cancer in snipped men verses tubal ligation and the woman's reduced risk for ovarian cancer?

Hope those nuts feel better today!

By Rick Schauer (not verified) on 21 Feb 2008 #permalink

Wow! If I knew what kind of traffic and comments this would draw, I'd have had it done sooner.

In all seriousness, thank you all for your kind thoughts, personal experiences, and questions. As soon as I can get some coffee, I'll try to address each of your comments. Things are going very well this morning - very, very little swelling, tender, but more itchy than painful.

Thanks also to the some 13 other bloggers who linked to this post. I hope that we've been able to use a little humor to get some men to consider having this done themselves.

More later. . . thanks, I've got some great readers!

You are a brave man..I went under the knife a few months ago.

Just wanted to share with you the wisdom of a nice bag of FROZEN PEAS, cheaper than the fancy gel pack and work pretty well.

Yeah, I had mine done a few years ago. I remember the initial consult with the doc (which was required) he said, "So IF you decide to go ahead..." He must have had a lot of guys who decided not to. And he seemed genuinely surprised to see me only a week later for the snipping.
I opted for the no-scalpel procedure, and it went very well. Slight discomfort and feeling of pressure for a while. I also got no T-3, just OTC stuff.
I too was able to fill the specimen cup at home and then take it to the clinic/lab. Let me tell you, that is a weird feeling, handing a small cup of your ejaculate to a perfect stranger.

Anyway, cheers! and good for you.

By gravitybear (not verified) on 22 Feb 2008 #permalink

I have given birth to two children and one tubal ligation. The tubal ligation hurt way 'effing more that labor and delivery. Way more. ("Some women experience slight post surgical discomfort" my ass.)

It is too bad we can't have selective pain memory. If we could bottle the pain of 9 months of morning sickness, a couple of days worth of contractions, add a dash of the severe abdominal pain that is characteristic of a tubal ligation -- there would be no need to have a vasectomy or a tubal ligation.

Because you would never want to have sex again. Ever.

The kids are cute, though.

Good for you! Thanks for sharing that. I hope you get feeling better soon.

I kinda wanted more detail as far as your thoughts and fears during the operation, but given that the whole procedure takes only about 20 minutes and that you're getting your general wang area hacked into, I can forgive you ;)

I had mine yesterday too. I think it was faster than yours and even less painful. I was told to shave the area at the front of the scrotum the night before so when I got there we were ready to go. Apart from the needle prick I didn't feel or smell a thing and it was over in about 12 minutes. I'm left with a small band-aid on my scrotum and a feeling not too dissimilar to "blue balls". I've taken Ibuprofen but I'm not sure I needed to.

I've been invited to a party tonight and I wasn't planning on going, but I don't see why not now.

"Also here in the UK the operation is free of charge."

Don't be naive, dc. Or, if you do wish to be naive don't think the rest of us are.

My vasectomy was one of the best decisions I ever made. Sure, it was uncomfortable and a little bit scary, but never having to worry about unwanted pregnancies again? Priceless. My girlfriend started to shave my scrotum and she was so nervous she forgot to take the plastic covering off the razor. Much laughter. She held my hand during the procedure, right up until she passed out on the floor. She did manage to take some photos, first, though. It's a manful thing, facing discomfort and taking responsibility. As I said, good decision. One I'm glad I'll not face again, but a good one nevertheless.

By Greg Peterson (not verified) on 22 Feb 2008 #permalink

Thanks for blogging this.

As far as deciding who gets sterilized, I, too, would worry about the consequences of rape - just over 5% of victims get pregnant; but now, in the fortunate places, there's the Morning After Pill, thank god, which prevents ovulation. And also, thank the New Democratic Part and its predecessors, we have health insurance so health care is available for all.

The requirement to shave is probably an old doctors' tale; studies have shown that shaving women's pubic area does does not decrease infections or complications in childbirth and its aftermath. However, anything that helps them to find the vas deferens is probably good.

Good luck healing. I like the cold beer treatment. And for all those who use frozen peas: frozen hash-browns are half the price.

The urologist who gave me my vasectomy was named, "Dr. Hatchett." Once I got over that, it was fine.

By fardels bear (not verified) on 22 Feb 2008 #permalink

Dude, yours sounds way worse than necessary. I went in, Dr. Snip (no joke, look him up at used a very Star-Trek like hypospray thing to inject the anestetic. One small incision and two snips and cauterization later, I was on my way home with a parting gift, a half-sized swiss army knife.

Dude, yours sounds way worse than necessary. I went in, Dr. Snip (no joke, look him up at used a very Star-Trek like hypospray thing to inject the anestetic. One small incision and two snips and cauterization later, I was on my way home with a parting gift, a half-sized swiss army knife.

I had mine done a year ago. Absolutely painless, done in under 5 minutes I'm sure. The one thing that was uncomfortable was how hot it was due to the super bright lights he use to make sure he could see properly.

I drove myself home with no discomfort.

Series of posts on the post op experience:…

Bravo! I salute you, your bravery, and your public service.

Just something I'd bring up for men who are considering a vasectomy, women do have options besides tubal ligation. There's Essure sterilization which is nonsurgical and a simple office procedure and is more effective than a tubal, and my own personal favorite is the Mirena IUD. I've had it for three years. I don't even have periods anymore which is wonderful, and it's every bit as effective as a vasectomy.

My husband was waiting for his vasectomy to be scheduled, and based on things I'd read online about possible complications, I went and got an IUD and he canceled his surgery. Most of the time things go fine, but there is that small percentage of men who end up with post vasectomy pain, and that's not something I wanted him to risk when there was something so simple that I could do instead.

You only got T3? YOU were robbed, man! My other half got a vas after managing to impregnate me four times (three of which came to fruition and are sitting in my living room right now). He got a LOT of percocet and sat stoned on the couch for 3 days with bags of frozen peas on his crotch (they take form so much better than ice packs do). His nuts swelled a little, but not an enormous amount - but man, were they ever black and blue afterwards. He doesn't like to talk about it much. Can't imagine why.

Wanna know what REALLY pissed him off? I had an emergent hystero-oophro-salpingectomy 6 weeks later. Even he admits that compared to what I went through giving birth unmedicated to babies who weighed in at 9lbs plus AND the hysterectomy, a vasectomy and it's accompanying pain was relatively trivial.

Props to you for getting it done, and bigger props to your Missus for going through all that to have your sprog.

Great! Thanks for posting.

One point, which I'm sure was mentioned to you by the doctor, but is worth repeating: vasectomies don't *always* work, so don't take it for granted that you are sterile until you get a test confirming it.

I had my vasectomy just over a year ago.
I'm expecting our second daughter to be born in about 4 months. I think we can all do the math.

Just to be clear, this isn't really a problem. After our first child was born by C-section (that required almost a month of convalescence), we had discussed having a second child, and it wasn't until my wife had an ectopic pregnancy that required emergency surgery that we decided that the risks were high enough that we'd settle for just one child. Then, after the vasectomy, we both kind of regretted not going ahead with a second child, and I never bothered getting tested. At least, not until after she got pregnant again. *Then* I got tested. As the lab put it, "Yep, they're there".

BlazingDragon - if you're still around, I'm echoing JS's recommendation on the Mirena IUD. Don't know if there's anything about lupus that would contraindicate it, but it's been awesome for me.

I'll keep my parts, thank you. And think everyone should.

I had this procedure 15 years ago - maybe they were a little slower then. I had a pretty similar prep with the needles and all - minor discomfort, smell of burning flesh etc. After about 15-20 minutes I see the doc bring his head up and I'm like, "all right, it's done" and then he says "Ok, now I'm going to do the other side" - oh crap!

But I'm glad he took his time. So far no problems and the equipment is still working great.

Hey, jc. Kept my parts just fine. Still have the lamps--just unplugged them from the sockets. And any guy who knows he doesn't want more kids and plans to be sexually active has a serious decision to make about how responsible he plans to be. This is a simple, barely uncomfortable procedure that for a lot of us, can enable our partners to go off of birth control with more substantial side effect risks. I'm not wearing condoms, and I don't expect others to take responsibility for my fertility. This was a logical choice for me--whereas what you wrote is just whimpy, selfish, and ignorant. I'm just saying.

By Greg Peterson (not verified) on 22 Feb 2008 #permalink

I thought this list should hear from someone who didn't have a great experience. It may be rare, but it happens. I had a "no-scalpel" procedure, and had pain and discomfort on and off for close to a year, despite various anti-inflammatories. The first few weeks were especially bad. I went to 2 doctors and neither seemed very interested, or at least had nothing helpful to say. All was eventually fine, but personally, I don't think I'd do it again. Recognize there are risks with every procedure.

By Ok in the end (not verified) on 22 Feb 2008 #permalink

Happy to hear it went well.

A friend I worked with had intermittent pain for weeks afterwards. A very physical job demanding a lot of odd positions, heavy lifting and stretching. He locked up once and I had to drag him out while he cupped his balls and pronounced a lot of one syllable words. We dropped by a convenience store and got a big bag of ice. He spent the remainder of the time in the office doing paperwork with a sack of ice between his legs.

We joked that if the building caught on fire we would have to roll him out chair, ice and all because walking was so slow. Doctors said he had gone back to work too soon and re-traumatized the area. According to them it wasn't serious and would go away in time. They were right, he recovered, but it took over a month.

Hopefully your recovery will be less dramatic.

Did you put a supply of your boys into a sperm bank to keep your options open down the road? You said you don't anticipate wanting any more kids but options are always good and you never know what life will send your way.

I'll keep my parts, thank you. And think everyone should.

I'm done using some of my parts and have no problem getting rid of them, as of the 28th (next week) in fact. Thanks for the very timely post!

By Mr. Flibble (not verified) on 22 Feb 2008 #permalink

but there is that small percentage of men who end up with post vasectomy pain, and that's not something I wanted him to risk when there was something so simple that I could do instead.

I love my Mirena, but after insertion I had two days of feeling like I had a butcher knife lodged in my back, another week of heavy cramping, and occasional weirdo back pain in that same spot for the whole 5 years after. I don't think that it was any less of a deal than a vasectomy, especially when the procedure has to be repeated every 5 years for the rest of my fertile life. A little post-vasectomy pain isn't that much of a risk to take, particularly when it only happens once. Not to mention the years of various other hormonal birth control screwing with my system before that. I honestly don't see how vasectomy is in any way on the same plane of difficulty as what women all routinely go through to try and prevent pregnancy.

Good for you! This is a brave and noble thing you have done. Plus I imagine it's quite convenient as well. I intend to do the same after having kid(s). Thank you for blogging it!

For those who've had a bad experience, I'm curious when you had it done and where. One of my coworkers tried to talk me out of it because his was very painful. Of course, he had his done by a generalist 15 years ago. I had mine done by a specialist one year ago. I'm just saying consider the whole picture.

WooHoo! I'll be getting mine in about six weeks. Number two was it for us, if one day we decide we want another child, we'll adopt or do foster care. I have to say that I am really looking forward to bringing spontaneity, back into the bedroom (or living room, sometimes the kitchen - alas, I imagine that elevators, libraries and parks will still be out - ahh to be late teens early twenties again).

I really appreciate what you have to say about tubals, compared to a vasectomy. I have never understood why people would actually do that to their partner. I got downright pissed at a friend who insisted that it was the women's place to deal with permanent solutions. My response was that he should really have a doctor take care of it for him, rather than his wife. Fortunately, our pastor was rather harsh with him about it too and shamed him into the vasectomy.

Impressive live blogging of the procedure BTW.

JC -

It's not a loss. As the youngest of several brothers, I have heard from most of them about their vasectomies (one ro two haven't taken the plunge yet). There is nothing to it, though one of them had an experience similar to that of Ok In The End. I am looking forward to having it done, as this will make for far more fun and spontaneity in the sex department. Dealing with spermicides and the like is just a drag. And after the nine months of sheer hell my partner just endured, there is absolutely no question about having another baby of our own (though as I mentioned, we may take in others eventually - mainly dependent on how much we screw up the boys we produced ourselves).

Probably pointless to add another comment to such a long thread, but I thought I'd put in my 2 cents as someone whose vasectomy took place 21 years ago. Son two, whose birth satisfied us that we had a good pair of children, is a senior in college. And son one is 24 and directed my attention to this blog.

The procedure is a vague and distant memory and I've totally forgotten what it feels like to wear a condom.

I have my procedure done on 2/7 and I was fully operational in time to celebrate Valentines days. The fiance was very concerned about the timing but it worked out well.

I had the no scalpel procedure done.
It was basically painless.

I did start moving around too much too soon and I did have some pain and swelling 6 and 7 days post op.

Overall I am very happy having this done - the fiance and I don't want any kids and this was the best way for us to accomplish that.

I've toyed with the idea of getting a vasectomy, but I am having a really difficult time finding online any references to what essentially are the side effects.

Any hormonal effects? change in the way the ejaculation looks or feels to my body? change in the way the produced fluid looks and feels? any risks?

Ira, the most complete yet concise answers to your questions I've found is at a site from the University of Texas Southwestern Medical Center.

My first appt with my urologist was solely a consultation to get answers to all the questions you have asked. Adverse effect frequency will vary from doc-to-doc because of slight differences in the procedure. I was told that infection or bleeding would occur in 1/100 to 1/250 cases. Swelling and discomfort are common but can be managed with icepacks, NSAIDs (like Aleve/naproxen) and a prescription for mild opiate painkillers like Tylenol #3 (300mg acetaminophen plus 30 mg codeine).

I'm doing pretty well today, 36 hr out. I was told to stay in bed for the first 24 hr and I even ventured around town for 30 min today. No lifting or sexual activity for 7-10 days.

Vasectomy is thought to be the most effective form birth control with a 1 in 2500 to 1 in 4000 failure rate that requires men to have a second procedure. Testosterone levels and sex drive should not change and sex drive may improve because of reduced fears of unwanted pregnancy. Semen composition and appearance should remain unchanged; spermatozoa comprise only about 1% of semen with the rest made up of proteins (i.e., semenogellin) to allow it to gel briefly when deposited in the vagina - it also contains basic compounds like polyamines to neutralize the slightly acidic environment of the vagina.

I write more on this later because one commenter asked about increased risk of testicular cancer. There was an initial report about 15 years ago that testicular cancer risk following vasectomy increased from 7 in 1000 to 13 in 1000. However, a subsequent study of almost 75,000 men revealed no change in testicular cancer risk. The previous results indicating an increase may have been due to increased detection since men who have vasectomies tend to pay more attention to their testicles afterward.

But my strongest advice is for you to go to your local urologist for a consultation - that in no way obligates you to the procedure and, as I noted above, I was asked one more time if I wanted to back out just before the procedure was started.

Good luck and let me know if I can be of any help.

Had mine about 7 years ago.
Was a less than fab experience, 2 emergency trips to hospital including 5 days o not knowing if i would end up singing in a much higher octave (YIKE)
10 days in hospital first time and 3 the second time 1 month later.

enough to say i was less than delighted with the process, but VERY happy with final result

Had mine in early Jan, with no complications, minor irritation for a week (more from oddness of feeling of shaved pubes than testicular issues), and totally glad that I did. (Although all I got was Celebrex and limited pity...)

My one additional bit of unexpected info: after a few weeks, I had around four ejaculates that included some blood clots. Nurse at the urologist told me this was totally normal, but people should be aware of this, especially if oral is on the horizon!

Liveblogging your vasectomy really requires some cojones, Abel Pharmboy. Not that they're hooked up to the delivery system after the surgery, but yeah...cojones, nevertheless.

Even if I had not been under general anesthesia for my own GU surgery on Friday, I would not have possessed the ovaries (huevolitas?) to liveblog the procedure. But afterwards, I visualized the surgery as having a small, shrieky, vituperative, and very hormonal Ann Coulter removed from the wall of my uterus. "Good riddance!", sez I. ;-)

It was either Ann Coulter, or that giant amoeba thing that invaded Spock's CNS in an old Star Trek episode.

Hey Pharmboy,

I found your description amusing (I'm still wiping the tears of laughter away) and enlightening. However, I'm wondering if this isn't a leeeetle TMI, i.e., I'll try to keep my eyes UP next time I see you!

Mazel tov.

Seriously, this was great, and I'll be passing it along to several folks I know.

By journonurse (not verified) on 28 Feb 2008 #permalink

Hey journonurse!

Surely you dealt with equally or more sensitive encounters with colleagues during your nursing days - or is that why you are now a journalist?!?

Indeed, this may have been TMI for people who know me in meatspace but boy did it get great exposure (see this followup post of blog links and comment threads elsewhere). This account truly cultivated discussions among men (and women) about fears and misconceptions surrounding the procedure. So, while self-effacing and revealing, I feel like we did a half-decent public service.

Well, I owe you lunch next time we meet - just no Rocky Mountain oysters, okay?

HA! I had to laugh while reading this...not because someone else's pain is funny (I mean it is written to be funny)... but because I am wondering how you guys would survive giving birth... which is you know, this plus hours and hours of labor , and then passing something the size of a bowling ball through your pelvis, with the associated tearing, stitches, sitting on ice for 2 days afterwards... and taking care of a baby every 5 minutes....

Plus, its a strange phenomenon how since I have had two children I have almost no modesty about what occurred in those delivery rooms- glad to see you don't have any either!!

Thanks for making me laugh..

As I said in my post to my wife on the birth of our daughter, we men are not man enough to be women.

I've only had one incident of noteworthy pain since the procedure, moving furniture around for our family's Easter celebration - even 4 weeks out, this wasn't quite wise.

Thanks for enjoying the post!

Try it in an operating theatre with 20 nurse recruits in attendance. The doc was a gas as he described the tools of the trade as he fished around for the tubes with his knitting needles, frying them with his soldering gun and stitching the caps on with his sewing needles. His motions were exaggerated so all could see what he was doing. Fortunately no bruising even after the jog home. okay ... that last part was an attempt at humor.

Ouch! Hope you feel better soon!

how many post snip checks for nonpatency did you do , just the one?

By cashmoney (not verified) on 11 Oct 2008 #permalink

Despite being in academic medicine, I haven't participated in any blogs dealing with science or medicine, and now here I am commenting on vasectomies! My wife and I had our third child recently, and have been considering long term contraceptive options. Because my wife is still quite young, she would have to use hormonal contraceptive methods for some 18 years or more. Although modern hormonal methods appear to be safe at all ages, I still don't want her to be using them for almost two decades. She is apprehensive about an IUD and having a foreign object inside her. If she is uncomfortable about this option, I certainly don't want to push it.

So...that leaves a vasectomy for me. I think it's a small measure of payback for her bearing the burden of contraception and childbirth in the past. I visited a young faculty member in Urology today. He explained the procedure--conscious IV sedation by Anesthesia in the OR, local anesthesia, two incisions with a scalpel, excising a large piece of each vas and closing both ends, etc. His group prefers this method over the no scalpel approach. He urged me to be sure about this decision and discuss it with my wife again.

Well, after due discussion, I'm going for it. Will make an appointment for surgery, which apparently will be in late December.

Thanks for sharing your experience, Pharmboy. I'll share my experience after getting my vasectomy!

By doubledoc (not verified) on 14 Nov 2008 #permalink

It's interesting to see how the procedure differs from one
patient/surgeon/country to another. My vasectomy (1996, done
by my local family doctor at a hearby hospital outpatient clinic
in western Canada) involved no shaving, just local anesthetic.
All I felt was the initial injection (about like any other
injection). The whole procedure took about 1/2 hour.
I think I took over-the-counter painkillers for a day or two
for the soreness, which took a couple of days to diminish to
the point where I felt ok walking around shopping, and a week
to completely disappear. I had no later side effects, in
particular no changes in sexual desire or sensations.

Overall, I rate it as sort of on a par with, or a bit less
unpleasant than, having my teeth cleaned.

cashmoney: just one time but I kept putting off my follow-up appt that was scheduled originally for 22 May. I was declared free of detectable sperm on 11 October 2008.

doubledoc: conscious IV sedation? wow! you'll have no problem at all. good luck next month and let us know how it goes - like you, it was the very least I could do in return to my wife's real suffering.

Jonathan: yes, since putting up this post I've seen a wide variety of reports on sedation vs. not, minimal pain meds to opiates, etc.

I got a 2" x 2" clear piece of tape put over the incision & stitches. Doc said the tape would come off on its own. Two weeks later and it's still there. Safe to remove it you think? I can't find any help on the subject out there...

Joe, I'm not a physician so I can't give you any advice other than call your doc or resident on-call.

For great patient information on everything from A to Z on vasectomies go to Tells you not to worry about cancer, side effects and incidence, comparisons with other permanent sterilization methods and even reversability. Check it out.

Another bad experience.

Thought I'd add my experience. I'm 25 and have 2 kids, the Urologist that performed the procedure claimed to be at around 3000 vasectomies. A coworker verified that the doctor has been doing vasectomies for at least 6 years.

Procedure left 2 ends tied and one end cauterized on each side. (Something about a bad reaction when the "live" nerve ending is cauterized.)

-3 Day.Initial consult, everything fine, no drug allergies or anything. Scheduled surgery for 3 days later. Doctor had a lisp and could be gay.

Surgery day, Doc verified identity, allergies, and intent to get snipped. Didn't shave recently, dry shave provided by doc .. no biggie. Generous amounts of cold antiseptic applied. Doc explained that the lidocaine would work for cutting and burning sensations but would not help for the pulling or tugging sensations.

Doc starts on left side, finding the tube through the skin and sqeezing it in place, this is very uncomfortable. Doc puts in 3 shots and engages in small talk. Shots are less painful then dental shots. After testing the site with what I assume is a scapel, I confirm that I can't feel the cutting and he continues. At this point I am looking at the ceiling and trying to relax. Doc grabs tube through incision. This feels like a solid flick in the nuts. He proceeds to pull enough tube out to work. Instant nausea, sweating, and lightheadedness. I explain that the pain is radiating down into my legs and up into my abdomen. Doc instructs nurse to get some cool cloths and then squirts area with lidocaine and continues. Doc puts clamp on other side of the tube and I tell him that is very painful. Nurse applies cool cloths to my face and attempts to engage me in conversation. Doc squirts more lidocaine, then pauses for a moment before resuming. I am able to think more clearly at this point and ask for some water. Doc cauterizes and finishes up left side, still very painful (think nuts being held with a pair of channel locks) but the worst was over. I continue talking as best I can, however I am not quite to complete sentences yet.

Doctor starts on right side, I do not notice anything different in method or procedure. However, when the tube is held in place there is significantly less discomfort compared to the left side. Nurse returns with a small ice cube and instructs me not to choke on it. The remainder of the procedure is completed without any significant pain. During the cleanup phase I am able to think clearly and form complete sentences and I notice the tray that all the used surgical instruments has approx 30 items of differing size shape and blood coverage. Doctor leaves for kidney cancer removal surgery.

Nurse makes sure I can stand before having me put clothes back on, hands me a prescription and a bag of ice, then escorts me to the main lobby area.

Drove to the pharmacy, walked across the icy parking lot and dropped off the prescription at the counter. At this point I am almost in tears. The pharmacist goes on about them not having extra strength and me having to chop pills in half before handing over the meds. (not sure what I was prescribed originally, but they handed me a bottle with 45 hydrocodone) Walked back, drove home and popped a couple before laying down with the bag of ice at my crotch. Additional support not needed after ice applied.

Today (5 days after surgery) I am browsing the internet wondering if the pain in my lower abdomen is going to go away...

When I had mine I didn't let the nurse stay in the room. She really wasn't necessary. Earlier when she informed me I must be shaved and told me to disrobe I told her I would do it, with some privacy.

There's really no reason why a nurse needs to be around. If she wants to gawk at men's privates she should go to a male strip club. I was never exposed in front of the nurse, I made sure of that. She was very snooty about it but I informed her that the only women that sees my privates is my wife.

So gentlemen, if you find yourself in this situation, you know now that there is no need to be exposed in front of a nurse. They want to, and try to, but if you say "NO" they'll have to comply.

Did you consider increased risk of testicular cancer in snipped men verses tubal ligation and the woman's reduced risk for ovarian cancer?

I thought I had a great pain tolerance...I suppose I do not. Five days, utterly miserable. Ice is my only friend. The surgery pain was moderate, but you will survive. I have obeyed every order the surgeon gave me and I still swell evvery night for about five hours. Ouch....

By John - Louisville (not verified) on 08 Apr 2009 #permalink

John, that is not a typical response - I'd recommend strongly that you call your doctor's office today and get checked immediately.

This blog is really very informative and helpful for men to go under this surgical procedure. For women there is a procedure which is known as tubal ligation which later can be reversed. The reversal procedure is known as Tubal reversal.

Had mine two days ago - Tuesday Sept. 8. The procedure itself was much as described in the other posts here so I won't go into it in any detail. When they pulled the vas I tensed up and pretty much stayed that way for the whole procedure. I kept waiting for the pain to get bad, but it never did. More a severe discomfort for a minute or two than anything. This morning I woke up and my balls were black and blue. Holy shit! I called the urologist's office and was told this was normal and to make sure they didn't swell a lot or feel warm to the touch. Also to call back if I have a fever. Other than that the pain hasn't been too bad. I haven't taken anything stronger than ibuprofen and I've kept "the boys" on ice as recommended.

If you're thinking about doing it I'd say go for it.

Did anyone else lose intensity or enjoyment of the Big O after having a vasectomy? I got mine 3 months ago and I am now making plans on having it reversed.