8 questions to ask before your vasectomy
A vasectomy is the most effective form of birth control, but many guys are a bit nervous about any procedure “down there.”
“There are men who come in to talk about the procedure because they're just thinking about it,” said Evangelos Geraniotis, MD, a urologist with offices in Hyannis, Sandwich and Nantucket. Initially, many men just want a few questions answered.
“Then they come in a year later because they're finally ready. I think coming in to talk about it is sometimes just as big of a step for a man as going through the procedure itself,” he said.
We asked Dr. Geraniotis to answer the most common questions about vasectomies.
- What is a vasectomy?
“A vasectomy is an operation that a man goes through if he wants to not have more children or if he doesn't want to have any children,” Dr. Geraniotis said.
“It involves removing a piece of the vas deferens, which is attached to each of the testicles. The purpose of the vas deferens is to transport sperm from the testicles, where it’s made, to the ejaculatory ducts where it comes out during the ejaculation process. So by interrupting the flow of sperm, we remove the part of the semen that is involved with the reproduction process.”
- How does a patient prepare for a vasectomy?
“We typically will see a patient for a pre-operative consultation to go over what exactly is involved, answer questions and go over the different risks. The procedure takes about 20 minutes. The typical arrival time is about an hour before; then the patient goes home about an hour after,” he said.
“Vasectomies can be done just with local anesthesia, but I have found that most men are anxious about the fact that the procedure is done in the scrotum, which is a sensitive part of the body. They like the idea of having some sedation to help ease the anxiety and take the stress of the procedure away.”
- Is a vasectomy painful?
“The local anesthesia stays in effect for somewhere between two and three hours, during which there is no pain. Afterwards, there is a minimum to a moderate amount of pain for the first 48 hours. After that, the pain should be pretty minimal,” he said.
“The way it’s now done is called a no-scalpel vasectomy. Instead of the incision that we used to make, we just make two very small punctures in the scrotal skin, which reduces a lot of the trauma of the procedure and makes it less uncomfortable afterwards.”
- What is the recovery like?
“We recommend taking it easy for three days, including the day of the procedure. Typically, it would be advisable for the man to stay home the day after, even though he's going to feel normal, in most cases. But it's important to not overdo it,” Dr. Geraniotis said. “Then the third day should be a very light duty day, just to minimize the swelling and discomfort. After that, he can go back to a normal routine, except for heavy lifting, straining, working out and sports, which we recommend staying away from for about a week.”
- What is the effectiveness rate of vasectomies?
“One of the advantages of the vasectomy is it’s the most effective form of birth control. Failure is about one in 2,000 men, which is better than any other form of birth control.
“It usually takes three or four months to clear the sperm out of the system. The sperm mature and are stored in the vas deferens, which is the tube that carries them. That tube is about 12 inches long, so it takes time for them to come out. I've had cases where it has taken up to six months to clear them completely. That’s why we do follow-up tests.”
- Can you reverse a vasectomy?
“Yes. Reversals are done with a microscope. It’s a two- to three-hour procedure. The success rate is very good if it’s done within the first five or six years,” he said.
- Are there any possible complications after a vasectomy?
“There is a small risk of bleeding or infection during the first 30 days. There is a small risk of chronic pain after a vasectomy where, for some reason, the area where the surgery was done becomes a sensitive spot. It’s usually men who have some underlying pain issues in that part of the body from lower back problems or other inflammatory conditions.”
- Why are vasectomies popular?
“I think vasectomies are popular because it is a straightforward procedure with minimal risks and a very high success rate. It's easier to go through a vasectomy than for a woman to have her tubes tied, which requires general anesthesia and has a higher failure rate. Also, after a vasectomy, nothing changes. The whole sexual process - hormone levels, erections and ejaculation - are completely the same,” said Dr. Geraniotis.
“I tell men: ‘You have it done, get it out of the way, and you have one less thing to think about.’”