If having children, or having more children, is not in your future, a vasectomy is something to consider. Vasectomies are safe and highly effective, and can eliminate the stress or hormone struggles of traditional birth control methods.

Board certified in urology, Dr. Joe Wiser has some answers to your questions about a vasectomy.

 

Q: Should I get a vasectomy?

The most important thing a man needs to consider about a vasectomy is if it’s the right time.

A vasectomy is permanent. Many men have it in the back of their minds that they can simply have a vas- reversal or in vitro fertilization done, should they change their minds in the future. While both are options, neither are 100 percent successful. In fact, in something like a vas-reversal, if it has been more than three years since the vasectomy procedure, pregnancy rates drop to 50 percent and then further beyond that time.

If you or your family are not ready for something permanent, it’s better to do non-permanent things for now.

 

Q: How do you do a vasectomy?

The way that I like to do a vasectomy is to take a segment of the vas deferens out and then sew a piece of tissue in between. These two steps combined have a success rate of over 99.5 percent. I’ve done 700-800 vasectomy procedures and have no failures yet (knock on wood).

If the semen check is negative after about three months, then the chance of a man getting a woman pregnant goes down to 1 in 2000. In medicine, we never say never or always, but the chances are pretty low of having any residual sperm in the semen.

 

Q: What are the risks of a vasectomy?

Any procedure can cause complications. A vasectomy is a minor procedure, so we expect the same rate of complications as other minor procedures. With a vasectomy, you have a one- or two-percent risk of bleeding and infections. There is also the risk of chronic pain after a vasectomy. The main sources of chronic pain are going to be congestion of sperm, where the sperm is backed up toward the testicle; or a sperm granuloma, which is a small collection of sperm that form a small inflammatory nodule in the scrotum; or nerve impingement related to the healing process.

In total, all of these together only cause pain in about 1-2 percent of men after a vasectomy.

 

Q: How do I prepare for a vasectomy?

Before a vasectomy, we ask that you clip away all the pubic and scrotal hair, which decreases the chance of infection after a vasectomy, and makes it a little easier to do the procedure. We also recommend that men have a little bit of food in their system, which helps keeps your stomach settled and decreases the chances of passing out.

 

Q: Does it hurt?

Pain control is usually not an issue during a vasectomy. We use a lot of local anesthetics to decrease pain. We use a combination of Lidocaine and Marcaine, which combined give a quick-acting and a medium-duration anesthesia.

Anxiety, on the other hand, is often an issue. It is very common for men to be anxious before and during a vasectomy. We offer Valium or Nitrous as options to help control anxiety, and have found that about three out of four men will choose will have some kind of anxiolytic medicine.

 

Q: What should I expect after a vasectomy?

After a vasectomy it is advisable to have at least two days afterwards with very minimal activity, and about a full week without any strenuous activity or heavy lifting. You’re really not going to hurt yourself if you do those things, although you’re likely going to have a lot more swelling and prolonged discomfort if you do.

 

Q: How do I manage discomfort after?

As far as controlling discomfort afterwards, usually its all the standard conservative things. Ice, especially for the first three days or so. Anti-inflammatories, if you can take them; I recommend Ibuprofen or Naproxen for at least three days, which will help prevent the inflammation from setting in and makes the overall course of discomfort pretty short. Of course, rest is also advisable. If you do all these things, most men do pretty darn well.  If needed, Tylenol (acetaminophen), can be taken as well.

 

Q: What OTC medications do you recommend?

For pain control afterwards, Ibuprofen, Naproxen or Acetaminophen work very well and can be very helpful. Most men won’t require anything besides these, and usually will stop taking them just one or two days afterwards.

 

Q: What do I need to watch for after a vasectomy?

Things to watch for after a vasectomy are really signs of inflammation and infection. Inflammation is very common and is normal. Infection is not. Infection differs in that the redness that occurs looks like a sunburn that starts to spread. Pus would obviously be an issue.  Low grade fevers are not uncommon, but if a fever gets above 100.5 degrees Fahrenheit, we consider that more likely associated with infection. If any of these are present, please call your urologist.

 

Q: Got any other recommendations or tips? 

Remember to choose good music for your vasectomy procedure. Something that you’re not going to want to listen to a lot in the future to remind you of your procedure, but something that isn’t painful by itself.

 

Dr. Joe Wiser is a board certified urology with Tanana Valley Clinic Urology. With experience and expertise in the clinical and surgical setting, Dr. Wiser is known for being easy to talk to and making his patients feel comfortable.