Vasectomy

How long after the vasectomy will it take until I am sterile?

Sterility is not immediate after vasectomy. You will not be sterile for 2-3 months or until 15-20 ejaculations.

When do I bring in the first semen specimen?

2 months

When can we stop birth control?

After two negative semen specimens.

When may I shower?

The next day.

When may I swim?

You may swim when the hole has closed completely. Usually the puncture takes 5-7 days to close. Please, do not get into lake water or a hot tub bath for 10-14 days

Do I need to use an ice pack?

You may use one, but it is not mandatory.

When can I have sex?

It is best to wait 5-7 days.

When can I stop using the scrotal support?

When you are comfortable walking without a support and you have no pain.

When may I resume my usual work out at the gym?

I recommend waiting about 1 week. Then try a light workout to see how you feel the next day. You can then slowly work your way back into a full routine over 1 week.

Will I need pain medication?

I usually give you 10 tablets of Hydrocodone 5/325mg. Most people are fine on only Tylenol or Ibuprofen.

When may I return to work?

You may return to work in 1-2 days for deskwork and in 4-5 days for more strenuous jobs.

How old can the semen specimen be? Is this the same as a 20-minute old infertility specimen?

No. It is not the same as an infertility specimen. It may be up to 4 hours old.

What do I put my specimen in?

You should have been given a specimen cup at the time of your postoperative visit. If you do not have a cup, any clean, disposable container will do. Some men even use a Ziploc bag.

Where is the procedure to take place?

The procedure is preformed in the office, not in the hospital.

Why the office and not the hospital?

The office avoids the expense of the hospital as well as exposure to its antibiotic resistant bacteria.

Who performs vasectomies?

About 75% of the vasectomies are done by urologists while the remainder is done by general surgeons and family practice doctors.

How common is vasectomy?

The USA has about 500,000 vasectomies per year. It is the fourth most common form of birth control after condoms, oral contraceptives, and tubal ligation.

Why vasectomy and not tubal ligation?

Vasectomy is minimally invasive, out patient, less risk, and less expensive with a quicker recovery.

Is a vasectomy covered by insurance?

Most insurance covers vasectomy. We will call your insurance company and check for you. Some people only pay an office’s co-pay while other insurance considers it a procedure applied against your surgical deductible.

What about Essure versus vasectomy?

Essure is a procedure done through the cervix and then evaluated again for success a second time through the cervix. Conformation of vasectomy success only requires a semen analysis.

May I store some of my sperm, in the sperm bank, before the vasectomy?

Yes you may. However, if you are that unsure about the vasectomy, you may want to wait before scheduling your vasectomy. Cryo-preservation costs about $50 -60 per month or about $600 to $720 per year.

How long does the procedure take?

Usually the total office visit is about 1hour; the actual procedure takes about 15-20 minutes.

Will I be put to sleep?

No, you will not. Almost all vasectomies are done in the office or clinic setting under local injection using a small needle. Oral sedation can be arranged upon request prior to your procedure but is rarely needed or requested.

Do I need to stop my baby Aspirin?

It is advised that you stop taking all forms of anticoagulation medication (Aspirin, Motrin, Ibuprofen Aleve, Naproxen, Coumadin, Warfarin, Plavix, and Clopidogrel) before having the procedure so as to lessen the chance of bleeding and bruising. Please discuss this at the time of your pre-op evaluation.

Why do I have to have a pre-op evaluation if I have already decided that vasectomy is right for me?

A full history and exam will be carried out to assess you for risk factors or physical findings that may complicate your vasectomy.

Do I need my wife’s permission for a vasectomy?

No, you do not, but it is recommended that it be a mutual decision.

Do I need to shave before the procedure?

No, you do not need to shave. I prefer to shave the site at the time of surgery. Shave bumps are Staph infections of the skin and may increase the risk of infection.

Do I need an ice pack or bag of frozen peas after the procedure?

No. Ice is optional and is left to your personal preference.

When do the stitches need to be removed?

In most cases, there are no skin sutures to be removed. If a skin closure suture is required, it will dissolve within 5-7 days.

Do I need a jock strap?

You need some kind of support, but it may be tight, white underwear, bicycle shorts, or a jockey strap, whichever is more comfortable for you. You do need to bring it with you on the day of the procedure. You will need it to wear home.

Will a vasectomy affect my erection?

No changes in erection will be noted.

Will I still produce fluid at ejaculation, or will it be dry?

Semen is made up of sperm from the testicle as well as fluid from the prostate and seminal vesicles. Only 5-10% of the ejaculate is sperm. The remainder of the fluid still comes out with ejaculation.

Will it affect my orgasm?

No, there will be no change after the immediate postoperative period is over. Initially, there may be discomfort slowly resolving over a 1-3-week period.

How will I know if the vasectomy works?

A microscopic examination of your semen specimen is required to determine if the procedure was successful.

When may I return to work?

For desk jobs, you may sometimes return to work the next day. For jobs requiring lifting, 3-5 days off of work is advised.

May my wife watch the procedure?

This is not usually allowed. Occasionally, observers will faint or cause other distractions. More often, their presence seems to worsen anxiety.

When may I go off birth control?

Birth control is typically required for an additional 8-12 weeks after vasectomy or 15 to 20 ejaculations. You must continue some form of birth control until you have 2 negative semen specimens.

Can a vasectomy be reversed?

Yes, it can be reversed. This is, however, usually not covered by insurance and costs $5,000 to $10,000 and has about a 50% fertility rate. So for practical purposes, it is permanent.

How often to people request a vasectomy reversal?

Nationally, it is stated that 1-2% of people will decide to have reversal.

Does the frequency of intercourse affect how quickly the sperm disappear from the semen?

Yes, the number of ejaculations does speed up the process. At the American average of intercourse 2 times per week, an average of 16 ejaculations or 2 months is required for most men to achieve sterility. More frequent ejaculation than 2 times per week can reduce the time to achieve sterility. It is noted, however, that most men are sterile after 3-4 months even with no ejaculation.

Is vasectomy better or worse than a woman having her tubes tied?

While they both have a failure rate of 1/2,000, there is less pain and risk involved in vasectomy.

How do I see if it works?

You simply bring in a semen specimen for microscopic evaluation. When no sperm are seen on 2 semen specimens one month apart, you may discontinue other forms of birth control.

When do I need to call for problems?

You should call the office if you have a discharge from the incision, rapid swelling over 1-2 hours, fever above 101°F, or if you just have other questions about recovery.

Will there be bruising of the scrotum?

There may be some bruising of the skin at the injection site or at the puncture site. Bruising will most likely show up 2-4 days after the procedure.

Do I need pain medication?

You may be prescribed narcotics such as Hydrocodone (Lortab), but most people do fine on oral over the counter medications such as Ibuprofen and Naprosyn.

Vasectomy vs. Tubal ligation – What are the pros and cons? What are the differences between these two procedures??

Vasectomy is an out-patient, office-based procedure that is done under local anesthesia. It is minimally invasive. The puncture is a single puncture into the scrotum. Any bleeding is usually readily identifiable in the scrotum by office physical examination with no risk of transfusion. Infection risk is 0.5 to 1% and is again scrotal. It is cheaper than tubal, less invasive, and safer. There has never been a reported death from vasectomy in the United States. Success is verifiable by semen analysis.

Tubal requires a general anesthetic and is an out-patient hospital-based procedure. Due to hospital place of service, tubal usually costs more than a vasectomy. It requires 2-3 punctures ¼ to ½ inches each into the abdomen. All infections, bleeding, and scarring are intra-abdominal and may require a CT scan for diagnosis. Success is assumed and is not usually verified. Sterility can only be verified by way of hysteroscopy and tubal injection of contrast, but this is rarely done.

Should I consider Essure as a method of birth control?

Essure is an office-based procedure done vaginally by passing an instrument into the uterus and then up into the fallopian tubes to deposit a coil that causes scarring and therefore blockage of the tubes preventing pregnancy. A second procedure similar to the first is required to confirm success several months later. This usually requires 3 months of birth control. Reported complications include its migration into the abdomen requiring surgical removal. Not all patients can have both tubes implanted; tubal pregnancies have been reported as well. Recovery takes about 1-14 days with the average recovery time being 3-5days.