Four Things Men Should Know Before Getting a Vasectomy

I’d always known that I didn’t want kids, but it took a friend’s pregnancy scare to provoke me into taking responsibility for that fact. Within two days of him detailing how his life nearly veered off in another direction, I was sat across from a vasectomy provider ready to put my balls on the line. After Dr. Sarah Miller of the Walton Family Health Center in the Bronx emphasized how quick and simple the procedure would be, I asked her to end my years-long game of reproductive Russian roulette without delay. Here’s what I didn’t know before that day.

The Empire State needed me to think things over.

“Could you do it like, today?” I asked, my paranoia getting the better of me.

“No,” she said. “I’m afraid you’re going to have to wait at least 30 days.”

Turns out that in the New York State, this month-long period is intended to give people ample opportunity to consider his or her decision about being permanently sterilized. Federally funded health insurance plans also require a 30-day wait, but in most other states, the waits are much shorter. In California, for example, you can get snipped a mere 72 hours after first talking to a provider. Check your state’s laws if you’re considering the procedure.

Despite using three forms of birth control with the woman I was seeing—the pill, condoms, and the withdrawal method—not to mention her lack of enthusiasm about reproducing, my next 30 days were filled with paranoia. As V-day inched ever closer, I was visited with nightmares about accidentally becoming a dad just as I was taking action to prevent it from happening.

It’s quick and virtually painless, but smells terrible.

These days, most vasectomies that are performed in the US are of the no-scalpel variety. Instead of slicing your scrotum open with a blade, a small puncture-hole is made. A hooked implement is then poked into that puncture hole and the vas deferens—the tubes that carry sperm from the testicles—are pulled through that hole one at a time. Once a loop of each vas deferens is pulled out, it’s cut, and the ends are cauterized or clamped.

The shot of local anesthetic to the region wasn’t especially pleasant, but much worse was the smell of my smoldering vas deferens after Dr. Miller zapped them with her cauterizing tool. Once that odiferous business is done, the disconnected tubes—which Dr. Miller described as feeling like al dente spaghetti—were tucked back into the puncture hole, which was covered with a small round Band-Aid. There’s no scalpel, no stitches, and no scar. In fact, the entire procedure was over so quickly that the snow in the treads of my boots still hadn’t melted by the time I gingerly hoisted by pants back up and headed back home on the subway.

You still need to wait a while.

Think that you’re good to go post-op? So did ,I but it turns out that even after the highways that carry sperm from the testicles are closed off, you’re still carrying live rounds. Male sexual health and fertility specialist Dr. Paul Turek described it like this: “You can turn the faucet off, but there’s still water in the hose, right?”

Right. So how do you know when all the water is out of the hose? Well, the general rule of thumb is 12 weeks or 20 ejaculations, though research has shown that it could well be longer. One Mexican study of 200 vasectomized volunteers found that fully 17 percent of them had not achieved sperm clearance by 24 weeks.

The only way to get peace of mind on this front, I learned, is for your doctor to analyze a semen sample and confirm that you are all clear. Not waiting until getting confirmation of azoospermia is the number one reason vasectomized men unwittingly end up fathering children. The other reason vasectomies fail is rarer, but fascinating—the recanalization of the vas deferens. Simply put, the cut ends of the tubes that carry sperm from the testicles find each other and link back up.

Jumping back into the fray too soon is a bad idea.

I woke up the following morning feeling just the same as I always had and made plans to see my girl. While Dr. Miller had said that having sex within a day or two of a no-scalpel vasectomy was typically fine, she did caution against overdoing it for the first week or so. It’s hard to quantify what overdoing it looks like, but the following morning, it was clear that’s exactly what I’d done. My entire scrotum was bruised black and blue and tender as all get out, and remained that way for the next several days. So if you go through with the procedure, learn from my mistake and give it a little more time.

via Four Things Men Should Know Before Getting a Vasectomy