“We treat people, not just problems.”
John L. Pfenninger, M.D.
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WHAT IS IT?
Vasectomy is a medical procedure used to obtain permanent sterilization for men. You should be sure you do not want to father children. The operation includes making a single opening into the scrotal sac (the bag that contains the testicles) and blocking the sperm ducts so that sperm are not included in the ejaculation (release of fluid). This prevents pregnancy. The procedure we do is an advanced technique that uses special instruments. No scalpel is used and no stitches are needed. The opening is only three eighths of an inch long. Many ask about “laser vasectomy”. There is no such procedure.
WHAT HAPPENS TO THE SPERM?
The body continues to make sperm, but they have no place to go. They die, dissolve, and are then absorbed by the body. It’s just like a man who never ejaculates. Sperm are still made but the body clears them away.
WHAT IS THE EFFECT ON ACTIVITY?
Most men experience minor, temporary discomfort and swelling following the operation. We recommend that you take it easy for 2 days after the surgery. No pumping weights or jogging for at least one week.
WHAT IS THE OPERATION'S EFFECTIVENESS?
You must use other contraception for at least three months after the procedure until the doctor has examined two separate semen specimens and found them to be sperm free. If two checks of the ejaculated fluid are negative, it is very likely that you will have permanent success. It is extremely rare that the tubes will ever grow back together if they have not done so by three months.
WILL A VASECTOMY AFFECT THE ENJOYMENT OF SEX?
Erections, climaxes, and ejaculations continue after vasectomy as they did before. Sometimes the removal of fear of accidental pregnancy may add a greater sense of pleasure.
IS THE OPERATION REVERSIBLE?
should not be considered
reversible. Research is continuing, but
presently, there is no method that can assure totally restoring fertility. Current techniques of reversal are only 80%
effective. If you have any doubts,
please discuss other temporary birth control measures that are available. It is also possible to freeze your sperm for
future use. Agencies in
ARE THERE ANY COMPLICATIONS OR RISKS?
In about 5% of the cases there will be some type of complication although usually minor. Minor problems can usually be cleared up by prompt medical treatment. A small blood vessel may continue to bleed inside the scrotum, or there may be an infection. There will generally be some bruising. Occasionally there may be a little blood in the ejaculate. You will probably feel a lump on both sides for 2-3 months until total healing takes place. Sometimes sperm can leak out the ends of the cut vas and cause an irritation called a sperm granuloma. Treatment is not usually necessary. Other complications are more rare. One in 1200 will fail and need repeat surgery. Some men (less than 1%) can experience a chronic ache in the sacks or groin. It’s more of an intermittent nuisance than anything else, but rarely, it could require surgery.
Once the area is numbed, there will be no discomfort for about 1˝ - 2 hours. It only takes 30 seconds to numb the area. After the procedure, if you don’t overdo it, there generally is only a slight ache. Some men feel pulling up in the groin for a few days.
When you come in for surgery, it will take approximately 10 minutes to get you ready, 10 minutes to do the procedure, and 10 minutes to put on the dressings and do the paperwork. Your partner may be in the room and watch if she wants or wait in the waiting room. Someone needs to drive you in and take you home if you take any relaxing pills.
Vasectomies are performed in the office and include the counseling, the surgery, two follow-up semen checks, and outpatient visits for any complications in the first year. There is also a pre-operative counseling visit. You and your partner will need to come in to watch a 20-minute videotape just before the visit. The doctor will then spend about 15 minutes to discuss your questions and examine you. The counseling visit costs $130.00. Check with you insurance. In most instances they will pay for the procedure. Semen checks cost $67.00 each at outside labs so be sure to bring them back to this office. Here there is no further charge. No appointment is needed but call ahead to be sure a physician will be there.
HOW CAN A VASECTOMY BE ARRANGED?
Please feel free to ask any questions or come in just to talk. Just because you have a counseling session does not mean you have to have a vasectomy. Other methods of birth control such as the newly approved IUD, diaphragms, the Norplant, etc. can be discussed.
In trying to decide between a vasectomy or tubal ligation, remember that no one has ever died from a vasectomy. Vasectomy is much cheaper and just as effective as a tubal. 1 out of 1200 vasectomies fail and one out of 500 tubal ligations will fail. With vasectomy, men’s semen can be checked afterwards so failures can be identified before a woman becomes pregnant. Even Ann Landers says that “all else being equal,” vasectomy is the best way to go!
(The videotape is available to review at home if you like.)
Copyright, 2011. John L. Pfenninger, M.D med/2005