I am 45 years old and have been divorced for several years. I have just recently entered into a new relationship, and the last thing I want to worry about is an unplanned pregnancy. I have thought about getting a vasectomy for years, but never did it. My questions are, how long does the actual procedure take, and how long is the recovery? Also, how soon after the procedure will it be safe to have sex without using a condom?
The vasectomy simply blocks the travel of sperm from the testicle to the penis. It prevents the sperm from being added to the semen, and getting out of the man’s body when he ejaculates. The semen is the fluid that comes from the prostate, seminal vesicles, and other sex glands. After a vasectomy, the body continues to produce semen which will be present when the man ejaculates, but the semen will not contain any sperm. And to address the most common questions and fears up front, a vasectomy does NOT cause voice changes, hair loss, cause erectile dysfunction, dry ejaculations, or loss of sexual desire and male hormones are not affected and continue to circulate normally.
To answer your first question, the procedure takes about 30 minutes to complete. The physician will usually give an injection of local anesthetic into the skin of the scrotum (i.e. the sac holding the testicles). This may feel like a brief pinch for about 30 seconds. The anesthetic will numb the area for about 2 hours. The doctor will then make 1 or 2 small, ½ inch openings in the skin, then gently pull up each tube (i.e. the vas deferens), cut them, cauterize them shut, and place a barrier between the cut ends. The openings in the scrotum are then closed with a dissolvable suture, an antibiotic ointment is applied, then gauze is placed over the wound. You will then wear a jock strap or some sort of athletic support that provides moderate pressure. This not only helps with bruising but relieves any post procedure discomfort.
At Optimal Male, we only utilize the “No-Scalpel Technique”. The no-scalpel technique is a method where the doctor uses a special instrument, instead of a scalpel, to enter the scrotum. This instrument has a sharp point and spreads the skin instead of cutting it. This makes a smaller opening and usually causes less bleeding and post procedure discomfort. Some patients ask about the possibility of undergoing a “laser vasectomy”, but this technique does not exist. Although the doctor could use a laser to cut the scrotum, there would be no benefit over using the no-scalpel surgical equipment.
To answer your second question, because of using the no-scalpel technique, patients will usually only need 1 or 2 days of rest after the vasectomy. They should avoid heavy lifting, jogging, and other sustained strenuous activities for at least 1 week. Usually, if a vasectomy is performed on a Friday the patient may go back to work on Monday. Patients may experience a few days of mild discomfort, such as a pulling or aching feeling in the groin. This discomfort can usually be relieved with Ibuprofen (Motrin or Advil) and good support with tight underwear. On a scale of 1 to 10, most men say the pain is a 2 to 3. Some bruising may occur, but this is perfectly normal. A very small number of men have more serious side effects, such as significant bleeding, infection, or painful sperm leakage (i.e. sperm granuloma). Patients should wait at least 1 week until some healing has taken place before having sex and should use another form of birth control until an examination shows sperm are no longer present in semen.
In answer to your last question, a vasectomy is considered effective when the semen has been tested and has been found to be free of sperm. A sperm check is done about 6 weeks after the procedure (or after at least 15 ejaculations). Many physicians will request a second check at 12 weeks to be sure the tubes haven’t reconnected, which occurs in less than 1% of the procedures. At Optimal Male, we only consider the vasectomy a success and consider you safe to have intercourse without a condom after both the 6-week and the 12-week semen analysis show no sperm.
I wish you all the best in your new relationship and would appreciate the opportunity to speak to you in person for a more in-depth conversation about vasectomy or any other services you may want or need. Be sure to schedule your free initial consultation and exam at Optimal Male Performance Center. We look forward to the opportunity to serve you.
Live well and be Optimal,
Richard Freier, M.D.
Optimal Male Performance Center