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First Considerations || No-Scalpel Vasectomy
Possible Risks || Preparing For Your Vasectomy ||
After The Vasectomy
Frequently Asked Questions
- Is it reversible?
It's not ethical to do vasectomies on a hundred men and then go ahead and reverse them after and see how many are successful. There are those that claim open-ended vasectomy (the 'technique within a technique' done here) increases the reversibility...but such claims suffer from the same problem of not having any hard evidence. The bottom line is you can put the tubes back together in the majority of cases, but you cannot guarantee that a pregnancy will result. And that is regardless of the method of vasectomy and the time between the vasectomy and its reversal.
- Where does the sperm go after the vasectomy?
A man does not eliminate all of the sperm he produces throughout life. The body is able to break down and re-absorb what is not otherwise ejected. The small volume of spermatic fluid containing the sperm is thus reabsorbed after vasectomy in a process that was present before the vasectomy. The prostate continues to make semen, however, which is ejaculated in the normal fashion after vasectomy...there's just no sperm in it anymore. You don't notice any difference after vasectomy in this way.
- Does vasectomy cause cancer?
A statistical study released in 1996 apparently showed a slightly increased statistical risk of prostate cancer in men who had undergone vasectomy (the same study also showed a reduction in most causes of death in men who had undergone vasectomy!). Subsequent studies and further analysis indicated that there is, in fact, no difference in risk of cancer in men with or without vasectomy. One study of autopsies in men over age 90 indicated a 100% risk of cancer of the prostate in all men over 90 with or without vasectomy (most have not had a vasectomy). The bottom line appears to be that vasectomy doesn't improve health, but it doesn't make things worse either.
- Does vasectomy change my sex drive or performance?
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Many studies have been done looking at tens of thousands of men over decades after vasectomy. There is no evidence to suggest that vasectomy increases the risk of erectile dysfunction (difficulty getting an erection) or changes one's sex drive or male sex hormone level. It is important to note that erection problems are common (about 40% of men aged 40 and about 2/3rds of men aged 70) and that these problems are often associated with other medical conditions that increase in frequency with age...with or without a vasectomy. Male sex hormone levels decline naturally with age...with or without a vasectomy. All things being equal, age should not preclude the enjoyment of healthy sexual activity.
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- Can I drink alcohol after my vasectomy?
Alcohol and Valium do not mix and so alcohol should not be consumed for some time after having taken Valium. Consult your pharmacist to determine when it will be safe for you to have a drink.
- Can I lift my children after the vasectomy?
You should try and not lift anything for one week after the procedure, including babies and children.
- When can I start playing golf again?
Refrain from all activities for one week after your vasectomy and try to stay off your feet as much as possible.
- Can I take a Sauna/bath/Jacuzzi/Whirlpool?
You don't want to bathe the scrotum in hot water no matter what...hence the recommendation to ice the scrotum the day of surgery. Also, even if you have the wound closed with skin glue, it is pushing it a bit to be immersing yourself in water. Showers are fine.
- Do I have to put ice on afterwards?
It is a good idea to ice the scrotum the day/evening of the vasectomy. The reusable gel ice pack provided in your kit is placed over the support, not directly on the skin, for 5-10 minutes on and 20 minutes off. Repeat this 3-4 times the day and evening of your vasectomy.
- Is there anyone else in the room during the procedure?
You will always be asked if someone else is to be present. On occasion the doctor has other physicians visiting to observe the procedure. All physicians greatly appreciate the opportunity to learn from others...but you may decline if you feel strongly otherwise. On the same note, however, no family members or partners will be allowed to attend. There is a difference between watching to learn as a physician and watching a loved one go through a surgical procedure.
- Can I waterski/ride horseback/snowmobile/bike/ride a motorcycle/do martial arts?
The idea here is that you want to avoid trauma to the scrotum for 30 days after the vasectomy. If there is a risk of receiving a blow to the scrotum, wear a hard cup or don't do it for 30 days. There is no harm in exercising...just not if you're going to increase the risk of internal bleeding which will take you out of action for another month or two.
- Why wait 12 weeks for testing after the vasectomy?
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Because the sperm live for some time in your body. We want to be sure that enough time has passed so that all the sperm 'downstream' have died before doing the test. That way, if we find a few dead sperm (which is not unusual) we can be sure that they are just 'leftovers'. Doing the test earlier risks finding these 'leftovers' still alive and then we have to wonder if they are new (meaning a failure of vasectomy) or old.
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- How soon can I travel afterward?
The considerations here are two-fold. Firstly, should a problem arise, it is a good idea to be able to come back to see the doctor to check things out. Secondly, you want to avoid lifting luggage. It's probably best to consider avoiding travel for 7-10 days after the surgery.
- How long does it take the Valium to wear off?
For the most part, the Valium wears off after about 4 hours. You are advised to avoid driving for the remainder of the day of your vasectomy.
- When can I shower afterwards?
If you had the skin glue applied, you can shower immediately. Otherwise wait 48 hours.
- Does the iodine come off?
Yes, in the shower.
- Is it better not to shower even if I have the glue?
With the glue, showering is really not a problem and you don't have to wait. Just be gentle and don't scrub the area.
- Do I have to count the number of ejaculations before the test or is it 12 weeks no matter what?
12 weeks regardless of the number of ejaculations. Sperm do not live for 12 weeks and so if there are live sperm at the 12 week mark, I am concerned and would want to repeat the test. Dead (or non-motile) sperm at 12 weeks is less of a worry.
- Do I have to wear the support 24 hours a day? To sleep?
You should wear the support while you are awake for the first 4 days and then anytime that you work out or exercise for the first month. You might be more comfortable wearing the support or snugly fitting underwear to bed for the first 4 days also, but that is your choice.
- When can I pick up my kids? (I put this in again because it gets asked so many times!!)
3 guesses and the first 2 don't count. No lifting for the first week.
- Do I have to ejaculate 20 times before doing the test?
What you tell your partner is your business...but time is more important than the number of ejaculations. Do your test at least 12 weeks after the vasectomy regardless of the number of ejaculations. Sperm die after a period of time. After your vasectomy, no living sperm should be added to the semen. If all the sperm are dead (or there are no sperm) in a fresh sample (less than one hour old) at 12 weeks, the vasectomy was successful.
- How can a vasectomy fail if you're cutting and burning the tubes?
The body has a remarkable ability to heal itself and, in rare cases, the tubes will 'rejoin' (about 3 in 1000 on average). Nothing in life is 100%. However, vasectomy has the lowest failure rate of any form of contraception. Period. Can it fail even after a clear test at 12 weeks? Yes, but this is extremely rare. You can test your semen every year, if you choose, but this is very seldom done.
- What was the "older" technique and what is the advantage of "no-scalpel-no-needle"?
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We used to use a scalpel, or knife, to cut through the skin and all the layers of tissue to get down to the vas deferens, the tube that carries the sperm. That means that we cut through blood vessels on the way down. With no-scalpel technique, we make a tiny opening and stretch it just enough to pull out the vas deferens and block it. By stretching a tiny opening, we push the blood vessels to the side instead of cutting through them. You would think that this results in less bleeding and that is precisely what it does...by about 90%. And remember that bleeding is the major painful complication of vasectomy. No-needle anaesthesia (freezing) uses air pressure to push the anaesthetic solution through the skin quickly and easily. Instead of a needle, you feel a 'pop' like a small rubber band against the skin. Aside from the fact that "you don't have to get a needle down there", this method results in a more rapid (seconds) and profound (deeper) freeze. Many men feel nothing during the vasectomy, others may feel some pressure or pulling, as a result of the better 'freezing'.
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- Why did my vasectomy not 'hurt' until 3 days after?
The body responds to any injury or insult with what is called an inflammatory reaction. Your immune system gets geared up and the healing process begins. Everyone is different and some may not feel these effects for several days. It is also a function of how you are built and how difficult the vasectomy was...how much the doctor had to pull etc. The anti-inflammatories that were prescribed to you are just the right thing for this kind of discomfort. Of course, everyone has a different 'pain threshold' and one man might feel discomfort while the next feels nothing at all.
- Will it hurt to pee (urinate)?
No.
- What holds the testicles if you cut the tube?
The vas deferens, the tube that carries the sperm, is only one of many structures that hold the testicles in place. There are blood vessels and other tissues that provide support and these are not disturbed. Your testicles will still be supported after the vasectomy, they won't roll around loosely in your scrotum.
- When can I start swimming?
What do you think? If the wound was closed with glue, you may shower but not bathe. I'd say swimming is closer to a bath than a shower.
- What can I do about the itching when the hair starts to grow back?
You've got to be kidding! If your worst problem is itching, I'd say you have little to worry about. Just don't apply any creams or ointments to the skin until the little wound is completely healed and closed (usually one week).
- How soon will I know if there are complications?
Most complications will occur in the first week. This is the really critical period. But you don't want to traumatize the area (like horseback riding) for the first month. Most other activities that don't involve an impact to the scrotum are unlikely to cause problems after the first week. Rarely problems can arise after the first week.
- Does it hurt when you cut the tube during the vasectomy?
In a word...no.
- What can I expect in the first few days after my vasectomy?
You really have to go back and read the "After the Vasectomy" section on this website or in your pamphlet.
- How do I know if it's okay to start exercising?
You'll have to take my word for it, ease back into your exercise after one week. Of course, you'll know if you can't start exercising if you continue to have pain or discomfort. Otherwise, if you are feeling okay, consider that a sign that you can go ahead.
- Do I have to abstain from sexual activity prior to the vasectomy?
No. Have all the fun you want before...just don't ejaculate for one week after.
The information on this page is reproduced by kind permission of Dr. Ronald S. Weiss.
Dr. Marc Iseri, a board certified urologist, is one of only two doctors on the west coast to offer the ground-breaking no needle no scalpel vasectomy procedure. Read more: Breakthrough No-Needle, No-Scalpel Vasectomy Now Available in the Treasure Valley
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