Does it affect your sexual function? Is it reversible? Does it hurt?
Simple questions on vasectomies answered.
Simple questions on vasectomies answered.
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LifestyleTranscript
00:00I wanted to have kids and you said that you wanted me to have a vasectomy when you said that you might want to have kids and I wasn't so sure who had the vasectomy first.
00:09Stip-stap, stip-stap, stip-stap!
00:20Honestly, the funny part about it is that most men come in shortly after their most recent kid is born, right?
00:26They're like, okay, this is kid number two, kid number three, I'm not sleeping, I'm exhausted, like, I don't want any more kids.
00:34And usually they've had a conversation with their partner who is on board with that as well.
00:38So that's like the most common type of person that comes in.
00:42And maybe they have a partner who's on some other form of contraception that might be causing a side effect.
00:47There are some men who come in who do not have, you know, are not in a current relationship, do not have children, but are fairly certain that that's not something that they want in the future.
00:58I have a conversation with those men too.
01:01I don't think that that negates their ability to have the procedure done.
01:05But I just counsel them to be certain that this is what they want because we tend to counsel patients to think of it as a permanent form of sterilization.
01:18A vasectomy implies that you are cutting the vas deferens, which is the tube that takes the sperm from the epididymis where they mature after they're made in the testicle.
01:33And it delivers the sperm into the ejaculate.
01:36When men are interested in sort of sterilizing themselves and are interested in a permanent form of sterilization, they can opt to undergo a vasectomy, which involves cutting that highway and often tying it off and doing everything we can to make sure the highway isn't put back together at some point afterward.
01:58It's pretty quick.
02:04It's I would say anywhere from like 20 to 40 minutes.
02:08It's done in the office setting in most cases.
02:10So it's a it's a pretty easy procedure as they go.
02:14Generally speaking, you know, we try to do these in my office, at least on Fridays, just to allow patients to recover on the weekend, assuming they're not having to work on the weekend.
02:28There's not any significant pain in most cases.
02:32We don't prescribe pain medications as part of the recovery.
02:36I encourage a lot of my patients to use ice, which helps reduce inflammation and swelling and can often help with any potential discomfort that's experienced after the procedure.
02:48It's also really important to have men wear some kind of compressive garment.
02:53And if you can manage the inflammation and the swelling, you've won the battle.
02:58It is technically reversible, but that's not always the easiest process.
03:02And so we don't want people making sort of rash decisions and and ultimately regretting having the vasectomy and having to find a way to get it reversed.
03:12If they were to opt to reverse it in the future, the process is is the exact opposite of what they are going to go through with a vasectomy.
03:20A vasectomy reversal is typically done in an operating room.
03:23It requires an operating microscope because you're trying to essentially put together two pieces of like a.
03:32To the size of a string of pasta, it takes several hours to do.
03:36And remember, you have to do both sides.
03:38And it's not always guaranteed that it will result in sperm returning to your ejaculate.
03:44And it's definitely not guaranteed that after the reversal, you'll be able to get somebody pregnant.
03:51It doesn't have any detrimental effects on sexual health, assuming that the procedure was straightforward and the recovery was as expected.
03:57I do get a lot of patients concerned about that, right, because you're sort of interfering with their manhood.
04:05It doesn't have any detrimental effects on sexual health, assuming that the procedure was straightforward and the recovery was as expected.
04:12I do get a lot of patients concerned about that, right, because you're sort of interfering with their manhood.
04:18And so they're concerned that they that it that it might have a detrimental effect on their sexual life.
04:25But there's no evidence of that.
04:27But there's no evidence of that.
04:33It does not prevent you from passing on sexually transmitted infections or HIV.
04:39Again, because the fluid is something that you still make and you still make the sperm.
04:46It's just that the sperm aren't allowed to get into the fluid.
04:49So the vasectomy just prevents the ability to get somebody pregnant.
04:53But the various infections that we screen people for, including HIV, are transmitted in the semen, which you do still make.
05:08There is always a risk of infection any time you're cutting into the body.
05:13Right. Even though it's a tiny, tiny incision, you are breaking the skin and you could introduce an infection.
05:20But the infection risk is so low.
05:22It's not standard to put people on antibiotics to prevent infection, which is commonly done with other procedures that have higher risk of infection.
05:31A lot of the procedure is done through palpation till you can feel the vas and then isolating it from the other structures around it.
05:41But because there's lymphatic vessels, there's veins, there's you know, there's arteries, there's fat all kind of surrounding it.
05:48There is the potential that one of those other structures could be injured.
05:52And that's what I was kind of alluding to in terms of like a potential complication.
05:57But that's exceedingly rare.
05:59So it's it's in general of the things that we do in our office, it's probably one of the safest procedures.