Vasectomy Frequently Asked Questions
Answer: Yes. It gets better. Now it's just recreation, no more procreation.
Answer: Typically, 13 ejaculates or 6 weeks. The busier you get, the quicker you will be infertile. I tell people to wait 3 months before they do a sperm check, as who wants to do that test more than once?
Answer: Yes. You're not infertile until your sperm check is negative for sperm which may take up to 3 months.
Answer: The majority of ejaculated material, what we call semen, is fluid created in the prostate. The prostate will trouble you when you're old, but while you're young, the prostate provides sperm with the nutrients and fluids needed to fertilize an ovum and, thus, a pregnancy. The testicles, which create millions of sperm, provide very little fluid to the ejaculated material. Over time, the testicles will stop making sperm. Things don't back up in the testicles, and production is shut down.
Answer: Yes. But, it would help if you entertained a vasectomy once you are certain you are finished having children. Vasectomy reversal is not covered by insurance and costs 10-15 thousand dollars. People have vasectomy reversals for three major reasons.
1. A great tragedy occurs to a young child or wife. These events are rare. We suffered a great tragedy (see in memoriam), but I was 55 and well past my child-rearing days. A vasectomy reversal done within 10 years or so is met with high pregnancy rates.
2. Divorce. Typically this event is a middle-aged man my age who divorces and marries a younger wife. He's got money, she wants a child, and he wants to retire. He had his vasectomy 25 years ago. Once you get 15-20 years beyond vasectomy, the testicles quit making sperm. Even if a reversal is done, it is less likely the sperm will become viable enough to produce a pregnancy.
3. A sudden change of heart. Again, the sooner a reversal can be done after a vasectomy, within 10 years or so, the more successful the results.
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Answer: No. First of all, it was expensive. But secondly, a vasectomy or any form of sterilization should be considered permanent sterility. Sperm banking is typically reserved for events like terminal illnesses, chemotherapy, perhaps surgical removal of one or both testicles or ovaries in a partner, or another catastrophic series of events or illnesses. If you wish to have a vasectomy, you must think, "I'm done having children."
Answer: No. If you're an adult, you can request permanent sterilization. If you're young, less than 25 or so, I will push on you to ensure your decision is complete, well-informed, and well-reasoned. In my experience, these folks have thought through the notion of being a parent and are quite insistent they don't want children. They're happy to be good uncles but do not wish to be parents. There is a shortage of decent people having children so you will feel some pushback from me, but that's only to ensure your decision is informed.
Answer: A vasectomy hurts less than another college tuition. It causes less pain than your adolescent children will cause you. It hurts way less than another pregnancy or the birthing event of children.
Answer: The significant risks of getting a vasectomy are infection and bleeding. You cannot cut anything and sew it back up without the risk of infection or bleeding. Infection and bleeding causing great trouble are rare. Being a full-time urologist for 25 years, I have done thousands of general urology procedures and hundreds to thousands of vasectomies. We receive a few post-vasectomy phone calls and visits. A vasectomy is much less risky than tubal ligation in a woman, which requires general anesthesia. It is much less painful than any in-office procedure created for permanent female sterility.
Answer: I'm a board-certified urologist. I did a 6-year surgical residency. I've trained residents. I've done thousands of operations. A vasectomy takes me 10-15 minutes, and we'll talk the entire time.
Answer: No.
Answer: Sperm granulomas form at the site where the vas deferens are cut and tied. They are typically pea size but can be up to marble size. They are benign, and most people don't notice; they rarely become infected or need any intervention.
Answer: Men. Typically fertile men present for a vasectomy when they are done having children, and their partners need to stop taking oral contraceptives. Oral contraceptives for women are used during childbearing, but as women get into their 30s or so, they need to get off these medications. While these drugs are safe, it's best to get off them once family planning is complete.
Answer: No. I'd wait until that child is born, and you're fairly certain the child will be healthy.
Answer: As a man said, "I'll love my 5 children, but if a great tragedy occurs, I'm happy with 4". So yes, if you have a full quiver of children, your wife is pregnant and while you're ecstatic with the proposition of having yet another but secretly think, OMG, how did this happen? Then sure, a vasectomy is for you.
Answer: If you are done having children, whether adopted or other, then yes, you need a vasectomy. The best way to have a "natural" pregnancy is to begin the adoption process. Many "infertile" couples have children after adoption or expensive infertility procedures.
Answer: I do not write narcotics. Period. Narcotics are poor pain medications. Narcotics kill people, not pain. Tylenol, Advil, ice packs, and time are your best friends after a vasectomy.