The testicles continue to produce the same things after vasectomy as before, namely testosterone and sperm. The testosterone is released into the bloodstream just as before vasectomy.  Sperm, however, come to the cut end of the vas and have no place to go.  After a short time, sperm cells break down into their components (proteins, lipids, DNA...), which are recycled by the body.

Most men experience no real pain during vasectomy.  But there is often minor discomfort during and after no-scalpel vasectomy.  The spray from the MadaJet feels like being snapped with a tiny rubber band.  And some men feel a pulling sensation while there is tension on the vas deferens.

Most men only need a dose or two of Tylenol after their vasectomy.  Dr. Golden reports that after he did his own vasectomy (yes, he did his own procedure), he took just a single dose of 2 Extra Strength Tylenol.   

To hear patients describe no-needle no-scalpel vasectomy with Dr. Golden, Listen to these Audio Testimonials.

Without a microscope, there is no perceptible change in the semen after vasectomy.  The ejaculate is comprised mainly of fluid from the seminal vesicles and from the prostate. Since sperm cells only makes up about 3% of the total semen volume, removing the sperm from the semen does not change the volume, appearance, consistency, or ejaculation.

 

No. Sperm are still present in the tubes beyond the point where they are divided.  

A confirmatory test is necessary to confirm absence of sperm.  Examination of a semen sample under a microscope is the standard test.  Another option is home use of a home test kit, SpermCheck Vasectomy.  Use another form of contraception until you have proof.

Maybe. Cryopreserving sperm is a reasonable option to consider.  But this question is a bit of a red flag.  If you think there is a reasonable chance you will desire future reproduction, then vasectomy probably isn't the best form of contraception for you at this time.  Make sure you are certain that your family is complete before having your vasectomy.

No.  While some doctors leave metal clips in the scrotum, Dr. Golden's technique leaves nothing permanent in the scrotum.  The only material left behind is a single absorbable knot on each side, separating the two ends of each cut vas.  This part of the procedure, known as fascial interposition, is the best way to minimize the risk of vasectomy failure.

Unfortunately, same day consult and procedure is not legal in this state.   California state law mandates a minimum of a 3-day waiting period between the day the decision is made to have a vasectomy and the day of the procedure.  

All procedures, medications, and even contraceptives carry some risk.  With that in mind, vasectomy in general is quite safe, while open-ended no-scalpel vasectomy reduces theses risks even further. The following statistics have been compiled from several large series:

  • risk of hematoma formation (bleeding into the scrotum): ~0.4%
  • risk of scrotal infection: <0.1%
  • risk of vasectomy failure (sperm still present in ejaculate) is less than 1 in 500. Despite the low risk, the downside of an unanticipated pregnancy is enormous.   For this reason, vasectomy patients must use another reliable form of contraception until a semen analysis 6-8 weeks after the procedure proves he is "shooting blanks." Until this test is performed, each patient should consider himself fertile.
  • post-vasectomy chronic testicular or epididymal pain occurs rarely and usually resolves spontaneously within a month or so.  The incidence of these troubling outcomes is ~3%, but in the open-ended procedure the risk appears to be <1%.   Ibuprofen and scrotal elevation with snug briefs or a jock strap during the day and a rolled towel between the legs at night are often helpful.

Yes. A home test kit, SpermCheck Vasectomy allows the confirmatory test to be performed in the privacy of your home. The test works by detecting specific proteins found only in sperm. The test is widely available by mail-order, including directly from the manufacturer and from Amazon.

No. Vasectomy does not alter sex drive, erections, or sexual function in any way.  There is no change in the production of testosterone, the male sexual hormone.  Similarly, sexual pleasure, orgasm, and ejaculation are unchanged.  Sex for most couples is better after vasectomy, once the anxiety around unintended pregnancy is gone.

         No needles required  Needles have several downsides: 

  • People are often afraid of needles, leading to anxiety before and during the procedure.  Some men avoid having a vasectomy just to avoid a needle.
  • Trauma to the tissue from a needle results in higher incidence of bleeding complications (hematoma).
  • Most of the medicine from a needle is deposited in the same tissue plane, reducing effectiveness.  
  • Risk of needle-stick injuries.

 

          MadaJet - pressurized spray device for no-needle anesthesia   No-Needle Anesthesia is a significant improvement: 

  • The spray's numbing effect is nearly instantaneous, with only slight discomfort.
  • The anesthetic spray spreads through multiple tissue layers, numbing more completely with less volume of medicine.
  • Multiple studies have shown higher satisfaction from patients having No-Needle anesthesia for their vasectomy.
  • Risk of bleeding during vasectomy or scrotal hematoma afterward are reduced.
  • Fear of needles is eliminated, so patients can relax and be more comfortable during their procedure.

In a standard vasectomy, the vas is cut and both ends are cauterized and/or tied.  Because the fluid produced by the testicle cannot escape the obstructed end, there may develop increased pressure within the testicle and epididymis.  The resulting "congestive epididymitis" is thought to be one of the main causes of post-vasectomy pain syndrome.  

"Open-ended" refers to the method of leaving the testicular end of the cut vas unobstructed.  The benefit is the reduced risk of post-vasectomy pain syndrome.  Unlike the traditional vasectomy, the unobstructed vas is less likely to result in pressure increase within the testicle and epididymis. The key step is thoroughly securing the abdominal end of the vas, ensuring the two cut ends never come in contact after the procedure. 

A more complete discussion of the value of "Open-Ended Vasectomy" can be read HERE, including literature references.

After your vasectomy, go home and relax.  Most men can return to their normal routine after a few days. You can do desk work the day after the procedure, but should avoid sexual activity and lifting anything over 20 pounds for at least 5 days. A scrotal support (snug briefs or jock strap) for the first 48 hours after the procedure is a good idea, as it minimizes bruising.  An ice pack (or bag bag of frozen peas) applied to the scrotum also helps minimize swelling and bruising.  

Avoid situations where scrotal trauma is likely. Don't ride a bike for a while and watch out for young children who like to jump on daddy!

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